TY - JOUR T1 - THORACIC ULTRASOUND-ASSISTED SELECTION FOR PLEURAL BIOPSY WITH ABRAMS NEEDLE JF - Respiratory Care DO - 10.4187/respcare.02378 SP - respcare.02378 AU - Maribel Botana-Rial AU - Virginia Leiro-Fernández AU - Cristina Represas-Represas AU - Ana González Piñeiro AU - Amara Tilve-Gómez AU - Alberto Fernández-Villar Y1 - 2013/05/25 UR - http://rc.rcjournal.com/content/early/2013/05/25/respcare.02378.abstract N2 - BACKGROUND: Closed pleural biopsy (CPB) in patients with malignant pleural effusion (MPE) is less sensitive than cytology. Ultrasound-assisted CPB allows biopsies to be performed in the lower thoracic parietal pleura, where secondary spread from pleural metastases is initially more likely to be found. OBJECTIVES: We analyzed whether choosing the point of entry for CPB with thoracic ultrasound assistance influences the diagnostic yield in MPE. METHODS: This prospective study included patients who underwent CPB performed by an experienced pulmonologist in 2008–2010 (group A), thoracic ultrasound was used to select the biopsy site. The results were compared with a historical series of CPB performed by the same pulmonologist without the assistance of thoracic ultrasound (group B). An Abrams needle was used in all cases. We analyzed the obtaining of pleural tissue and the diagnostic yield. RESULTS: We included 114 CPB from group A (23% TPE, 27.2% MPE) and 67 CPB from group B (24% tuberculous pleural effusion (TPE), 30% MPE) (p= 0.7). Pleural tissue was obtained in 96.5% of group A CPB and 89.6% of group B CPB (p=0.05). The diagnostic yields of CPB for TPE and MPE in group A were 89.5% and 77.4%, respectively, and 91.7% and 60%, respectively, in group B (p=0.8, TPE and p=0.18, MPE). CONCLUSIONS: Selecting the point of entry for CPB using thoracic ultrasound increases the likelihood of obtaining pleural tissue and the diagnostic yield, but without statistically significance. We recommend ultrasound-assisted CPB to investigate pleural effusion, since the diagnostic yield of a pleural biopsy with an Abrams needle increased by >17% in patients with MPE. ER -