The following is a summary of “Autofluorescence imaging-assisted medical thoracoscopy in the diagnosis of malignant pleural disease,” published in the FEBRUARY 2023 issue of Pulmonology by Wang, et al.

Because pleural disorders’ endoscopic appearance might be deceptive, medical thoracoscopy (MT) does not always diagnose pleural diseases definitively. A useful tool for aiding in diagnosis is autofluorescence imaging (AFI). Its clinical usefulness for pleural illness, though, was still debatable. For a study, the clinical value of AFI-assisted MT for identifying malignant pleural illnesses was assessed by researchers.

Participants included those admitted with unexplained pleural effusion to our clinics between December 2018 and September 2021. Before AFI during MT, they did white-light thoracoscopy (WLT). In both approaches, pictures of real-time endoscopic lesions were captured. Pathological analysis was performed on pleural biopsy samples. 95% CIs were used to evaluate between-group variations in diagnostic sensitivity, specificity, positive-predictive value (PPV), and negative-predictive value (NPV). The diagnostic effectiveness of these two approaches was examined using receiver operating characteristic curves and decision curve analysis.

Among the 126 eligible patients, 73 cases of malignant pleural illness were found. We looked for pathological abnormalities in 1,292 biopsy samples from 492 pleural locations. AFI had a 99.7% diagnostic sensitivity, a 58.2% PPV, and a 99.2% NPV, respectively. With a sensitivity of 79.7%, PPV of 50.7%, and NPV of 62.8%, AFI greatly outperformed WLT. Compared to WLT, subgroup analysis revealed that the AFI type III pattern was considerably more selective for malignant pleural illness.

By offering improved visualization, comfort, and safety, AFI could increase the diagnostic effectiveness of MT even more.

Reference: resmedjournal.com/article/S0954-6111(23)00002-1/fulltext