DIAGNOSTIC ACCURACY OF THORACIC ULTRASOUND IN DETECTING PLEURAL MALIGNANCY USING HISTOPATHOLOGY AS THE GOLD STANDARD

Abstract

Background: Pleural malignancy posses a major challenge regarding diagnosis because of the similarity of imaging with malignant pleural disease and benign pleural disease. Timely and proper management requires early and proper detection. The thoracic ultrasound is a non-invasive imaging technique that is both widely available and a radiation-free form of imaging that is used to examine pleural abnormalities and biopsy guide. Its diagnostics should be proven against histopathology.

Objective: To identify the accuracy of thoracic ultrasound in diagnosis of pleural malignancy, to establish the ultimate level as a gold standard, which is found in histopathology.

Materials and Methods: The present study was a descriptive cross-sectional study that occurred in the Department of Radiology, Lady Reading Hospital, Peshawar, in a period of four months, from December 24, 2025 to April 24, 2026. The sample of 241 patients with suspected pleural lesions aged 14-70 was selected as a result of consecutive non-probability sampling. Ultrasound results that indicated the possibility of malignancy were pleural nodularity, parietal pleural thickening of more than 1 cm, and pleural irregularity. Pleural biopsy was done using ultrasound guidance and histopathology was used as a reference. The computerized values included sensitivity, specificity, positive predictive value, and negative predictive value.

Results: Histopathology established the presence of pleural malignancy in 42.3. The sensitivity of ultrasound was 73.5, specificity 85.6, positive predictive value was 78.9 and negative predictive value was 81.5. The overall accuracy of diagnosing was 80.5%.

Conclusion: Thoracic ultrasound has excellent diagnostic quality and may be regarded as a valid first line imaging modality in suspected pleural malignancy, especially in resource constrained practices.