Diagnostic yield of Xpert MTB/RIF on contrast-enhanced ultrasound-guided pleural biopsy specimens for pleural tuberculosis. (July 2021)

• Record Type: Journal Article
• Authors: Sun, Wenwen; Zhou, Yiming; Li, Wenting; Wang, Yin; Xiong, Kunlong; Zhang, Zhemin; Fan, Lin
• Is Part Of: International journal of infectious diseases. Volume 108(2021)
• Page Start: 89
• Page End: 95
• Publication Date: 2021-07
• Subjects: Contrast-enhanced ultrasound -- Ultrasound-guided pleural biopsy -- Xpert MTB/RIF -- Pleural tuberculosis -- Etiological diagnosis; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.05.023
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: Xpert could achieve high diagnostic sensitivity on CEUS-guided biopsy specimens. CEUS-guided pleural biopsy is efficient, minimally invasive and safe. CEUS improved the Xpert positive detection by accurately identifying necrosis. Abstract: Background: A 3-year prospective study was conducted to evaluate the efficacy of Xpert MTB/RIF (Xpert) in the diagnosis of pleural tuberculosis (pTB) on contrast -enhanced ultrasound (CEUS)-guided pleural biopsy specimens. Method: Patients suspected with pTB were prospectively enrolled to receive CEUS-guided biopsy. Specimens (pleural tissue and fluid) were submitted for Xpert and other routine examinations. Surgical thoracoscopy was performed on undiagnosed cases. Result: A total of 316 patients were enrolled, including 280 cases of pTB (definite 195, possible 85) and 36 cases of non-pTB. The sensitivity of Xpert was 69.64% (195/280) in biopsy specimens, which was significantly higher than that in pleural effusion specimens ( p < 0.01). In 195 definite cases, the highest sensitivity of 100% (195/195) and NPV of 29.75% (36/121) were achieved by Xpert on biopsy specimens. Xpert-positive results were obtained in 149 culture-negative cases and 90 histopathological MTB PCR-negative cases. The incidence of necrosis by CEUS in Xpert-positive pTB was significantly higher than that in Xpert-negative pTB (χ 2 = 72.41; p < 0.01). No serious complications occurred. Conclusion: Xpert achieved highly diagnostic sensitivity in pTB through CEUS-guided biopsy sampling, especially on necrotic lesions, which was proven to be efficient, minimally invasive and safe.