Thoracic ultrasound (TUS) is widely used to detect pleural effusions but can also play an important role in managing pleural disorders.

“We’ve all been using thoracic ultrasound for a very long time for diagnosis,” explained Amit Chopra, MBBS, FCCP, Associate Professor of Medicine and Director of Pulmonary and Critical Care Fellowship at Albany Medical Center. “It’s time to expand its use. This is not only a diagnostic technique but can also provide useful information for managing pleural effusions, as well as guiding and improving the safety of pleural procedures.”

Dr. Chopra will chair a panel discussion on the role of TUS in pleural diseases, Thoracic Ultrasound Advancements for the Assessment and Management of Pleural Disorders, Monday, October 7, at 9:15 am ET, in Room 253C of the Boston Convention & Exhibition Center. He will be joined by Session Co-Chair, Kurt Hu, MD, Assistant Professor at Froedtert & the Medical College of Wisconsin, as well as John Huggins, MD, from the Medical University of South Carolina, and Keriann Van Nostrand, MD, from the University of California, San Diego.

“Ultrasound is a skill that improves with practice, time, and repetition,” Dr. Hu said. “You have to learn where to put the probe, how to manipulate it, and how to acquire the images. It’s important that pulmonologists become proficient in performing thoracic ultrasounds because it is a standard of care in evaluating and managing pleural effusions.”

The session will describe how to use TUS to characterize pleural effusions—for example, how to differentiate between transudates and exudates—as well as some of the advantages of using TUS to guide invasive pleural procedures and biopsies. Compared with other imaging techniques, such as radiographs or CT scans, TUS can be done in real time, can be repeated multiple times, does not expose the patient to radiation, and provides a dynamic image.

“Other imaging techniques often don’t give us good enough images to do some of the interventional procedures we need to do for patients with pleural disorders,” Dr. Hu said. “Ultrasound provides a dynamic image that gives us a better understanding of what’s going on and increases our ability to discern important features.”

Ultimately, this can lead to safer procedures for patients.

“We can do ultrasound-guided pleural procedures in real time or just before the procedure,” Dr. Chopra said. “This can help us determine where to do a thoracentesis, to localize blood vessels in high-risk patients, and to minimize bleeding and risk of complications. It can also help us determine who may not need the procedure.”

Speakers will also discuss challenges and pitfalls of TUS in the assessment of pleural disorders. In particular, technical challenges in some patients, such as those with subcutaneous emphysema or obesity, can make TUS more difficult.