{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:49:10Z","timestamp":1792205350619,"version":"4.4.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2017,8,1]],"date-time":"2017-08-01T00:00:00Z","timestamp":1501545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>During diagnostic thoracoscopy, talc pleurodesis after biopsy is appropriate if the probability of malignancy is sufficiently high. Findings on direct visual assessment of the pleura during thoracoscopy, rapid onsite evaluation (ROSE) of touch preparations (touch preps) of thoracoscopic biopsy specimens, and preoperative imaging may help predict the likelihood of malignancy; however, data on the performance of these methods are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the performance of ROSE of touch preps, direct visual assessment of the pleura during thoracoscopy, and preoperative imaging in diagnosing malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent ROSE of touch preps during thoracoscopy for suspected malignancy were retrospectively reviewed. Malignancy was diagnosed on the basis of final pathologic examination of pleural biopsy specimens. ROSE results were categorized as malignant, benign, or atypical cells. Visual assessment results were categorized as tumor studding present or absent. Positron emission tomography (PET) and computed tomography (CT) findings were categorized as abnormal or normal pleura. Likelihood ratios were calculated for each category of test result.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 44 patients, 26 (59%) with a final pathologic diagnosis of malignancy. Likelihood ratios were as follows: for ROSE of touch preps: malignant, 1.97 (95% confidence interval [CI], 0.90\u20134.34); atypical cells, 0.69 (95% CI, 0.21\u20132.27); benign, 0.11 (95% CI, 0.01\u20130.93); for direct visual assessment: tumor studding present, 3.63 (95% CI, 1.32\u20139.99); tumor studding absent, 0.24 (95% CI, 0.09\u20130.64); for PET: abnormal pleura, 9.39 (95% CI, 1.42\u201362); normal pleura, 0.24 (95% CI, 0.11\u20130.52); and for CT: abnormal pleura, 13.15 (95% CI, 1.93\u201389.63); normal pleura, 0.28 (95% CI, 0.15\u20130.54).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A finding of no malignant cells on ROSE of touch preps during thoracoscopy lowers the likelihood of malignancy significantly, whereas finding of tumor studding on direct visual assessment during thoracoscopy only moderately increases the likelihood of malignancy. A positive finding on PET and\/or CT increases the likelihood of malignancy significantly in a moderate-risk patient group and can be used as an adjunct to predict malignancy before pleurodesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201701-056oc","type":"journal-article","created":{"date-parts":[[2017,4,13]],"date-time":"2017-04-13T14:58:18Z","timestamp":1492095498000},"page":"1326-1331","source":"Crossref","is-referenced-by-count":10,"title":["Pleural Touch Preparations and Direct Visualization of the Pleura during Medical Thoracoscopy for the Diagnosis of Malignancy"],"prefix":"10.1093","volume":"14","author":[{"given":"Horiana B.","family":"Grosu","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Macarena","family":"Vial-Rodriguez","sequence":"additional","affiliation":[{"name":"Universidad del Desarrollo Cl\u00ednica Alemana de Santiago, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Vakil","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"},{"name":"Universidad del Desarrollo Cl\u00ednica Alemana de Santiago, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto F.","family":"Casal","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George A.","family":"Eapen","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Morice","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care, University of Texas Health Science Center at Houston, Houston, Texas; and"},{"name":"Department of Pathology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona G.","family":"Sarkiss","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Ost","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, University of Texas M.D. Anderson Cancer Center, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,8,1]]},"reference":[{"key":"2026020403001325100_bib1","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1056\/NEJMcp010731","article-title":"Clinical practice: pleural effusion","volume":"346","author":"Light","year":"2002","journal-title":"N Engl J Med"},{"key":"2026020403001325100_bib2","doi-asserted-by":"crossref","first-page":"368s","DOI":"10.1378\/chest.07-1391","article-title":"Palliative care in lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition)","volume":"132","author":"Kvale","year":"2007","journal-title":"Chest"},{"key":"2026020403001325100_bib3","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1136\/thoraxjnl-2014-205285","article-title":"Predicting survival in malignant pleural effusion: development and validation of the LENT prognostic score","volume":"69","author":"Clive","year":"2014","journal-title":"Thorax"},{"key":"2026020403001325100_bib4","first-page":"173","article-title":"[Accuracy of pleural fluid cytology in malignant effusions] [article in Spanish]","volume":"25","author":"Bielsa","year":"2008","journal-title":"An Med Interna"},{"key":"2026020403001325100_bib5","doi-asserted-by":"crossref","first-page":"1677","DOI":"10.1378\/chest.121.5.1677","article-title":"Diagnostic value of medical thoracoscopy in pleural disease: a 6-year retrospective study","volume":"121","author":"Blanc","year":"2002","journal-title":"Chest"},{"key":"2026020403001325100_bib6","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/S0954-6111(98)90100-7","article-title":"Medical thoracoscopy, results and complications in 146 patients: a retrospective study","volume":"92","author":"Hansen","year":"1998","journal-title":"Respir Med"},{"key":"2026020403001325100_bib7","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000083404","article-title":"Does \u201cidiopathic pleuritis\u201d exist? 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