ULTRASOUND TIPS IN THE LUNG CANCER DIAGNOSIS: A PILOT STUDY

Objective: The objective of this pilot study is to evaluate the ability of lung ultra-sound to provide signs of suspicion of lung cancer in patients with respiratory symptoms related to a real-world setting. Patients and Methods: This is a monocentric pilot study. All patients belonging to the Internal Medicine ward with respiratory symptoms including cough, chest pain or dyspnea were recruited. Pa-tients with previous diagnoses of respiratory diseases were excluded. An ultrasound and chest radi-ography (CR) were performed by expert operator. Computed tomography was carried out in case of discrepant imaging or suspect of cancer. The gold standard was the discharge diagnosis.Results: The final diagnosis included 51 cases of lung cancer, and 386 other diagnoses, which included pneumonia, heart failure, chronic obstructive pulmonary disease (COPD), tuberculosis, pneumothorax or fibrosis/restrictive syndrome. Consolidation areas were found in 75.4% of patients diagnosed with lung cancer, in 51% of all other diseases. Single sides pleural effusion was found in 52.9% of lung cancer (4.2% in the absence of pathology vs. 25.1% other diagnoses. A significantly higher prevalence of pleural pain and lactate were observed in cancer patients (23.5% and 34.7%, respectively). A receiver operating characteristics curve (ROC) showed a high LUS accuracy for both operators (LUS-I AUROC: 0.855 [95% CI: 0.793-0.917]; p<0.001 and LUS-II AUROC: 0.838 [95% CI: 0.774-0.902]; p<0.001), with a sensitivity and specificity of 92.2% and 87.8%, respectively.Conclusions: The findings showed the lung ultrasound might be useful in the diagnosis of lung cancer in clinical practice. These data need to be supported by a large clinical trial.