Article Text

Download PDFPDF
Investigation of a unilateral pleural effusion: What CT scan coverage is optimal?
  1. Tom Syer1,
  2. David T Arnold1,
  3. Sonia Patole2,
  4. John Harvey2,
  5. Andrew Medford2,
  6. Nicholas A Maskell2,
  7. Anthony Edey1,3
  1. 1 Academic Respiratory Unit, University of Bristol, Bristol, Bristol, UK
  2. 2 Respiratory, North Bristol NHS Trust, Bristol, UK
  3. 3 Radiology, North Bristol NHS Trust, Bristol, UK
  1. Correspondence to Dr Nicholas A Maskell, Respiratory, North Bristol NHS Trust, Bristol BS10 5NB, UK; Nick.Maskell{at}


The use of thoracic CT for patients presenting with a unilateral pleural effusion is well established. However, there is no consensus with regard to the inclusion of the entire abdomen and pelvis in the initial imaging protocol. In this prospective UK-based study, 249 patients presenting with a unilateral effusion had a CT thorax/abdomen/pelvis performed. The prevalence of malignancy on thoracic CT was 56% (140/249). Clinically significant findings below the diaphragm were identified in 59 patients (24%). Integrating this approach into standard practice allows more rapid identification of the primary malignancy, upstaging lesions or alternative sites for biopsy.

  • pleural disease
  • lung cancer
  • imaging/CT MRI etc
  • mesothelioma

Statistics from


  • Twitter @tom_syer

  • Contributors TS, DTA, NAM and AE wrote the manuscript. NAM and AE conceived and planned the study. TS performed the statistical analysis. SP led the recruitment of patients and curation of the database. NAM, AM and JH carried out the primary observational cohort study. All authors discussed the results and contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.