Imaging of pleural masses: which to choose?

The differential diagnosis of pleural masses is limited. Asbestos-related disease and invasive bronchogenic carcinoma make up the majority of cases. The diagnostic yield of biopsies is low, and invasive procedures are often required to achieve diagnosis. A variety of imaging techniques are available to help differentiate between benign and malignant disease to help discern which patients to biopsy. While computed tomography has a relatively good sensitivity and specificity, magnetic resonance imaging (MRI) and positron emission tomography (PET) both appear to have higher accuracy. MRI has the added benefit of being an excellent aid in determining surgical resectability of tumors. MRI and PET are limited, however, by their cost and availability in certain regions.