Key result
Pericardial fluid volumes greater than 60 mL yielded a higher malignancy fraction compared to volumes of 60 mL or less (18.1% vs 10.6%, P=.03).
Why the study?
Does submitting a pericardial fluid volume of >60 mL improve the diagnostic yield for malignancy compared to ≤60 mL in pericardiocentesis specimens?
Observational (n=480)
Does submitting a pericardial fluid volume of >60 mL improve the diagnostic yield for malignancy compared to ≤60 mL in pericardiocentesis specimens?
Absolute Event Rate: 18.1% vs 10.6%
p-value: p=.03
Submitting more than 60 mL of pericardial fluid for cytology significantly increases the diagnostic yield for detecting malignant pericardial effusions.
Volumes >60 mL may enhance malignancy yield on cytology; leaves open standardization of volume thresholds in diagnostic protocols.
OBJECTIVES: This study aims to determine the minimum pericardial fluid volume necessary for adequate cytologic diagnosis. METHODS: We identified 480 pericardiocentesis specimens, divided them by volume into six bins, and calculated the malignancy fraction (percentage of malignant diagnoses) for each bin. We then combined bins at various cutoffs to determine a minimum threshold volume and evaluated their sensitivity. RESULTS: The malignancy fraction increased from 6.5% for specimens 10 mL or less to 20.7% for more than 600 mL (P = .03). While the cumulative malignancy fraction was 18.1% above a cutoff of 60 mL, it was 10.6% below this threshold (P = .03). The sensitivity of cytology compared with pericardial biopsy was 70.0% for 60 mL or less and 91.1% for more than 60 mL (P = .14). CONCLUSIONS: Small-volume pericardiocentesis specimens detect fewer malignancies and have inferior sensitivity compared with pericardial biopsy. A volume of more than 60 mL should be submitted to cytology to ensure adequate diagnosis of pericardial fluids.
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Rooper et al. (2015) conducted an observational in Pericardial effusions (n=480). Pericardial fluid volume > 60 mL vs. Pericardial fluid volume ≤ 60 mL was evaluated on Malignancy fraction (percentage of malignant diagnoses) (p=.03). Pericardial fluid volumes greater than 60 mL yielded a higher malignancy fraction compared to volumes of 60 mL or less (18.1% vs 10.6%, P=.03).