Talc pleurodesis

Rebecca Lindell

Research output: Chapter in Book/Report/Conference proceedingChapter


Imaging description Talc pleurodesis is used to manage symptomatic benign and malignant pleural effusions, as well as recurrent pneumothoraces [1, 2]. Talc can be administered via chest tube or by insufflation during thoracoscopy [1]. It works by inciting an inflammatory reaction that results in adherence of the visceral and parietal pleura [2]. CT after talc pleurodesis typically shows high-attenuation areas along the pleura, more often linear than nodular, that are often most prominent in the posterior basal regions [2]. The high-attenuation material may also extend up to the apices, along the mediastinum, or within the fissures [Figures 69.1 and 69.2] [2]. The appearance of talc pleurodesis deposits on CT remains unchanged over time [2, 3]. Patients with residual pleural effusion may demonstrate high-attenuation talc along both the parietal and visceral surfaces around the pleural effusion on CT, giving a variant of the split pleura sign [2]. Talc pleurodesis deposits may show increased FDG uptake on PET, presumably due to secondary pleural inflammation [3, 4]. Importance Correct identification of the CT appearance of talc pleurodesis is important not only for the sake of accuracy, but also because adhesions from a prior talc pleurodesis procedure may complicate or preclude thoracoscopy or lung transplantation [1]. In addition, it is important to not confuse imaging findings of talc pleurodesis with more serious diseases such as empyema or metastases [2–4].

Original languageEnglish (US)
Title of host publicationPearls and Pitfalls in Thoracic Imaging
Subtitle of host publicationVariants and Other Difficult Diagnoses
PublisherCambridge University Press
Number of pages4
ISBN (Electronic)9780511977701
ISBN (Print)9780521119078
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • General Medicine


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