Radiology plays a crucial role in the evaluation of the pleura. A range of imaging tools are available to aid the diagnosis of pleural disease and to guide intervention for diagnostic testing or treatment. Chest radiographs are ideally suited to confirm significant pleural effusions but may miss subtle or early pleural disease. CT has superior sensitivity and specificity to plain radiographs and is the main imaging tool for the detection and diagnosis of pleural pathology. Hybrid PET-CT has an emerging role in the evaluation of pleural malignancy that is yet to be clearly defined. The role of these imaging modalities in the investigation and management of pneumothorax, pleural infection and pleural malignancy will be discussed in this chapter, including emerging novel techniques that may complement the established imaging techniques of radiographs and CT.

Cite as: Duerden L, Benamore R, Edey A. Radiology: what is the role of chest radiographs, CT and PET in modern management? In: Maskell NA, Laursen CB, Lee YCG, et al., eds. Pleural Disease (ERS Monograph). Sheffield, European Respiratory Society, 2020; pp. 48–72 [https://doi.org/10.1183/2312508X.10032419].