Using a retrospective analysis of pts undergoing VATS for suspected pleural malignancy, the authors assessed the utility of CT in diagnosing pleural malignancy.  Of 370 pts studied, 211 had a pleural malignancy diagnosis established by biopsy.  The sensitivity of CT for detecting malignancy was 68%, and the negative predictive value was 65%.  CT alone is not highly effective in determining which patients should have invasive pleural biopsies.