Highlights•A novel MRI biomarker of pleural malignancy is described – Early Contrast Enhancement.•Early Contrast Enhancement is a semi-objective, perfusion-based biomarker.•Early Contrast Enhancement can be measured in patients with minimal pleural thickening.
Highlights•Asbestos exposure is an independent predictor of negative pleural fluid cytology.•A malignant CT is an independent predictor of negative pleural fluid cytology.•Failure of predictive marker testing in pleural fluid is common in ovarian cancer.•Negative pleural fluid cytology is associated with an increased time to diagnosis.