Objective: The goal of this study is to evaluate the sensitivity and specificity of the presence of pneumothorax on a 4-hour CXR after image-guided transthoracic lung biopsy (TTLB) for diagnosing subsequent clinically significant pneumothorax.
Hypothesis to be tested: The investigators hypothesize that an absence of pneumothorax on CXR at 4 hours can accurately predict an absence of clinically significant pneumothorax at 16 to 20 hours.
Design and subjects: This is a prospective, single-centre, diagnostic accuracy study conducted at a tertiary referral centre in Hong Kong. Patients will be recruited if an image-guided TTLB is arranged.
Study instruments: CXRs will be performed for patients at different time points. The presence and size of pneumothorax (if any) will be recorded.
Outcome: The diagnostic capacity of a 4-hour CXR after image-guided TTLB will be provide evidence regarding the safety and patient selection for same-day discharge.
Patients whose image-guided TTLB, including ultrasound or CT-guided, is arranged for diagnostic purposes
Patients who are able to sign written informed consent to participate in the study
Patients with resolution of lung lesion prior to the scheduled image-guided TTLB
Patients have active exacerbation of underlying diseases causing unstable respiratory conditions (e.g. exacerbation of COPD, pneumonia) which would lower the threshold for invasive interventions for iatrogenic pneumothorax
Patients with psychiatric disease or cognitive impairment that may limit their ability to understand or give consent to the study
Patients who decline to join the study