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Trial registered on ANZCTR


Registration number
ACTRN12625000980437
Ethics application status
Approved
Date submitted
18/08/2025
Date registered
5/09/2025
Date last updated
5/09/2025
Date data sharing statement initially provided
5/09/2025
Type of registration
Retrospectively registered

Titles & IDs
Public title
Using a handheld ultrasound to check for collapsed lung (pneumothorax) after lung biopsy procedures
Scientific title
A feasibility study to investigate the role of ultra-portable thoracic ultrasound in the detection of post-procedural pneumothorax
Secondary ID [1] 315162 0
Nil known
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
pneumothorax 338593 0
Condition category
Condition code
Respiratory 334894 334894 0 0
Other respiratory disorders / diseases

Intervention/exposure
Study type
Observational
Patient registry
False
Target follow-up duration
Target follow-up type
Description of intervention(s) / exposure
Description:
Participants undergoing CT-guided or bronchoscopy-guided lung biopsy were observed with serial ultra-portable thoracic ultrasound (UP-TUS) examinations to detect post-procedural pneumothorax. The device used was a Butterfly iQ+ handheld ultrasound probe (Butterfly Network, Burlington, USA) connected to a smart device with the “lung mode” setting.
Each assessment involved scanning four pre-specified locations per hemithorax to assess for pleural sliding, B-lines, seashore sign, and (where relevant) lung point.

Mode of delivery and timing:
UP-TUS was performed in a semi-recumbent (45-degree) position.
Assessments were conducted at three timepoints:
Pre-procedure (screening, bilateral) to confirm lung sliding.
Immediately post-procedure (ipsilateral side to biopsy).
One hour post-procedure (ipsilateral side).

Who delivered the assessment:
Examinations were performed at the bedside by Thoracic Society of Australia and New Zealand (TSANZ) accredited respiratory clinicians (Respiratory Registrars with greater than 6 years postgraduate experience and Respiratory Physicians).

Location:
Procedures and ultrasound assessments occurred in a tertiary hospital setting (CT suite, bronchoscopy suite, or operating theatre recovery).

Duration/dose:
Each assessment took approximately 9 minutes. Participants received between 2–3 assessments depending on feasibility of the pre-procedural examination. If participants chose not to be involved in the study they may still be investigated with the Butterfly iQ+ at the discretion of the treating physician.
Intervention code [1] 331780 0
Diagnosis / Prognosis
Comparator / control treatment
All participants underwent standard erect chest radiography (CXR) at approximately 1 hour post-procedure.
Control group
Active

Outcomes
Primary outcome [1] 342519 0
The sensitivity of ultra-portable thoracic ultrasound in detecting post-procedural pneumothorax, compared with erect chest radiography as the reference standard.
Timepoint [1] 342519 0
This primary outcome was assessed at immediate post-procedure and at one hour post-procedure, corresponding to the timing of ultra-portable thoracic ultrasound (examinations and the one-hour erect chest radiograph reference standard.
Primary outcome [2] 342597 0
The specificity of UP-TUS in detecting post-procedural pneumothorax.
Timepoint [2] 342597 0
This primary outcome was assessed immediately after procedure and at one hour post-procedure, corresponding to the timing of UP-TUS examinations and erect CXR
Secondary outcome [1] 451159 0
Detection of clinically significant pneumothorax (pre-defined by the presence of symptoms, hypoxia, or requirement for intervention such as chest drain insertion) by ultra-portable ultrasound (UP-TUS) compared with chest radiograph (CXR).
Timepoint [1] 451159 0
One hour post-procedure (timing of CXR), with additional earlier assessment if clinical deterioration has occurred.
Secondary outcome [2] 451476 0
Time to diagnosis of pneumothorax with UP-TUS compared to CXR in the setting of clinical deterioration.
Timepoint [2] 451476 0
The time at which the imaging modalities occur
Secondary outcome [3] 451477 0
Cost comparison between UP-TUS and CXR, including total time for CXR, total time for UP-TUS, number of CXR taken, total staff time and disposable costs.
Timepoint [3] 451477 0
Five patient journeys for each type of procedure were followed and averaged to determine staff time and use of disposable items.
Secondary outcome [4] 451478 0
Qualitative assessment of ultrasound image quality
Timepoint [4] 451478 0
The Likert score was completed by the clinician after all three UP-TUS assessments had taken place.
Secondary outcome [5] 451479 0
Qualitative assessment of a clinician’s confidence in using UP-TUS without CXR to detect a post-procedural pneumothorax
Timepoint [5] 451479 0
The 5-point Likert score was completed by the clinician after all three UP-TUS examinations were completed

Eligibility
Key inclusion criteria
We included patients undergoing (1) CT-guided lung biopsy, (2) transbronchial forceps biopsy (TBFB), (3) transbronchial cryobiopsy (TBCB), and (4) radial endobronchial ultrasound (Radial-EBUS) biopsy at Flinders Medical Center.
Minimum age
18 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
Exclusion criteria included (1) age under 18 years, (2) participants unable to provide consent due to severe intellectual disability, language barriers or severe psychiatric conditions, (3) if PTX had been diagnosed on the side of biopsy in the preceding 6 weeks, or (4) if an accredited clinician was not available to perform an assessment.

Participants were also excluded from analysis after consent if they (1) did not proceed with a biopsy, or (2) if a chest drain was inserted during the procedure to manage an immediate PTX.

Study design
Purpose
Duration
Selection
Timing
Prospective
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
SA
Recruitment hospital [1] 28342 0
Flinders Medical Centre - Bedford Park
Recruitment postcode(s) [1] 44560 0
5042 - Bedford Park

Funding & Sponsors
Funding source category [1] 319738 0
Hospital
Name [1] 319738 0
Flinders Medical Centre
Country [1] 319738 0
Australia
Primary sponsor type
Individual
Name
Dr Emelie Ross - Flinders Medical Centre
Address
Country
Australia
Secondary sponsor category [1] 322243 0
None
Name [1] 322243 0
Address [1] 322243 0
Country [1] 322243 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 318288 0
Southern Adelaide Clinical Human Research Ethics Committee
Ethics committee address [1] 318288 0
Ethics committee country [1] 318288 0
Australia
Date submitted for ethics approval [1] 318288 0
27/03/2022
Approval date [1] 318288 0
25/05/2022
Ethics approval number [1] 318288 0
2022\HRE00074

Summary
Brief summary
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 143714 0
Dr Emelie Ross
Address 143714 0
Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042
Country 143714 0
Australia
Phone 143714 0
+61479067257
Fax 143714 0
Email 143714 0
Contact person for public queries
Name 143715 0
Emelie Ross
Address 143715 0
Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042
Country 143715 0
Australia
Phone 143715 0
+61479067257
Fax 143715 0
Email 143715 0
Contact person for scientific queries
Name 143716 0
Emelie Ross
Address 143716 0
Flinders Medical Centre, Flinders Drive, Bedford Park, SA 5042
Country 143716 0
Australia
Phone 143716 0
+61479067257
Fax 143716 0
Email 143716 0

Data sharing statement
Will the study consider sharing individual participant data?
No


What supporting documents are/will be available?

No Supporting Document Provided


Results publications and other study-related documents

Documents added manually
No documents have been uploaded by study researchers.

Documents added automatically
No additional documents have been identified.