title: A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax?
abstract: BACKGROUND
  This study aimed to discuss the effectiveness of Pneumoscan working with micropower impulse radar (MIR) technology in diagnosing pneumothorax (PTX) in the emergency department.
  
  
  METHODS
  Patients with suspicion of PTX and indication for thorax tomography (CT) were included into the study. Findings of the Thorax CT were compared with the results of Pneumoscan. Chi-square and Fisher's exact tests were used in categorical variables.
  
  
  RESULTS
  One hundred and fifteen patients were included into the study group; twelve patients presented with PTX diagnosed by CT, 10 of which were detected by Pneumoscan. Thirty-six true negative results, sixty-seven false positive results, and two false negative results were obtained, which resulted in an overall sensitivity of 83.3%, specificity of 35.0% for Pneumoscan. There was no statistically significant difference between the effectiveness of Pneumoscan and CT on the detection of PTX (p=0.33). There was no difference between the size of PTX diagnosed by CT and PTX diagnosed by Pneumoscan (p=0.47). There was no statistically significant difference between Pneumoscan and CT on detecting the localisation of the PTX (p=1.00). For the 10 cases diagnosed by Pneumoscan, mean chest wall thickness was determined as 50.3 mm while mean chest wall thickness for two false negatives diagnosed by Pneumoscan was 56.5 mm. However, no statistically significant difference was found between the chest wall thickness and the effectiveness of Pneumoscan on the detection of the PTX (p=0.77). Among sixty-seven false positives diagnosed by Pneumoscan, 46.3% had additional medical signs such as bronchiectasis, pulmonary consolidation, pulmonary edema or pulmonary tumor when they had a reading with CT. The relationship between having additional medical signs at the reading with CT and the effectiveness of Pneumoscan on the detection of the PTX was investigated and no significant difference was found (p=0.472).
  
  
  CONCLUSIONS
  Using Pneumoscan to detect PTX is controversial since the device has a high false positive ratio. Wherein, false positive diagnosis can cause unjustifiable chest tube insertion. In addition, the device failed to show the size of the PTX, and therefore, it did not aid in determining the treatment and prognosis on contrary to traditional diagnostic methods. The findings could not demonstrate that the device was efficient in emergency care. Further studies and increasing experience may change this outcome in upcoming years.
authors.affiliation: Department of Emergency Medicine, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Hocagil
authors.affiliation: Department of Emergency Medicine, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey.
authors.forename: Abdullah Cüneyt
authors.initials: AC
authors.lastname: Hocagil
authors.affiliation: Department of Emergency Medicine, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Karacabey
authors.affiliation: Department of Biostatistics & Epidemiology/mph, University At Albany, Suny, School of Public Health, Albany, New York, USA.
authors.forename: Tuğba
authors.initials: T
authors.lastname: Akkaya
authors.affiliation: Department of Emergency Medicine, Dr. Lutfi Kirdar Kartal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Gözde
authors.initials: G
authors.lastname: Şimşek
authors.affiliation: Department of Emergency Medicine, Sanlıurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
authors.forename: Erkman
authors.initials: E
authors.lastname: Sanrı
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011030:Pneumothorax / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D011446:Prospective Studies; D011825:Radar / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult