Pleural biopsy is a closed procedure performed under radiological imaging guidance (ultrasound or CT), which does not require general anesthesia. Before the procedure, a patient's chest X-ray or computed tomography (CT) scan is examined to determine the location of any pleural thickening or pleural effusion (fluid accumulation between the pleural membranes). The procedure is carried out after administering local anesthesia to the sampling area and establishing a sterile field. Under imaging guidance, a tissue sample from the pleura or a pleural fluid sample is typically taken by entering between the ribs from the side or back of the chest.