scholarly journals Methylene Blue versus Coil-Based Computed Tomography-Guided Localization of Lung Nodules

2020 ◽  
Vol 68 (06) ◽  
pp. 540-544 ◽  
Author(s):  
Ze-Dong Zhang ◽  
Hua-Long Wang ◽  
Xian-Yan Liu ◽  
Feng-Fei Xia ◽  
Yu-Fei Fu
Keyword(s):  
Computed Tomography ◽  
Methylene Blue ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Lung Nodule ◽  
Lung Nodules ◽  
Complication Rates ◽  
Success Rates ◽  
Technical Success ◽  
Ct Guided

Abstract Background Preoperative computed tomography (CT)-guided localization has been shown to significantly improve lung nodule video-assisted thoracoscopic surgery (VATS)-based wedge resection technical success rates. However, at present, there was insufficient research regarding the optimal approaches to localization of these nodules prior to resection. We aimed to compare the relative clinical efficacy of preoperative CT-guided methylene blue and coil-based lung nodule localization. Methods In total, 91 patients with lung nodules were subjected to either CT-guided methylene blue (n = 34) or coil (n = 57) localization and VATS resection from January 2014 to December 2018. We compared baseline data, localization-associated complication rates, as well as the technical success of localization and resection between these two groups of patients. Results In total, 42 lung nodules in 34 patients underwent methylene blue localization, with associated localization and wedge resection technical success rates of 97.6 and 97.6%, respectively. A total of 71 lung nodules in 57 patients underwent coil localization, with associated localization and wedge resection technical success rates of 94.4 and 97.2%, respectively. There were no significant differences in technical success rates of localization or wedge resection between these groups (p = 0.416 and 1.000, respectively). The coil group sustained a longer duration between localization and VATS relative to the methylene blue group (13.2 vs. 2.5 hours, p = 0.003). Conclusion Both methylene blue and coil localization can be safely and effectively implemented for conducting the diagnostic wedge resection of lung nodules. The coil-based approach is compatible with a longer period of time between localization and VATS procedures.

Computed Tomography-Guided Transfissural Coil Localization of Lung Nodules

2019 ◽  
Vol 68 (06) ◽  
pp. 545-548 ◽  
Author(s):  
Feng-Fei Xia ◽  
Yi-Bing Shi ◽  
Tao Wang ◽  
Yu-Fei Fu
Keyword(s):  
Computed Tomography ◽  
Success Rate ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Lung Nodules ◽  
Adenocarcinoma In Situ ◽  
Technical Success ◽  
Invasive Adenocarcinoma ◽  
Ct Guided ◽  
Technical Success Rate

Background The objective of this study was to evaluate the feasibility, safety, and clinical effectiveness of preoperative computed tomography (CT)-guided transfissural coil localization (TFCL) of subfissural lung nodules. Methods Five patients with lung nodules who underwent CT-guided TFCL before video-assisted thoracoscopic surgery between November 2015 and December 2018 were included. Technical success rates of TFCL and wedge resection were assessed, as well complications and pathological results. Results The technical success rate of TFCL was 100%. Two patients experienced parenchymal hemorrhage around the needle path, and two patients experienced asymptomatic pneumothorax after TFCL. The technical success rate of the wedge resection of lung nodules was also 100%. The pathological diagnoses of the five nodules were minimally invasive adenocarcinoma (n = 3), adenocarcinoma in situ (n = 1), and inflammatory nodule (n = 1). Conclusion CT-guided TFCL is a safe and effective method for the preoperative localization of subfissural lung nodules.

Computed Tomography-Guided Trans-scapular Coil Localization for Pulmonary Nodules

2020 ◽  
Author(s):  
Jian-Hua Zhang ◽  
Shi-Qing Zhou ◽  
Feng-Fei Xia ◽  
Tao Wang
Keyword(s):  
Computed Tomography ◽  
Success Rate ◽  
Thoracoscopic Surgery ◽  
Wedge Resection ◽  
Pulmonary Nodules ◽  
Technical Success ◽  
Ct Guided ◽  
Technical Success Rate ◽  
Preoperative Ct ◽  
Video Assisted Thoracoscopic Surgery

Abstract Background The aim of the study is to evaluate the feasibility, safety, and effectiveness of preoperative computed tomography (CT)-guided trans-scapular coil localization (TSCL) of scapula-blocked pulmonary nodules (PNs). Methods Between November 2015 and May 2020, 11 patients underwent preoperative CT-guided TSCL procedures owing to PN occlusion by scapula. Results A 100% technical success rate was achieved for CT-guided TSCL, with one coil being used for each PN. One patient (9.1%) developed pneumothorax. Successful video-assisted thoracoscopic surgery (VATS)-guided wedge resection of these scapula-blocked PNs was conducted in all patients. Conclusion CT-guided TSCL can be simply and safely used to facilitate successful VATS-guided wedge resection of scapula-blocked PNs.

scholarly journals Electromagnetic navigation-guided versus computed tomography-guided percutaneous localization of small lung nodules before uniportal video-assisted thoracoscopic surgery: a propensity score-matched analysis

2020 ◽  
Vol 58 (Supplement_1) ◽  
pp. i85-i91 ◽  
Author(s):  
Chia-Tsung Hung ◽  
Chun-Ku Chen ◽  
Ying-Yueh Chang ◽  
Po-Kuei Hsu ◽  
Jung-Jyh Hung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Propensity Score ◽  
Thoracoscopic Surgery ◽  
Preoperative Localization ◽  
Lung Nodules ◽  
Complication Rates ◽  
Surgical Results ◽  
Ct Guided ◽  
Electromagnetic Navigation ◽  
Video Assisted

Abstract OBJECTIVES An optimal method for preoperative localization of small lung nodules is yet to be established, and there are few comparative studies in the literature. In the present study, we aimed to compare electromagnetic navigation-guided and computed tomography (CT)-guided methods of percutaneous transthoracic localization. METHODS The clinical, radiographic, surgical and pathological data of patients who underwent electromagnetic navigation-guided localization (EMNGL) and CT-guided localization (CTGL) before uniportal video-assisted thoracic surgery (VATS) were reviewed. Propensity score matching analysis was performed to compare the localization and surgical results. RESULTS After matching, 25 EMNGL and 50 CTGL patients were included in the analysis. In the CTGL group, pulmonary haemorrhage and pneumothorax were noted in 56% and 34% of patients, respectively, on postprocedural CT scans. Successful localization was achieved in 96% and 100% of patients in the EMNGL and CTGL groups, respectively (P = 0.333). The median time in the operation room was significantly shorter in the CTGL group {142.5 [interquartile range (IQR) 123.8–175.0] vs 205.0 [IQR 177.5–290.0] min, P < 0.001}. In contrast, EMNGL significantly decreased the total time [205.0 (IQR 177.5–290.0) vs 324.0 (IQR 228.3–374.0) min, P = 0.002]. The median duration of chest drainage was 1 day shorter in the EMNGL group [2.0 (IQR 1.5–2.5) vs 3.0 (IQR 2.0–3.0), P = 0.002]; the surgical complication rates were comparable between the 2 groups. CONCLUSIONS The localization and surgical results were similar between the EMNGL and CTGL groups. EMNGL is comparable to conventional CTGL with respect to preoperative localization of small lung nodules before uniportal VATS.

scholarly journals Preoperative computed tomography-guided coil localization for multiple lung nodules

2020 ◽  
Vol 14 ◽  
pp. 175346662090976
Author(s):  
Fei Teng ◽  
An-Le Wu ◽  
Shan Yang ◽  
Jia Lin ◽  
Yu-Tao Xian ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Success Rate ◽  
Wedge Resection ◽  
Single Stage ◽  
Lung Nodules ◽  
Technical Success ◽  
Ct Guided ◽  
Technical Success Rate ◽  
Preoperative Ct ◽  
Multiple Lung Nodules

Background: Preoperative computed tomography (CT)-guided coil localization can increase the technical success of video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection of lung nodules relative to cases treated without localization. When multiple lung nodules (MLNs) are to be resected, preoperative localization for each lung nodule is required. The aim of this study was to explore the feasibility, safety, and clinical efficacy of preoperative CT-guided coil localization of MLNs. Methods: Between November 2015 and July 2019, 31 patients with MLNs were assessed via CT-guided coil localization followed by VATS-guided wedge resection. Rates of technical success for both the localization and wedge resection procedures, as well as data pertaining to patient complication rates and long-term outcomes were recorded and assessed. Results: In total, 68 nodules (average of 2.2 nodules/patient) were localized and resected using this approach. Nodules were unilateral and bilateral in 23 and 8 patients, respectively. The rate of CT-guided coil localization technical success for these nodules was 98.5% (67/68), with a technical success rate of single-stage coil localization on a per-patient basis of 96.8% (30/31). Following localization, asymptomatic pneumothorax occurred in four patients (12.9%). The wedge resection technical success rate was 100%. Mean VATS operative time was 167.3 ± 75.2 min, with a mean blood loss of 92.6 ± 61.5 ml. Patients were followed between 3 and 46 months (median: 24 months), with no evidence of new nodules, distant metastases, or postoperative complications in any patients. Conclusion: Preoperative CT-guided multiple coil localization can be easily and safely used to guide single-stage VATS diagnostic wedge resection in patients with MLNs. The reviews of this paper are available via the supplemental material section.

scholarly journals Computed tomography-guided biopsy of small lung nodules: diagnostic accuracy and analysis for true negatives

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051987900
Author(s):  
Xing-Li Liu ◽  
Wei Li ◽  
Wei-Xin Yang ◽  
Mao-Ping Rui ◽  
Zhi Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Chronic Inflammation ◽  
Cox Regression ◽  
Benign Lesion ◽  
Lung Nodules ◽  
Biopsy Result ◽  
Technical Success ◽  
Ct Guided ◽  
Cox Regression Analysis

Objective We evaluated the diagnostic accuracy of computed tomography (CT)-guided transthoracic core needle biopsy (TCNB) for small (≤20-mm) lung nodules and identified predictive factors for true negatives among benign biopsy results. Methods From March 2010 to June 2015, 222 patients with small lung nodules underwent CT-guided TCNB. We retrospectively analysed data regarding technical success, diagnostic accuracy, and predictors of true negatives. Results The technical success rate was 100%. The TCNB results of the 222 lung nodules included malignancy (n = 136), suspected malignancy (n = 8), specific benign lesion (n = 17), and nonspecific benign lesion (n = 61). The final diagnosis of 222 lung nodules included malignant (n = 160), benign (n = 60), and nondiagnostic lesions (n = 2). The sensitivity, specificity, and overall diagnostic accuracy of CT-guided TCNB for small lung nodules were 90.0%, 100%, and 92.7%, respectively. Pneumothorax and haemoptysis occurred in 23 and 41 patients, respectively. Based on the Cox regression analysis, the significant independent predictive factor for true negatives was a biopsy result of chronic inflammation with fibroplasia. Conclusions CT-guided TCNB offers high diagnostic accuracy for small lung nodules, and a biopsy result of chronic inflammation with fibroplasia can predict a true-negative result.

scholarly journals Skin marking with computed tomography at functional residual capacity to predict lung nodule site

2019 ◽  
Vol 30 (1) ◽  
pp. 36-38
Author(s):  
Ryo Miyoshi ◽  
Akihiko Yamashina ◽  
Shigeto Nishikawa ◽  
Shigeyuki Tamari ◽  
Misa Noguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Functional Residual Capacity ◽  
Thoracoscopic Surgery ◽  
Lung Nodule ◽  
Lung Nodules ◽  
Non Invasive ◽  
Residual Capacity ◽  
Preoperative Ct ◽  
Marking Technique ◽  
The Mean

Abstract Various marking techniques for lung nodules may be complex and can cause serious complications. In this study, we aimed to describe and evaluate the feasibility of CTFRC marking, a novel preoperative skin marking technique guided by computed tomography (CT) at functional residual capacity (FRC). This simple and non-invasive marking technique only requires a preoperative CT scan without any anaesthesia. We retrospectively reviewed CTFRC markings performed for 109 lung nodules in 108 patients. The mean nodule size was 11.4 ± 5.0 mm. The mean distance from the nodule to the lung marking point was 3.8 ± 7.3 mm. We found no procedure-associated complications. CTFRC marking is a simple, safe and non-invasive method to predict the precise location of lung nodules during thoracoscopic surgery.

scholarly journals Comparison of CT-guided localization using hook wire or coil before thoracoscopic surgery for ground glass nodules

2020 ◽  
Vol 93 (1111) ◽  
pp. 20190956 ◽  
Author(s):  
Junzhong Liu ◽  
Xinhua Wang ◽  
Yongming wang ◽  
Minfeng Sun ◽  
Changsheng Liang ◽  
...  
Keyword(s):  
Postoperative Complication ◽  
Thoracoscopic Surgery ◽  
Preoperative Localization ◽  
Ground Glass ◽  
Complication Rates ◽  
Success Rates ◽  
Ct Guided ◽  
Hook Wire ◽  
Video Assisted Thoracoscopic Surgery ◽  
Ground Glass Nodules

Objective: To compare two kinds of metal markers for preoperative localization of ground glass nodules (GGNs). Methods: We retrospectively investigated data from 198 cases of GGN localization and compared the success rate and complications of both approaches. Results: In the hook wire and coil groups, the success rates of CT-guided localization for GGNs were 99.2 and 98.7%, respectively (p = 1.000). The success rates of video-assisted thoracoscopic surgery in both groups were 100% without transthoracic surgery. The post-localization complication rates in the hook wire group and coil group were 36.9 and 32.9% (p = 0.568), and the postoperative complication rates in the hook wire and coil groups were 13.9 and 11.8%, respectively (p = 0.672). Conclusions: Preoperative localization of GGNs with both hook wire and coil methods proved to be useful and effective. Both methods have acceptable preoperative and postoperative complication rates, but the localization and operation times were shorter for the hook wire group than the coil group. Advances in knowledge: Most of previous articles studied a single preoperative localization method. Few studies have compared the preoperative and postoperative methods for metal markers. This paper compared two preoperative localization methods for GGNs to provide clinical guidance.

Computed tomography-guided preoperative localization of small lung nodules with indocyanine green

2017 ◽  
Vol 59 (7) ◽  
pp. 830-835 ◽  
Author(s):  
Keisuke Nagai ◽  
Keiko Kuriyama ◽  
Atsuo Inoue ◽  
Yuriko Yoshida ◽  
Koji Takami
Keyword(s):  
Computed Tomography ◽  
Indocyanine Green ◽  
Pulmonary Nodules ◽  
Preoperative Localization ◽  
Lung Nodules ◽  
Complication Rates ◽  
Ct Guided ◽  
Institutional Review ◽  
Small Pulmonary Nodules ◽  
Age Range

Background Small, deep-seated lung nodules and sub-solid nodules are often difficult to locate without marking. Purpose To evaluate the success and complication rates associated with the use of indocyanine green (ICG) to localize pulmonary nodules before resection. Material and Methods This retrospective study was approved by our institutional review board. Informed consent for performing preoperative localization using ICG marking was obtained from all patients. Thirty-seven patients (14 men, 23 women; mean age = 63.1 years; age range = 10–82 years) with small peripheral pulmonary nodules underwent computed tomography (CT)-guided ICG marking immediately before surgery between March 2007 and June 2016. The procedural details and complication rates associated with ICG marking are described. Results The average nodule size and depth were 9.1 mm (range = 2–22 mm) and 9.9 mm (range = 0–33 mm), respectively. Marking was detected at the pleural surface in 35 patients (95%). Three cases of mild pneumothorax (8%), five cases of cough (14%), and one case of mild bloody sputum (3%) with no clinical significance were noted. There were no severe complications. The average duration required to perform the marking was 19.4 min (range = 12–41 min). Conclusion Our results indicate that CT-guided ICG marking is safe and useful for detecting the location of small pulmonary nodules preoperatively.

scholarly journals Retrospective analysis of computed tomography-guided percutaneous nephrostomies in cancer patients

2019 ◽  
Vol 52 (3) ◽  
pp. 148-154 ◽  
Author(s):  
Marcio dos Santos Meira ◽  
Paula Nicole Vieira Pinto Barbosa ◽  
Almir Galvão Vieira Bitencourt ◽  
Maria Fernanda Arruda Almeida ◽  
Chiang Jeng Tyng ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cancer Patients ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Malignant Neoplasm ◽  
Percutaneous Nephrostomy ◽  
Complication Rates ◽  
Success Rates ◽  
Ct Guided ◽  
Referral Center

Abstract Objective: To establish an overview of computed tomography (CT)-guided percutaneous nephrostomy performed at a referral center for cancer, addressing the characteristics of patients submitted to this intervention, as well as the indications for it, the technical specificities of it, and its main complications. Materials and Methods: This was a retrospective study involving a review of the electronic medical records and images of patients submitted to CT-guided percutaneous nephrostomy at a referral center for cancer between 2014 and 2016. Results: A total of 201 procedures were evaluated. In most cases, the obstruction was caused by a malignant neoplasm. Complications occurred in 9.5% of the cases, and an additional intervention was required (typically for catheter repositioning) in 36.6%. Post-procedure complications were not found to be significantly associated with the type of previous cancer treatment, the technique used, the caliber of the drain used in the procedure, or the degree of dilatation of the collection system prior to the procedure. Conclusion: In cancer patients, CT-guided percutaneous nephrostomy is an effective treatment, with success rates and complication rates similar to those reported in the general population.

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