scholarly journals CT-guided microcoil implantation for localizing pulmonary ground-glass nodules: feasibility and accuracy of oblique approach for lesions difficult to access on axial images

2020 ◽  
Vol 93 (1109) ◽  
pp. 20190571
Author(s):  
Li Chuan-dong ◽  
Sun Hong-liang ◽  
Huang Zhen-guo ◽  
Gao Bao-xiang ◽  
Chen He ◽  
...  
Keyword(s):  
Success Rate ◽  
Blood Vessels ◽  
Thoracoscopic Surgery ◽  
Ground Glass ◽  
Imaging Data ◽  
Ct Guided ◽  
Friendship Hospital ◽  
Time Required ◽  
Oblique Approach ◽  
Ground Glass Nodules

Objective: (1) To evaluate the value of CT-guided microcoil implantation for localizing pulmonary ground-glass nodules (GGNs) before video-assisted thoracoscopic surgery (VATS). (2) To evaluate the feasibility, safety and accuracy of cephalic-caudal oblique approach for lesions difficult to access on axial images owing to overlying bony structures, large vessels or interlober fissures. Methods: From June 2016 to March 2019, all patients with GGNs resected by VATS after marking using CT-guided microcoil implantation in China-Japan friendship hospital were enrolled and clinical and imaging data were retrospectively analyzed. According to the microcoil marked path, the GGNs were divided into cephalic-caudal oblique group (oblique group) and non-oblique group. The success rate of marking, the time required for marking and the incidence of complications between the two groups were compared. Results: 258 GGNs from 215 consecutive patients were included in this study. The diameter of GGNs was 1.22 ± 0.50 cm, and the shortest distance from GGNs to the pleura was 1.56 ± 1.09 cm. All 258 GGNs were successfully resected by VATS under the guidance of implanted microcoils, and no case was converted to thoracotomy. During CT-guided microcoil implantation, cephalic- caudal oblique approach was taken in 56 GGNs (oblique group) to avoid bone, interlobar fissure and blood vessels. The time required for marking was significantly longer for oblique group compared with non-oblique group (16.6 ± 2.4 vs. 13.1 ± 1.9 min, p<0.01). No significant differences in the success rate of marking (94.6% vs 91.6%), the incidence of pneumothorax (19.6% vs 17.8%), the bleeding rate (10.7% vs 8.9%), and the hemoptysis rate (1.8% vs 1.5%) were observed between the two groups. Conclusion: CT-guided microcoil implantation can effectively guide VATS to resect GGNs. For GGNs difficult to access on axial images, CT-guided cephalic-caudal oblique approach is feasible, safe, and accurate. Advances in knowledge: CT-guided microcoil implantation can effectively guide VATS to resect GGNs. The marked path with cephalic-caudal obliquity can effectively avoid bone, interlobar fissure and blood vessels, successfully mark GGNs difficult to access on axial images, while keeping the distance from the pleura to the lesion on the marked path as short as possible at the same time.

CT-guided preoperative localization of ground glass nodule: comparison between the application of embolization microcoil and the locating needle designed for pulmonary nodules

2021 ◽  
pp. 20210193
Author(s):  
Chuan-dong Li ◽  
Zhen-Guo Huang ◽  
Hong-liang Sun ◽  
Li-tao Wang ◽  
Yu-li Wang
Keyword(s):  
Success Rate ◽  
Complication Rate ◽  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Preoperative Localization ◽  
Ground Glass ◽  
Special Treatment ◽  
Ct Guided ◽  
Ground Glass Nodule ◽  
Marking Time

Objectives: To compare the efficacy and safety of preoperative localization of ground glass nodule (GGN) using embolization microcoils and the locating needles designed for pulmonary nodules. Methods: From June 2019 to December 2020, 429 patients who received CT-guided localization of single GGN before video-assisted thoracoscopic surgery (VATS) were enrolled. The diameter and depth of GGNs were 0.84 ± 0.39 cm and 1.66 ± 1.37 cm. Among 429 cases, the first 221 GGNs were marked with microcoils (the microcoil group), and the remaining 208 GGNs were marked with the locating needles designed for pulmonary nodules (the locating needle group). SPSS 17.0 statistical software was used to compare the marking success rate, marking time, marking-related complications between two groups. p values < 0.05 were considered statistically significant. Results: The marking time in the microcoil group was longer than that in the locating needle group (11.1 ± 3.9 vs 8.2 ± 2.0 min, t = −7.87, p = 0.000). The marking success rate in the microcoil group was lower than that in the locating needle group (91.4% vs 98.6%, χ2 = 11.27, p = 0.001). In the microcoil group, marking failures included 16 cases of microcoil dislocation and 3 cases of unsatisfactory microcoil position, while all 3 cases of marking failure in the locating needle group were due to unsatisfactory anchor position. No significant differences in the incidence of total complications (23.1% vs 22.1%), pneumothorax (18.1% vs 19.2%), hemorrhage (9.5% vs 9.1%), and hemoptysis (1.8% vs 1.4%) were observed between the two groups. All the complications were minor and did not need special treatment. Except for one case in the microcoil group, which was converted to thoracotomy, the remaining 428 GGNs were successfully resected by VATS. Conclusions: It is safe and effective to perform preoperative localization of GGN using either embolization microcoil or the locating needle designed for pulmonary nodules. The locating needle is superior to microcoil for marking GGN in terms of procedure time and the success rate. The complication rate of both methods is similar. Advances in knowledge: The locating needle designed for pulmonary nodules has recently been used to mark pulmonary nodule. Its structure can effectively avoid dislocation after localization, and the marking process is simple and quick. Compared with localization using microcoil, it takes less time and has higher success rate to mark GGNs using the locating needle. The complication rate of both methods is similar.

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.

scholarly journals Association Between 18F-FDG PET/CT-Based SUV Index and Malignant Status of Persistent Ground-Glass Nodules

2021 ◽  
Vol 11 ◽  
Author(s):  
Rong Niu ◽  
Yuetao Wang ◽  
Xiaoliang Shao ◽  
Zhenxing Jiang ◽  
Jianfeng Wang ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Correlation Factor ◽  
Ground Glass ◽  
Imaging Data ◽  
Malignancy Risk ◽  
Pet Ct ◽  
Average Probability ◽  
Fdg Pet Ct ◽  
Benign Group ◽  
Ground Glass Nodules

To explore the association between 18F-FDG PET/CT-based SUV index and malignant risk of persistent ground-glass nodules (GGNs). We retrospectively analyzed a total of 166 patients with GGN who underwent PET/CT examination from January 2012 to October 2019. There were 113 women and 53 men, with an average age of 60.8 ± 9.1 years old. A total of 192 GGNs were resected and confirmed by pathology, including 22 in benign group and 170 in adenocarcinoma group. They were divided into three groups according to SUV index tertiles: Tertile 1 (0.14–0.54), Tertile 2 (0.55–1.17), and Tertile 3 (1.19–6.78), with 64 GGNs in each group. The clinical and imaging data of all patients were collected and analyzed. After adjusting for the potential confounding factors, we found that the malignancy risk of GGN significantly decreased as the SUV index increased (OR, 0.245; 95%CI, 0.119–0.504; P &lt;0.001), the average probability of malignant GGN was 89.1% (95% CI, 53.1–98.3%), 80.5% (95% CI, 36.7–96.7%), and 34.3% (95%CI, 9.5–72.2%) for Tertile 1 to Tertile 3. And the increasing trend of SUV index was significantly correlated with the reduction of malignant risk (OR, 0.099; 95%CI, 0.025–0.394; P = 0.001), especially between Tertile 3 versus Tertile 1 (OR, 0.064; 95%CI, 0.012–0.356; P = 0.002). Curve fitting showed that the SUV index was linearly and negatively correlated with the malignant risk of GGN. SUV index is an independent correlation factor for malignancy risk of GGN, the higher the SUV index, the lower the probability of GGN malignancy.

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.

Multi-detector spiral CT study of the relationships between pulmonary ground-glass nodules and blood vessels

2013 ◽  
Vol 23 (12) ◽  
pp. 3271-3277 ◽  
Author(s):  
Feng Gao ◽  
Ming Li ◽  
Xiaojun Ge ◽  
Xiangpeng Zheng ◽  
Qingguo Ren ◽  
...  
Keyword(s):  
Blood Vessels ◽  
Spiral Ct ◽  
Ground Glass ◽  
Ground Glass 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 Trans-Scapular Approach Coil Localization for Scapular-Blocked Pulmonary Nodules: A Retrospective Study

2020 ◽  
Author(s):  
Juan Wu ◽  
Min-Ge Zhang ◽  
Jin Chen ◽  
Wen-Bin Ji
Keyword(s):  
Success Rate ◽  
Thoracoscopic Surgery ◽  
Pulmonary Nodules ◽  
Adenocarcinoma In Situ ◽  
Technical Failure ◽  
Technical Success ◽  
Ct Guided ◽  
Technical Success Rate ◽  
Preoperative Ct ◽  
The Mean

Abstract Background: Preoperative computed tomography (CT)-guided coil localization (CL) is commonly employed to facilitate the video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) will be localized, the trans-scapular CL (TSCL) should be performed. In this study, we investigated the safety, feasibility, and clinical efficacy of preoperative CT-guided TSCL for SBPNs.Materials and Methods: From January 2014 to September 2020, a total of 152 patients with PNs underwent CT-guided CL prior to VATS-guided WR. Among them, 14 patients had the SBPNs and underwent TSCL procedure. Results: A total of 14 SBPNs were localized in the 14 patients. The mean diameter of the 14 SBPNs was 7.4 ± 2.4 mm. Technical success rate of puncture of the scapula was 100%. No complications occurred near the scapula. Technical success rate of CL was 92.9%. One coil dropped off when performing the VATS procedure. The mean duration of the TSCL was 14.2 ± 2.7 min. Two patient (14.3%) developed aysmptomatic pneumothorax after TSCL. Technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean VATS procedure duration and blood loss were 90.0 ± 42.4 min and 62.9 ± 37.2 ml, respectively. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma (n = 4), adenocarcinoma in situ (n = 9), and benign (n = 1).Conclusions: Preoperative CT-guided TSCL can be safely and simply used to facilitate high successful rates of VATS-guided WR of SBPNs.

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