scholarly journals Efficacy and Safety of Preoperative vs. Intraoperative Computed Tomography-Guided Lung Tumor Localization: A Randomized Controlled Trial

2022 ◽  
Vol 8 ◽  
Author(s):  
Hsin-Yueh Fang ◽  
Kuei-An Chen ◽  
Yu-Wen Wen ◽  
Chih-Tsung Wen ◽  
Kuang-Tse Pan ◽  
...  
Keyword(s):  
Operating Room ◽  
Pulmonary Nodules ◽  
Single Step ◽  
Ct Guided ◽  
Randomized Controlled ◽  
Step Procedure ◽  
Procedural Time ◽  
Time Required ◽  
Small Pulmonary Nodules ◽  
Lesion Localization

Background: Thoracoscopic removal of small pulmonary nodules is traditionally accomplished through a two-step approach—with lesion localization in a CT suite as the first step followed by lesion removal in an operating room as the second step. While the advent of hybrid operating rooms (HORs) has fostered our ability to offer a more patient-tailored approach that allows simultaneous localization and removal of small pulmonary nodules within a single-step, randomized controlled trials (RCTs) that compared the two techniques (two- vs. single-step) are still lacking.Methods: This is a RCT conducted in an academic hospital in Taiwan between October 2018 and December 2019. To compare the outcomes of traditional two-step preoperative CT-guided small pulmonary nodule localization followed by lesion removal vs. single-step intraoperative CT-guided lesion localization with simultaneous removal performed by a dedicated team of thoracic surgeons. The analysis was conducted in an intention-to-treat fashion. The primary study endpoint was the time required for lesion localization. Secondary endpoints included radiation doses, other procedural time indices, and complication rates.Results: A total of 24 and 25 patients who received the single- and two-step approach, respectively, were included in the final analysis. The time required for lesion localization was significantly shorter for patients who underwent the single-step procedure (median: 13 min) compared with the two step-procedure (median: 32 min, p < 0.001). Similarly, the radiation dose was significantly lower for the former than the latter (median: 5.64 vs. 10.65 mSv, respectively, p = 0.001).Conclusions: The single-step procedure performed in a hybrid operating room resulted in a simultaneous reduction of both localization procedural time and radiation exposure.

scholarly journals Preoperative CT versus Intraoperative Hybrid DynaCT Imaging for Localization of Small Pulmonary Nodules: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Yin Kai Chao ◽  
Kuang-Tse Pan ◽  
Chih-Tsung Wen ◽  
Hsin-Yueh Fang ◽  
Ming-Ju Hsieh
Keyword(s):  
Computed Tomography ◽  
Operating Room ◽  
Controlled Trial ◽  
Operating Time ◽  
Pulmonary Nodules ◽  
Controlled Clinical Trial ◽  
Open Label ◽  
Intraoperative Computed Tomography ◽  
Randomized Controlled ◽  
Lesion Localization

Abstract Background Localization of small and/or deep pulmonary nodules before thoracoscopic exploration is paramount to minimize the likelihood of unplanned conversion to thoracotomy. As far as the percutaneous approach is concerned, the most common workflow consists of preoperative computed tomography (POCT) imaging-guided tumor marking (performed in an interventional CT suite) followed by their removal in an operating room (OR). However, the advent of hybrid ORs has allowed intraoperative computed tomography (IOCT)-guided lesion localization. This single center, open-label, randomized, controlled clinical trial aims to compare the efficacy and safety of IOCT versus POCT. Methods/design The study sample will consist of patients presenting with small and/or deep pulmonary nodules who will be randomly allocated to either POCT or IOCT. The time required to complete lesion localization will be the primary efficacy outcome. The following parameters will serve as secondary endpoints: rate of successful targeting during localization and in the operating field, time at risk, operating time, length of time under anesthesia, global operating room utilization time, complication (pneumothorax and hemorrhage) rates, and radiation exposure. Discussion Owing to the increased availability of HORs, our data will be crucial to clarify the feasibility and safety of IOCT versus the traditional POCT approach.

scholarly journals Preoperative CT versus Intraoperative Hybrid DynaCT Imaging for Localization of Small Pulmonary Nodules: A Randomized Controlled Trial

2018 ◽  
Author(s):  
Yin Kai Chao ◽  
Kuang-Tse Pan ◽  
Chih-Tsung Wen ◽  
Hsin-Yueh Fang ◽  
Ming-Ju Hsieh
Keyword(s):  
Controlled Trial ◽  
Pulmonary Nodules ◽  
Controlled Clinical Trial ◽  
Open Label ◽  
Intraoperative Computed Tomography ◽  
Randomized Controlled ◽  
Efficacy Outcome ◽  
Preoperative Ct ◽  
Time Required ◽  
Small Pulmonary Nodules

Abstract Background Small and/or deep pulmonary nodules have been traditionally localized using preoperative CT (POCT) imaging. However, the advent of hybrid operating rooms (ORs) has allowed intraoperative computed tomography (IOCT)-guided lesion localization. This single center, open-label, randomized, controlled clinical trial aims to compare the efficacy and safety of IOCT versus POCT. Methods/design The study sample will consist of patients presenting with small and/or deep pulmonary nodules who will be randomly allocated to either POCT or IOCT. The time required for identifying the lesion will be the primary efficacy outcome. The following parameters will serve as secondary endpoints: rate of successful targeting in the operating field, time at risk, complication (pneumothorax and hemorrhage) rates, and radiation exposure. Discussion Owing to the increased availability of HORs, our data will be crucial to clarify the feasibility and safety of IOCT versus the traditional POCT approach.

CT-guided Needle Biopsy of Small Pulmonary Nodules: Value of Respiratory Gating

Radiology ◽  
2000 ◽  
Vol 217 (3) ◽  
pp. 907-910 ◽  
Author(s):  
Noriyuki Tomiyama ◽  
Naoki Mihara ◽  
Munehiro Maeda ◽  
Takeshi Johkoh ◽  
Takenori Kozuka ◽  
...  
Keyword(s):  
Needle Biopsy ◽  
Respiratory Gating ◽  
Pulmonary Nodules ◽  
Ct Guided ◽  
Small Pulmonary Nodules

scholarly journals Usefulness of 3D-printed Coplanar Puncture Template Assisted CT- guided Percutaneous Core Needle Biopsy of Small (≤20mm) Pulmonary Nodules: 3 years of experience

2021 ◽  
Author(s):  
Hansheng Wang ◽  
Xiao Chen ◽  
Tao Ren ◽  
Peipei Chen ◽  
Guoshi Luo ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Pulmonary Nodules ◽  
Percutaneous Biopsy ◽  
Ct Scans ◽  
Ct Guided ◽  
Core Needle ◽  
Percutaneous Core Needle Biopsy ◽  
3D Printed ◽  
Small Pulmonary Nodules

Abstract Background and Objective: Computed tomography guided percutaneous lung biopsy is a commonly used method for clarifying the nature of pulmonary nodules. However, due to the existence of breathing movement, the lungs have greater mobility, and biopsy of small pulmonary nodules is difficult. In recent years, 3D-printed coplanar templates are gradually used in percutaneous biopsy of small pulmonary nodules. Therefore, this study aimed to evaluate the application value of 3D-printed coplanar puncture template assisted computed tomography guided percutaneous core needle biopsy of small (≤20mm) pulmonary nodules.Method: From January 2018 to January 2021 in Taihe Hospital, 210 hospitalized patients with pulmonary nodules underwent percutaneous core needle biopsy for histopathology/cytopathology diagnosis and were included in the study. All patients were allocated into two groups, patients in Free-hand group underwent percutaneous core needle biopsy without 3D-printed coplanar templates, and patients in 3D-PCT group underwent percutaneous core needle biopsy with 3D-printed coplanar templates. The number of needle adjustments, number of CT scans, surgical time-consuming, diagnostic accuracy, and incidence of complications were recorded and compared between the two groups. Rapid on site evaluation was routinely used for guiding specimens’ triage. Approval for this trial was obtained from the Ethics Committee of the Taihe hospital.Result：The number of needle adjustments (1.41±0.63 vs. 2.23±0.85), the number of CT scans (3.63±0.73 vs. 4.25±0.81) and the incidence of pneumothorax (9.6% vs. 21.1%) during the procedure were significantly lower in the observation group than the control group (P< 0.05), whereas there were no significant differences in the diagnostic accuracy (95.2% vs. 94.3%) and incidence of pulmonary hemorrhage (65.4% vs. 62.3%) between the two groups (P> 0.05), however, the surgical time-consuming in 3D-PCT group is significantly more than Free-hand group.Conclusions: These findings indicated that the 3D-printed coplanar puncture template combined with CT guided percutaneous biopsy can relatively fix the target lesion, reduce the number of needle adjustments and number of CT scans, reduce iatrogenic radiation, and reduce the incidence of complications, especially pneumothorax

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