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Journal of Cardiothoracic Surgery

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Open Access 01-12-2021 | Computed Tomography | Research article

Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study

Authors: Juan Wu, Min-Ge Zhang, Jin Chen, Wen-Bin Ji

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

Preoperative computed tomography (CT)-guided coil localization (CL) is commonly used to facilitate video-assisted thoracoscopic surgery (VATS)-guided diagnostic wedge resection (WR) of pulmonary nodules (PNs). When a scapular-blocked PN (SBPN) is localized, the trans-scapular CL (TSCL) is commonly 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. Of these patients, 14 had SBPNs and underwent the 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. The technical success rate of the scapula puncture was 100%. No complications occurred near the scapula. The 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 patients (14.3%) developed asymptomatic pneumothorax after TSCL. The technical success rate of VATS-guided WR was 92.9%. The patient who experienced technical failure of TSCL directly underwent lobectomy. The mean duration of the VATS was 90.0 ± 42.4 min and the mean blood loss was 62.9 ± 37.2 ml. The final diagnoses of the 14 SBPNs included invasive adenocarcinoma (n = 4), adenocarcinoma in situ (n = 9), and benign disease (n = 1).

Conclusions

Preoperative CT-guided TSCL is a safe and simple procedure that can facilitate high success rates of VATS-guided WR of SBPNs.

van't Westeinde SC, de Koning HJ, Xu DM, Hoogsteden HC, van Klaveren RJ. How to deal with incidentally detected pulmonary nodules less than 10mm in size on CT in a healthy person. Lung Cancer. 2008;60(2):151–9. https://doi.org/10.1016/j.lungcan.2008.01.020.CrossRef

Winer-Muram HT. The solitary pulmonary nodule. Radiology. 2006;239(1):34–49. https://doi.org/10.1148/radiol.2391050343.CrossRefPubMed

Xie Y, Zhang J, Xia Y. Semi-supervised adversarial model for benign-malignant lung nodule classification on chest CT. Med Image Anal. 2019;57:237–48. https://doi.org/10.1016/j.media.2019.07.004.CrossRefPubMed

Zhang Y, Shen Y, Qiang JW, Ye JD, Zhang J, Zhao RY. HRCT features distinguishing pre-invasive from invasive pulmonary adenocarcinomas appearing as ground-glass nodules. Eur Radiol. 2016;26(9):2921–8. https://doi.org/10.1007/s00330-015-4131-3.CrossRefPubMed

Zhang Y, Qiang JW, Ye JD, Ye XD, Zhang J. High resolution CT in differentiating minimally invasive component in early lung adenocarcinoma. Lung Cancer. 2014;84(3):236–41. https://doi.org/10.1016/j.lungcan.2014.02.008.CrossRefPubMed

MacMahon H, Naidich DP, Goo JM, Lee KS, Leung ANC, Mayo JR, et al. Guidelines for Management of Incidental Pulmonary Nodules Detected on CT images: from the Fleischner society. Radiology. 2017;2017:284228–43.

Godoy MCB, Odisio EGLC, Truong MT, de Groot PM, Shroff GS, Erasmus JJ. Pulmonary nodule Management in Lung Cancer Screening: a pictorial review of lung-RADS version 1.0. Radiol Clin N Am. 2018;56(3):353–63. https://doi.org/10.1016/j.rcl.2018.01.003.CrossRefPubMed

Park CH, Han K, Hur J, Lee SM, Lee JW, Hwang SH, et al. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: a systematic review and meta-analysis. Chest. 2017;151(2):316–28. https://doi.org/10.1016/j.chest.2016.09.017.CrossRefPubMed

Li Y, Wang T, Fu YF, Shi YB, Wang JY. Computed tomography-guided biopsy for sub-centimetre lung nodules: technical success and diagnostic accuracy. Clin Respir J. 2020;14(7):605–10. https://doi.org/10.1111/crj.13172.CrossRefPubMed

10.

Fu YF, Li GC, Xu QS, Shi YB, Wang C, Wang T. Computed tomography-guided lung biopsy: a randomized controlled trial of low-dose versus standard-dose protocol. Eur Radiol. 2020;30(3):1584–92. https://doi.org/10.1007/s00330-019-06464-6.CrossRefPubMed

11.

Liu GS, Wang SQ, Liu HL, Liu Y, Fu YF, Shi YB. Computed tomography-guided biopsy for small (≤20 mm) lung nodules: a meta-analysis. J Comput Assist Tomogr. 2020;44(6):841–6. https://doi.org/10.1097/RCT.0000000000001071. Epub ahead of print. PMID: 32976266.CrossRefPubMed

12.

Finley RJ, Mayo JR, Grant K, Clifton JC, English J, Leo J, et al. Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial. J Thorac Cardiovasc Surg. 2015;149(1):26–31. https://doi.org/10.1016/j.jtcvs.2014.08.055.CrossRefPubMed

13.

Rossi UG, Seitun S, Ferro C. MDCT-guided transthoracic needle aspiration biopsy of the lung using the transscapular approach. Cardiovasc Intervent Radiol. 2011;34(1):184–7. https://doi.org/10.1007/s00270-010-9816-z.CrossRefPubMed

14.

Rebonato A, Maiettini D, Andolfi M, Fischer MJ, Vannucci J, Metro G, et al. CT-guided percutaneous trans-scapular lung biopsy in the diagnosis of peripheral pulmonary lesion nodules of the superior lobes using large needles. Cardiovasc Intervent Radiol. 2018;41(2):284–90. https://doi.org/10.1007/s00270-017-1768-0.CrossRefPubMed

15.

Iguchi T, Hiraki T, Ishii H, Gobara H, Fujiwara H, Matsui Y, et al. Transosseous route for CT fluoroscopy-guided radiofrequency ablation of lung tumors. J Vasc Interv Radiol. 2015;26(11):1694–8. https://doi.org/10.1016/j.jvir.2015.08.012.CrossRefPubMed

16.

Fu YF, Zhang M, Wu WB, Wang T. Coil localization-guided video-assisted thoracoscopic surgery for lung nodules. J Laparoendosc Adv Surg Tech A. 2018;28(3):292–7. https://doi.org/10.1089/lap.2017.0484.CrossRefPubMed

17.

Su TH, Fan YF, Jin L, He W, Hu LB. CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection. Eur Radiol. 2015;25(9):2627–33. https://doi.org/10.1007/s00330-015-3676-5.CrossRefPubMed

18.

Xia FF, Shi YB, Wang T, Fu YF. Computed tomography-guided Transfissural coil localization of lung nodules. Thorac Cardiovasc Surg. 2020;68:545–8.CrossRef

19.

Fu YF, Gao YG, Zhang M, Wang T, Shi YB, Huang YY. Computed tomography-guided simultaneous coil localization as a bridge to one-stage surgery for multiple lung nodules: a retrospective study. J Cardiothorac Surg. 2019;14:43.CrossRef

20.

Teng F, Wu AL, Yang S, Lin J, Xian YT, Fu YF. Preoperative computed tomography-guided coil localization for multiple lung nodules. Ther Adv Respir Dis. 2020;14:1753466620909762.CrossRef

Title: Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study
Authors: Juan Wu
Min-Ge Zhang
Jin Chen
Wen-Bin Ji
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Computed Tomography
Pneumothorax
Computed Tomography
Pulmonary Nodule
Pneumothorax
Pneumothorax
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01446-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Trans-scapular approach coil localization for scapular-blocked pulmonary nodules: a retrospective study

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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