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European Radiology
Published in: European Radiology 9/2015

01-09-2015 | Interventional

CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection

Authors: Tian-Hao Su, Yue-Feng Fan, Long Jin, Wen He, Li-Bao Hu

Published in: European Radiology | Issue 9/2015

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Abstract

Objectives

To describe and assess the localization of small peripheral pulmonary nodules prior to video-assisted thoracoscopic surgical (VATS) resection using the implantation of microcoils.

Methods

Ninety-two patients with 101 pulmonary nodules underwent computed tomography (CT)-guided implantation of microcoils proximal to each nodule. Patients were randomly assigned to undergo entire microcoil or leaving-microcoil-end implantations. The complications and efficacy of the two implantation methods were evaluated. VATS resection of lung tissue containing each pulmonary lesion and microcoil were performed in the direction of the microcoil marker. Histopathological analysis was performed for the resected pulmonary lesions.

Results

CT-guided microcoil implantation was successful in 99/101 cases, and the placement of microcoils within 1 cm of the nodules was not disruptive. There was no difference in the complications and efficacy associated with the entire implantation method (performed for 51/99 nodules) versus the leaving-microcoil-end implantation method (performed for 48/99 nodules). All nodules were successfully removed using VATS resection. Asymptomatic pneumothorax occurred in 16 patients and mild pulmonary haemorrhage occurred in nine patients. However, none of these patients required further surgical treatment.

Conclusions

Preoperative localization of small pulmonary nodules using a refined percutaneous microcoil implantation method was found to be safe and useful prior to VATS resection.

Key Points

• An increasing number of small, indeterminate pulmonary lesions need to be characterized.
• Entire microcoil and leaving-microcoil-end implantation methods were described for nodule localization.
• Adjacent microcoil localization prior to video-assisted thoracoscopic surgical resection involved minimal intervention.
• Preoperative microcoil localization facilitates the definitive resection of small pulmonary nodules.
Literature
1.
Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90PubMedCrossRef
2.
Ost D, Fein AM, Feinsilver SH (2003) Clinical practice. The solitary pulmonary nodule. N Engl J Med 348:2535–2542PubMedCrossRef
3.
Ng YL, Patsios D, Roberts H, Walsham A, Paul NS, Chung T et al (2008) CT-guided percutaneous fine-needle aspiration biopsy of pulmonary nodules measuring 10 mm or less. Clin Radiol 63:272–277PubMedCrossRef
4.
Powell TI, Jangra D, Clifton JC, Lara-Guerra H, Church N, English J et al (2004) Peripheral lung nodules: fluoroscopically guided video-assisted thoracoscopic resection after computed tomography-guided localization using platinum microcoils. Ann Surg 240:481–488, discussion 488–489PubMedCentralPubMedCrossRef
5.
Mayo JR, Clifton JC, Powell TI, English JC, Evans KG, Yee J et al (2009) Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology 250:576–585PubMedCrossRef
6.
Heran MK, Sangha BS, Mayo JR, Blair G, Skarsgard ED (2011) Lung nodules in children: video-assisted thoracoscopic surgical resection after computed tomography-guided localization using a microcoil. J Pediatr Surg 46:1292–1297PubMedCrossRef
7.
Liu L, Zhang LJ, Chen B, Cao JM, Lu GM, Yuan L et al (2013) Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study. Acta Radiol 55:699–706PubMedCrossRef
8.
Wang YZ, Boudreaux JP, Dowling A, Woltering EA (2010) Percutaneous localisation of pulmonary nodules prior to video-assisted thoracoscopic surgery using methylene blue and TC-99. Eur J Cardiothorac Surg 37:237–238PubMedCrossRef
9.
Chen W, Chen L, Yang S, Chen Z, Qian G, Zhang S et al (2007) A novel technique for localization of small pulmonary nodules. Chest 131:1526–1531PubMedCrossRef
10.
Lee NK, Park CM, Kang CH, Jeon YK, Choo JY, Lee HJ et al (2012) CT-guided percutaneous transthoracic localization of pulmonary nodules prior to video-assisted thoracoscopic surgery using barium suspension. Korean J Radiol 13:694–701PubMedCentralPubMedCrossRef
11.
Kim YD, Jeong YJ IH, Cho JS, Lee JW, Kim HJ et al (2011) Localization of pulmonary nodules with lipiodol prior to thoracoscopic surgery. Acta Radiol 52:64–69PubMedCrossRef
12.
Kawanaka K, Nomori H, Mori T, Ikeda K, Ikeda O, Tomiguchi S et al (2009) Marking of Small Pulmonary Nodules Before Thoracoscopic Resection: Injection of Lipiodol Under CT-fluoroscopic Guidance. Acad Radiol 16:39–45PubMedCrossRef
13.
Bellomi M, Veronesi G, Trifiro G, Brambilla S, Bonello L, Preda L et al (2010) Computed tomography-guided preoperative radiotracer localization of nonpalpable lung nodules. Ann Thorac Surg 90:1759–1764PubMedCrossRef
14.
Tyng CJ, Baranauskas MV, Bitencourt AG, Almeida MF, Matsushita JP Jr, Barbosa PN et al (2013) Preoperative computed tomography-guided localization of ground-glass opacities with metallic clip. Ann Thorac Surg 96:1087–1089PubMedCrossRef
15.
Yoshida Y, Inoh S, Murakawa T, Ota S, Fukayama M, Nakajima J (2011) Preoperative localization of small peripheral pulmonary nodules by percutaneous marking under computed tomography guidance. Interact Cardiovasc Thorac Surg 13:25–28PubMedCrossRef
16.
Chen YR, Yeow KM, Lee JY, Su IH, Chu SY, Lee CH et al (2007) CT-guided hook wire localization of subpleural lung lesions for video-assisted thoracoscopic surgery (VATS). J Formos Med Assoc 106:911–918PubMedCrossRef
17.
Asamura H, Kondo H, Naruke T, Tsuchiya R, Wakao F, Kaneko M et al (1994) Computed tomography-guided coil injection and thoracoscopic pulmonary resection under roentgenographic fluoroscopy. Ann Thorac Surg 58:1542–1544PubMedCrossRef
18.
Iqbal SI, Molgaard C, Williamson C, Flacke S (2014) Purposeful creation of a pneumothorax and chest tube placement to facilitate ct-guided coil localization of lung nodules before video-assisted thoracoscopic surgical wedge resection. J Vasc Interv Radiol 25(7):1133–1338PubMedCrossRef
19.
Wahidi MM, Govert JA, Goudar RK, Gould MK, McCrory DC (2007) Evidence for the treatment of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest 132:94S–107SPubMedCrossRef
Metadata
Title
CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection
Authors
Tian-Hao Su
Yue-Feng Fan
Long Jin
Wen He
Li-Bao Hu
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3676-5

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