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World Journal of Surgical Oncology
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Open Access 01-12-2024 | Research

Noninferiority comparison of electromagnetic navigation-guided versus computed tomography-guided percutaneous localization of multiple small pulmonary nodules: a prospective randomized clinical trial

Authors: Hongliang Hui, Haoran Miao, Fan Qiu, Huaming Li, Yangui Lin, Yiqian Zhang, Bo Jiang

Published in: World Journal of Surgical Oncology | Issue 1/2024

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Abstract

Background

Accurate preoperative localization is a challenge in thoracoscopic surgery for multiple pulmonary nodules. In this study, we aimed to assess the accuracy and feasibility of electromagnetic navigation (EN)-guided percutaneous localization.

Methods

We enrolled 50 patients with multiple pulmonary nodules for EN-guided (EN group) or CT-guided (CT group) localization. The primary outcome was the localization accuracy, and the primary analysis was to assess the noninferiority (noninferiority margin of 5 mm) of EN-induced localization deviation compared with that of CT-induced deviation. The secondary outcomes included the procedural duration, anxiety score, and incidence of complications.

Results

Among the 50 patients randomized to the EN- and CT-guided groups, 24 patients (53 nodules) underwent EN-guided preoperative marking, and 25 patients (54 nodules) underwent CT-guided preoperative marking. The demographic, clinical, and radiological characteristics did not differ significantly between the groups (P > 0.05). Among these patients, the EN group was noninferior in terms of localization deviation compared with the CT group (9.0 [6.5] vs. 7.5 [6.0] mm; P = 0.33; absolute difference 0.9 [95% CI] 0.03–1.77]). Furthermore, the procedural duration was 16.3 (4.2) minutes for the EN group and 22.3 (8.2) minutes for the CT group (P = 0.002). Additionally, the EN group exhibited significant improvements compared with the CT group on the basis of the Amsterdam Preoperative Anxiety and Information Scale, particularly in relation to the S and C subscales’ cumulative scores.

Conclusions

EN was found to be noninferior to CT in terms of localization accuracy, as it significantly decreased the procedural duration and relieved psychological stress for patients who underwent simultaneous surgery for multiple pulmonary nodules.

Clinical Trial Registration

Chinese Clinical Trial Registry Identifier: ChiCTR2200056734.
Appendix
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Literature
1.
Adams SJ, Stone E, Baldwin DR, Vliegenthart R, Lee P, Fintelmann FJ. Lung cancer screening. Lancet. 2023;401:390–408.CrossRefPubMed
2.
Heuvelmans MA, Walter JE, Peters RB, Bock GH, Yousaf-Khan U, Aalst CMV, Groen HJM, Nackaerts K, Ooijen PMV, Koning HJ, et al. Relationship between nodule count and lung cancer probability in baseline CT lung cancer screening: the NELSON study. Lung Cancer. 2017;113:45–50.CrossRefPubMed
3.
Ujiie H, Gregor A, Yasufuku K. Minimally invasive surgical approaches for lung cancer. Expert Rev Respir Med. 2019;13:571–8.CrossRefPubMed
4.
Sarsam M, Baste JM, Thiberville L, Salaun M, Lachkar S. How bronchoscopic dye marking can help minimally invasive lung surgery. J Clin Med 2022, 11.
5.
Refai M, Andolfi M, Barbisan F, Roncon A, Guiducci GM, Xiumè F, Salati M, Tiberi M, Giovagnoni A, Paci E. Computed tomography-guided microcoil placement for localizing small pulmonary nodules before uniportal video-assisted thoracoscopic resection. Radiol Med. 2020;125:24–30.CrossRefPubMed
6.
Thistlethwaite PA, Gower JR, Hernandez M, Zhang Y, Picel AC, Roberts AC. Needle localization of small pulmonary nodules: lessons learned. J Thorac Cardiovasc Surg. 2018;155:2140–7.CrossRefPubMed
7.
Hopkins KG, Ferson PF, Shende MR, Christie NA, Schuchert MJ, Pennathur A. Prospective study of quality of life after lung cancer resection. Ann Transl Med. 2017;5:204.CrossRefPubMedPubMedCentral
8.
Park CH, Han K, Hur J, Lee SM, Lee JW, Hwang SH, Seo JS, Lee KH, Kwon W, Kim TH, Choi BW. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: a systematic review and Meta-analysis. Chest. 2017;151:316–28.CrossRefPubMed
9.
Wang K, Huang W, Chen X, Li G, Li N, Huang X, Liao X, Song J, Yang Q, He K, et al. Efficacy of Near-Infrared fluorescence video-assisted thoracoscopic surgery for small pulmonary nodule resection with Indocyanine Green Inhalation: a Randomized Clinical Trial. Ann Surg Oncol. 2023;30:5912–22.CrossRefPubMed
10.
Wang L, Sun D, Gao M, Li C. Computed tomography-guided localization of pulmonary nodules prior to thoracoscopic surgery. Thorac Cancer. 2023;14:119–26.CrossRefPubMed
11.
Zhang H, Li Y, Chen X, He Z. Comparison of hook-wire and medical glue for CT-guided preoperative localization of pulmonary nodules. Front Oncol. 2022;12:922573.CrossRefPubMedPubMedCentral
12.
Yang F, Min J. Hemorrhagic shock caused by preoperative computed tomography-guided microcoil localization of lung nodules: a case report. BMC Surg. 2022;22:247.CrossRefPubMedPubMedCentral
13.
Green M, Marom EM, Konen E, Kiryati N, Mayer A. Patient-specific image denoising for ultra-low-dose CT-guided lung biopsies. Int J Comput Assist Radiol Surg. 2017;12:2145–55.CrossRefPubMed
14.
Mehta AC, Hood KL, Schwarz Y, Solomon SB. The Evolutional history of electromagnetic Navigation Bronchoscopy: state of the art. Chest. 2018;154:935–47.CrossRefPubMed
15.
Hsu PK, Wu YC. Electromagnetic Navigation-guided one-stage dual localization of small pulmonary nodules. Chest. 2018;154:1462–3.CrossRefPubMed
16.
Hsu PK, Wu YC. The feasibility of electromagnetic navigation-guided percutaneous microcoil localization for thoracoscopic resection of small pulmonary nodules. J Thorac Cardiovasc Surg. 2019;157:e211–4.CrossRefPubMed
17.
Piaggio G, Elbourne DR, Altman DG, Pocock SJ, Evans SJ. Reporting of noninferiority and equivalence randomized trials: an extension of the CONSORT statement. JAMA. 2006;295:1152–60.CrossRefPubMed
18.
Zhang L, Wang L, Kadeer X, Zeyao L, Sun X, Sun W, She Y, Xie D, Li M, Zou L, et al. Accuracy of a 3-Dimensionally printed navigational template for localizing small pulmonary nodules: a Noninferiority Randomized Clinical Trial. JAMA Surg. 2019;154:295–303.CrossRefPubMed
19.
Nardini M, Dunning J. Pulmonary nodules precision localization techniques. Future Oncol. 2020;16:15–9.CrossRefPubMed
20.
Manca G, Davini F, Tardelli E, De Liperi A, Falaschi F, Melfi F, Colletti PM, Rubello D, Volterrani D, Boni G. Clinical impact of Radioguided localization in the treatment of Solitary Pulmonary Nodule: a 20-Year retrospective analysis. Clin Nucl Med. 2018;43:317–22.CrossRefPubMed
21.
Fan L, Yang H, Yu L, Wang Z, Ye J, Zhao Y, Cai D, Zhao H, Yao F. Multicenter, prospective, observational study of a novel technique for preoperative pulmonary nodule localization. J Thorac Cardiovasc Surg. 2020;160:532–e539532.CrossRefPubMed
22.
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;25:2627–33.CrossRefPubMed
23.
Rodrigues JCL, Pierre AF, Hanneman K, Cabanero M, Kavanagh J, Waddell TK, Chung TB, Pakkal M, Keshavjee S, Cypel M, et al. CT-guided Microcoil Pulmonary Nodule localization prior to video-assisted thoracoscopic surgery: diagnostic utility and recurrence-free survival. Radiology. 2019;291:214–22.CrossRefPubMed
24.
Zhao ZR, Lau RWH, Yu PSY, Ng CSH. Devising the guidelines: the techniques of pulmonary nodule localization in uniportal video-assisted thoracic surgery-hybrid operating room in the future. J Thorac Dis. 2019;11:S2073–8.CrossRefPubMedPubMedCentral
25.
Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, Aoki T, Okami J, Yoshino I, Ito H, et al. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open-label, phase 3, randomised, controlled, non-inferiority trial. Lancet. 2022;399:1607–17.CrossRefPubMed
26.
Zhang L, Li M, Li Z, Kedeer X, Wang L, Fan Z, Chen C. Three-dimensional printing of navigational template in localization of pulmonary nodule: a pilot study. J Thorac Cardiovasc Surg. 2017;154:2113–e21192117.CrossRefPubMed
27.
Hung CT, Chen CK, Chang YY, Hsu PK, Hung JJ, Huang CS, Wu YC, Hsu HS. Electromagnetic navigation-guided versus computed tomography-guided percutaneous localization of small lung nodules before uniportal video-assisted thoracoscopic surgery: a propensity score-matched analysis. Eur J Cardiothorac Surg. 2020;58:i85–91.CrossRefPubMed
28.
Anayama T, Qiu J, Chan H, Nakajima T, Weersink R, Daly M, McConnell J, Waddell T, Keshavjee S, Jaffray D, et al. Localization of pulmonary nodules using navigation bronchoscope and a near-infrared fluorescence thoracoscope. Ann Thorac Surg. 2015;99:224–30.CrossRefPubMed
29.
Patrucco F, Daverio M, Airoldi C, Falaschi Z, Longo V, Gavelli F, Boldorini RL, Balbo PE. 4D electromagnetic Navigation Bronchoscopy for the Sampling of Pulmonary lesions: first European real-life experience. Lung. 2021;199:493–500.CrossRefPubMedPubMedCentral
30.
Park S, Kang CH, Hwang Y, Seong YW, Lee HJ, Park IK, Kim YT. Risk factors for postoperative anxiety and depression after surgical treatment for lung cancer†. Eur J Cardiothorac Surg. 2016;49:e16–21.CrossRefPubMed
31.
Hu L, Gao J, Hong N, Liu H, Chen C, Zhi X, Sui X. Simultaneous preoperative computed tomography-guided microcoil localizations of multiple pulmonary nodules. Eur Radiol. 2021;31:6539–46.CrossRefPubMed
Metadata
Title
Noninferiority comparison of electromagnetic navigation-guided versus computed tomography-guided percutaneous localization of multiple small pulmonary nodules: a prospective randomized clinical trial
Authors
Hongliang Hui
Haoran Miao
Fan Qiu
Huaming Li
Yangui Lin
Yiqian Zhang
Bo Jiang
Publication date
01-12-2024
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2024
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-024-03606-z

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