Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 7/2022

10-03-2022 | Pulmonary Nodule | Interventional

Marking ground glass nodules with pulmonary nodules localization needle prior to video-assisted thoracoscopic surgery

Authors: Chuan-dong Li, Zhen-guo Huang, Hong-liang Sun, Li-tao Wang, Yu-li Wang, Bao-xiang Gao, Min-xing Yang

Published in: European Radiology | Issue 7/2022

Login to get access

Abstract

Objectives

To evaluate the efficacy and safety of marking ground glass nodules (GGNs) with pulmonary nodules localization needle (PNLN) prior to video-assisted thoracoscopic surgery (VATS).

Materials and methods

From June 2020 to February 2021, all patients with GGNs who received CT-guided localization using PNLN before VATS were enrolled. Clinical and imaging data were retrospectively analyzed.

Results

A total of 352 consecutive patients with 395 GGNs were included in the study. The mean diameter of GGNs was 0.95 ± 0.48 cm, and the shortest distance from nodules to the pleura was 1.73 ± 0.96 cm. All 395 GGNs were marked using PNLNs. The time required for marking was 7.8 ± 2.2 min. The marking success rate was 99.0% (391/395). The marking failure of four nodules was all due to the unsatisfactory position of PNLNs. No marker dislocation occurred. Marking-related complications included pneumothorax in 63 cases (17.9%), hemorrhage in 34 cases (9.7%), and hemoptysis in 6 cases (1.7%). All the complications were minor and did not need special treatment. Localization and VATS were performed on the same day in 95 cases and on different days in 257 cases. All GGNs were successfully removed by VATS. No patient converted to thoracotomy. Histopathological examination revealed 74 (18.7%) benign nodules and 321 (81.3%) malignant nodules.

Conclusions

It is safe and reliable to perform preoperative localization of GGNs using PNLNs, which can effectively guide VATS to remove GGNs.

Key Points

• Preoperative localization of GGNs could effectively guide VATS to remove GGNs.
• PNLN was based on the marking principle of hook-wire, through the improvement of its material, specially designed to mark pulmonary nodules.
• The application of PNLN to mark GGNs had high success rate, good patient tolerance, and no dislocation. Meanwhile, VATS could be performed 2 to 3 days after marking GGNs with PNLN.
Literature
1.
Goldstraw P, Chansky K, Crowley J et al (2016) The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 11:39–51PubMed
2.
Sawabata N, Asamura H, Goya T et al (2010) Japanese lung cancer registry study: first prospective enrollment of a large number of surgical and nonsurgical cases in 2002. J Thorac Oncol 5:1369–1375CrossRef
3.
Callister ME, Baldwin DR, Akram AR et al (2015) British Thoracic Society guidelines for the 3.investigation and management of pulmonary nodules. Thorax 70(Suppl 2):ii1–ii54CrossRef
4.
Yamaguchi M, Furuya A, Edagawa M et al (2015) How should we manage small focal pure ground-glass opacity nodules on high-resolution computed tomography? A single institute experience. Surg Oncol 24:258–263CrossRef
5.
Wood DE, Kazerooni EA, Baum SL et al (2018) Lung cancer screening, version 3.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw 16:412–441CrossRef
6.
MacMahon H, Naidich DP, Goo JM et al (2017) Guidelines for management of incidental pulmonary nodules detected on CT images: from the Fleischner Society 2017. Radiology. 284:228–243CrossRef
7.
8.
Shimizu K, Ikeda N, Tsuboi M, Hirano T, Kato H (2006) Percutaneous CT-guided fine needle aspiration for lung cancer smaller than 2 cm and revealed by ground-glass opacity at CT. Lung Cancer 51:173–179
9.
Suzuki K, Nagai K, Yoshida J et al (1999) Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest 115:563–568CrossRef
10.
Li C, Liu B, Jia H, Dong Z, Meng H (2018) Computed tomography-guided hook wire localization facilitates video-assisted thoracoscopic surgery of pulmonary ground-glass nodules. Thorac Cancer 9:1145–1150
11.
Klinkenberg TJ, Dinjens L, Wolf RFE et al (2017) CT-guided percutaneous hookwire localization increases the efficacy and safety of VATS for pulmonary nodules. J Surg Oncol 115:898–904CrossRef
12.
Suzuki K, Shimohira M, Hashizume T et al (2014) Usefulness of CT-guided hookwire marking before video-assisted thoracoscopic surgery for small pulmonary lesions. J Med Imaging Radiat Oncol 58:657–662CrossRef
13.
Hwang S, Kim TG, Song YG (2018) Comparison of hook wire versus coil localization for video-assisted thoracoscopic surgery. Thorac Cancer 9:384–389CrossRef
14.
Hu L, Gao J, Chen C, Zhi X, Liu H, Hong N (2019) Comparison between the application of microcoil and hookwire for localizing pulmonary nodules. Eur Radiol 29:4036–4043
15.
Rostambeigi N, Scanlon P, Flanagan S et al (2019) CT fluoroscopic-guided coil localization of lung nodules prior to video-assisted thoracoscopic surgical resection reduces complications compared to hook wire localization. J Vasc Interv Radiol 30:453–459CrossRef
16.
Yang F, Zhao H, Sui X et al (2020) Comparative study on preoperative localization techniques using microcoil and hookwire by propensity score matching. Thorac Cancer 11:1386–1395CrossRef
17.
Mayo JR, Clifton JC, Powell TI et al (2009) Lung nodules: CT guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology 250:576–585CrossRef
18.
Su TH, Fan YF, Jin L, He W, Hu L-B (2015) CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection. Eur Radiol 25:2627–2633
19.
Kha LC, Hanneman K, Donahoe L (2016) Safety and efficacy of modified preoperative lung nodule microcoil localization without pleural marking: a pilot study. J Thorac Imaging 31:15–22CrossRef
20.
21.
Liu L, Zhang LJ, Chen B et al (2014) Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study. Acta Radiol 55:699–706CrossRef
22.
Xu Y, Ma L, Sun H et al (2020) CT-guided microcoil localization for pulmonary nodules before VATS: a retrospective evaluation of risk factors for pleural marking failure. Eur Radiol 30:5674–5683CrossRef
23.
Tseng YH, Lee YF, Hsieh MS et al (2016) Preoperative computed tomography-guided dye injection to localize multiple lung nodules for video-assisted thoracoscopic surgery. J Thorac Dis 8:S666–S671CrossRef
24.
Miura H, Yamagami T, Tanaka O et al (2016) CT findings after lipiodol marking performed before video-assisted thoracoscopic surgery for small pulmonary nodules. Acta Radiol 57:303–310CrossRef
25.
Lee NK, Park CM, Kang CH et al (2012) CT-guided percutaneous transthoracic localization of pulmonary nodules prior to video-assisted thoracoscopic surgery using barium suspension. Korean J Radiol 13:694–701CrossRef
26.
Nardini M, Bilancia R, Paul I et al (2018) 99mTechnetium and methylene blue guided pulmonary nodules resections: preliminary British experience. J Thorac Dis 10:1015–1021CrossRef
27.
Tao G, Jingying Y, Tan G, Xiaotao D, Min C (2018) A novel CT-guided technique using medical adhesive for localization of small pulmonary ground-glass nodules and mixed ground-glass nodules ( ≤ 20 mm) before video-assisted thoracoscopic surgery. Diagn Interv Radiol 24:209–212
28.
Fan L, Yang H, Yu LM et al (2020) Multicenter, prospective, observational study of a novel technique for preoperative pulmonary nodule localization. J Thorac Cardiovasc Surg 160(2):532–539.e2CrossRef
29.
Hawker GA, Mian S, Kendzerska T, French M (2011) Measures of adult pain: Visual Analog Scale for Pain (VAS pain), Numeric Rating Scale for Pain (NRS pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res 63:S240–S252
Metadata
Title
Marking ground glass nodules with pulmonary nodules localization needle prior to video-assisted thoracoscopic surgery
Authors
Chuan-dong Li
Zhen-guo Huang
Hong-liang Sun
Li-tao Wang
Yu-li Wang
Bao-xiang Gao
Min-xing Yang
Publication date
10-03-2022
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 7/2022
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-022-08597-7

Other articles of this Issue 7/2022

European Radiology 7/2022 Go to the issue

Head and Neck

A diagnostic index based on quantitative susceptibility mapping and voxel-based morphometry may improve early diagnosis of Alzheimer’s disease

Musculoskeletal

Identification of abnormal BMD and osteoporosis in postmenopausal women with T2*-corrected Q-Dixon and reduced-FOV IVIM: correlation with QCT

Correction

Correction to: Prostate volume prediction on MRI: tools, accuracy and variability

Correction

Correction to: Ensuring competence in ultrasound-guided procedures—a validity study of a newly developed assessment tool

Urogenital

mEPE-score: a comprehensive grading system for predicting pathologic extraprostatic extension of prostate cancer at multiparametric magnetic resonance imaging

Chest

CT-defined visual emphysema in smokers with normal spirometry: association with prolonged air leak and other respiratory complications after lobectomy for lung cancer