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European Radiology

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01-09-2023 | Pulmonary Nodule | Interventional

CT-guided microcoil localization of pulmonary nodules before VATS: clinical experience in 1059 patients

Authors: Libao Hu, Jian Gao, Nan Hong, Huixin Liu, Xin Zhi, Jian Zhou

Published in: European Radiology | Issue 3/2024

Abstract

Objective

To retrospectively evaluate the efficacy and safety of CT-guided microcoil localization of pulmonary nodules before video-assisted thoracoscopic surgery (VATS).

Methods

A total of 1059 consecutive patients with 1331 pulmonary nodules treated between July 2018 and April 2021 were included in this study. Of the 1331 nodules, 1318 were localized using the tailed method and 13 were localized using the non-tailed method. The localization technical success rate and complications of the microcoil localization procedure were assessed. Univariate and multivariate logistic regression analyses were used to determine potential risk factors for technical failure, pneumothorax, and pulmonary hemorrhage.

Results

The technical success rate of the localization procedure was 98.4% (1310/1331 nodules). Nodule location in the lower lobes (p = 0.015) and need for a longer needle path (p < 0.001) were independent predictors of technical failure. All localization procedure–related complications were minor (grade 1 or 2) adverse events, with the exception of one grade 3 complication. The most common complications were pneumothorax (302/1331 nodules [22.7%]) and pulmonary hemorrhage (328/1331 nodules [24.6%]). Male sex (p = 0.001), nodule location in the middle (p = 0.003) and lower lobes (p = 0.025), need for a longer needle path (p < 0.001), use of transfissural puncture (p = 0.042), and simultaneous multiple localizations (p < 0.001) were independent risk factors for pneumothorax. Female sex (p = 0.015), younger age (p = 0.023), nodules location in the upper lobes (p = 0.011), and longer needle path (p < 0.001) were independent risk factors for pulmonary hemorrhage.

Conclusions

CT-guided microcoil localization of pulmonary nodules before VATS using either the tailed or non-tailed method is effective and safe.

Clinical relevance statement

CT-guided microcoil localization of pulmonary nodules before VATS resection is effective and safe when using either the tailed or non-tailed method. Nodules requiring transfissural puncture and multiple nodules requiring simultaneous localizations can also be successfully localized with this method.

Key Points

• Pre-VATS CT-guided microcoil localization of pulmonary nodules by tailed or non-tailed method was effective and safe.

• When the feasible puncture path was beyond the scope of wedge resection, localization could be performed using the non-tailed method.

• Although transfissural puncture and simultaneous multiple localization were independent risk factors for pneumothorax, they remained clinically feasible.

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Title: CT-guided microcoil localization of pulmonary nodules before VATS: clinical experience in 1059 patients
Authors: Libao Hu
Jian Gao
Nan Hong
Huixin Liu
Xin Zhi
Jian Zhou
Publication date: 01-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Pulmonary Nodule
Pulmonary Hemorrhage
Pneumothorax
Pneumothorax
Pneumothorax
Computed Tomography
Computed Tomography
Published in: European Radiology / Issue 3/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10152-x

2024 ASCO Annual Meeting

Springer Medicine

CT-guided microcoil localization of pulmonary nodules before VATS: clinical experience in 1059 patients

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance statement

Key Points

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

Clinical relevance statement

Key Points

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