Thorac Cardiovasc Surg 2024; 72(07): 550-556
DOI: 10.1055/a-2168-9230
Original Thoracic

Outcomes of CT-Guided Deeper Localization Technique for Superficial Pulmonary Nodules

Jingpeng Wu
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
,
Ye Tian
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
,
Jianli An
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
,
Zibo Zou
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
,
Yanchao Dong
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
,
Zhuo Chen
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
,
Hongtao Niu
1   Department of Interventional Treatment, First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, People's Republic of China
› Author Affiliations
Funding The Qinhuangdao Science-Technology Support Projects of China (202101A205).

Abstract

Background The possibility of coil dislocation in computed tomography (CT)-guided microcoil localization of superficial pulmonary nodules is relatively high. The aim of the study is to investigate the outcomes of deeper localization technique during CT-guided microcoil localization of superficial pulmonary nodules before video-assisted thoracoscopic surgery (VATS).

Methods Fifty-seven identified superficial pulmonary nodules (nodule–pleural distance ≤ 1 cm on CT image) from 51 consecutive patients underwent CT-guided microcoil localization, and subsequent VATSs were included. The rate of technical success, complications, and excised lung volume were compared between deeper localization technique group and conventional localization technique group.

Results The technical success rate of the localization procedure was 100% (25/25) in the deeper localization group and 81.3% (26/32) in the conventional localization group (p = 0.030). Excluding one case of lobectomy, the excised lung volume in the deeper localization group and the conventional localization group was 39.3 ± 23.5 and 37.2 ± 16.2 cm3, respectively (p = 0.684). The incidence of pneumothorax was similar between the deeper localization group and the conventional localization group (24.0 vs. 21.9%, respectively, p = 0.850). The incidence of intrapulmonary hemorrhage in the deeper localization group was higher (16.0%) than that in the conventional localization group (6.3%), but the difference was not statistically significant (p = 0.388).

Conclusion CT-guided microcoil localization of superficial pulmonary nodules prior to VATS using a deeper localization technique is feasible. Deeper localization technique reduced the occurrence of dislocation but did not increase excised lung volume.

Authors' Contribution

H.T.N., J.P.W., and T.Y. conceptualized and designed the work; data collection was done by all authors; analysis and interpretation of the data by Y.C.D. and T.Y.; statistical analysis by Y.C.D. and Z.C.; drafting the manuscript by J.P.W., Z.B.Z., and J.L.A.; and critical revision of the manuscript by J.L.A., Z.B.Z., Z.C., and H.T.N.




Publication History

Received: 12 June 2023

Accepted: 05 September 2023

Accepted Manuscript online:
06 September 2023

Article published online:
23 October 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Qiang Y, Zhang L, Yang N. et al. Diagnostic and therapeutic value of computed tomography guided coil placement after digital subtraction angiography guided video-assisted thoracoscopic surgery resection for solitary pulmonary nodules. Transl Lung Cancer Res 2015; 4 (05) 598-604
  • 2 Suzuki K, Nagai K, Yoshida J. et al. Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest 1999; 115 (02) 563-568
  • 3 Jin X, Wang T, Chen L. et al. Single-stage pulmonary resection via a combination of single hookwire localization and video-assisted thoracoscopic surgery for synchronous multiple pulmonary nodules. Technol Cancer Res Treat 2021; 20: 15 330338211042511
  • 4 Li CD, Huang ZG, Sun HL, Wang LT, Wang YL. CT-guided preoperative localization of ground glass nodule: comparison between the application of embolization microcoil and the locating needle designed for pulmonary nodules. Br J Radiol 2021; 94 (1123) 20210193
  • 5 Chen J, Pan X, Gu C. et al. The feasibility of navigation bronchoscopy-guided pulmonary microcoil localization of small pulmonary nodules prior to thoracoscopic surgery. Transl Lung Cancer Res 2020; 9 (06) 2380-2390
  • 6 Hasegawa T, Kuroda H, Chatani S. et al. Comparison of radiopaque dye materials for localization of pulmonary nodules before video-assisted thoracic surgery. J Thorac Dis 2020; 12 (05) 2070-2076
  • 7 Jangra D, Powell T, Kalloger SE. et al. CT-directed microcoil localization of small peripheral lung nodules: a feasibility study in pigs. J Invest Surg 2005; 18 (05) 265-272
  • 8 Finley RJ, Mayo JR, Grant K. et al. Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial. J Thorac Cardiovasc Surg 2015; 149 (01) 26-31
  • 9 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 (03) 292-297
  • 10 McGuire AL, Vieira A, Grant K. et al. Computed tomography-guided platinum microcoil lung surgery: a cross-sectional study. J Thorac Cardiovasc Surg 2019; 158 (02) 594-600
  • 11 Xu Y, Ma L, Sun H. et al. CT-guided microcoil localization for pulmonary nodules before VATS: a retrospective evaluation of risk factors for pleural marking failure. Eur Radiol 2020; 30 (10) 5674-5683
  • 12 Huang ZG, Wang CL, Sun HL. et al. CT-guided microcoil localization of small peripheral pulmonary nodules to direct video-assisted thoracoscopic resection without the aid of intraoperative fluoroscopy. Korean J Radiol 2021; 22 (07) 1124-1131
  • 13 National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v4.0. 2009. Accessed June 12, 2023; available at: https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03/Archive/CTCAE_4.0_2009-05-29_QuickReference_8.5x11.pdf
  • 14 Seo JM, Lee HY, Kim HK. et al. Factors determining successful computed tomography-guided localization of lung nodules. J Thorac Cardiovasc Surg 2012; 143 (04) 809-814
  • 15 Huang ZG, Wang CL, Sun HL, Qin SZ, Li CD, Gao BX. CT-guided microcoil localization of pulmonary nodules: the effect of the position of microcoil proximal end on the incidence of microcoil dislocation. Br J Radiol 2022; 95 (1129) 20200381
  • 16 Hu L, Gao J, Hong N. et al. Simultaneous preoperative computed tomography-guided microcoil localizations of multiple pulmonary nodules. Eur Radiol 2021; 31 (09) 6539-6546
  • 17 Park CH, Han K, Hur J. et al. Comparative effectiveness and safety of preoperative lung localization for pulmonary nodules: a systematic review and meta-analysis. Chest 2017; 151 (02) 316-328
  • 18 Sui X, Zhao H, Yang F, Li JL, Wang J. Computed tomography guided microcoil localization for pulmonary small nodules and ground-glass opacity prior to thoracoscopic resection. J Thorac Dis 2015; 7 (09) 1580-1587