Background To assess relative safety and diagnostic performance for low- and standard-dose computed tomography (CT)-guided core needle biopsy (CNB) for lung nodules (LNs). Materials and Methods This is a prospective randomized controlled trial (RCT) from a single-center. From June 2020 to December 2020, consecutive patients with LNs were randomly assigned into low- or standard-dose groups. The primary outcome was diagnosis accuracy, while secondary outcomes encompassed technical success, diagnostic yield, operative time, radiation dose, and CNB-related complications. This RCT was listed within ClinicalTrials.gov (NCT04217655), registered 3 January 2020. Results A total of 200 patients were randomly assigned to low-dose (n = 100) and standard-dose (n = 100) groups. All patients achieved technical success of CT-guided CNB and the definite final diagnoses. No significant difference was found for operative times (n = 0.231) between 2 groups. The mean dose-length product was markedly reduced within low-dose group in comparison to standard-dose group (34.6 ± 11.1 vs. 351.4 ± 107.4 mGy-cm, P < 0.001). Within low-dose group, the diagnostic yield, sensitivity, specificity, and diagnosis accuracy were 68%, 91.5%, 100%, and 94%, respectively. Within standard-dose group, the diagnostic yield, sensitivity, specificity, and diagnosis accuracy were 65%, 88.6%, 100%, and 92%, respectively. There were no significances in diagnostic yield (P = 0.653) and diagnostic accuracy (P = 0.579) between 2 groups. No significant differences within rates of pneumothorax (P = 0.836) and lung hemorrhage (P = 0.744) between 2 groups were observed. Conclusions Compared with standard-dose CT-guided CNB for LNs, low-dose CT can significantly reduce radiation dose, while yield comparable safety and diagnostic accuracy.

Background To assess relative safety and diagnostic performance of low- and standard-dose computed tomography (CT)-guided biopsy for pulmonary nodules (PNs). Materials and methods This was a single-center prospective randomized controlled trial (RCT). From June 2020 to December 2020, consecutive patients with PNs were randomly assigned into low- or standard-dose groups. The primary outcome was diagnosis accuracy. The secondary outcomes included technical success, diagnostic yield, operation time, radiation dose, and biopsy-related complications. This RCT was registered on 3 January 2020 and listed within ClinicalTrials.gov (NCT04217655). Results Two hundred patients were randomly assigned to low-dose (n = 100) and standard-dose (n = 100) groups. All patients achieved the technical success of CT-guided biopsy and definite final diagnoses. No significant difference was found in operation time (n = 0.231) between the two groups. The mean dose-length product was markedly reduced within the low-dose group compared to the standard-dose group (31.5 vs. 333.5 mGy-cm, P < 0.001). The diagnostic yield, sensitivity, specificity, and accuracy of the low-dose group were 68%, 91.5%, 100%, and 94%, respectively. The diagnostic yield, sensitivity, specificity, and accuracy were 65%, 88.6%, 100%, and 92% in the standard-dose group. There was no significant difference observed in diagnostic yield (P = 0.653), diagnostic accuracy (P = 0.579), rates of pneumothorax (P = 0.836), and lung hemorrhage (P = 0.744) between the two groups. Conclusions Compared with standard-dose CT-guided biopsy for PNs, low-dose CT can significantly reduce the radiation dose, while yielding comparable safety and diagnostic accuracy.

Background Preoperative computed tomography (CT)-guided localization has been used to guide the video-assisted thoracoscopic surgery (VATS) sublobar (wedge or segmental) resection for pulmonary nodules (PNs). We aimed to assess the relative efficacy and safety of CT-guided methylene blue (MB)- and coil-based approaches to the preoperative localization of multiple PNs (MPNs). Methods Between January 2015 and December 2020, 31 total cases suffering from MPNs at our hospital underwent CT-guided localization and subsequent VATS resection in our hospital, of whom 15 and 16 respectively underwent MB localization (MBL) and coil localization (CL). The clinical effectiveness and complication rates were compared between 2 groups. Results The PN- and patient-based technical success rates in the MBL group were both 100%, whereas in the CL group they were 97.2% (35/36) and 93.8% (15/16), respectively, with no substantial discrepancies between groups. Patients in the MBL group illustrated a substantially shorter CT-guided localization duration compared with the CL group (18 min vs. 29.5 min, P < 0.001). Pneumothorax rates (P = 1.000) and lung hemorrhage (P = 1.000) were comparable in both groups. In the MBL and CL groups, the median interval between localization and VATS was 1 h and 15.5 h, respectively (P < 0.001). One-stage VATS sublobar resection of the target nodules was successfully performed in all patients from both groups. Conclusion Both CT-guided MBL and CL can be readily and safely utilized for preoperative localization in individuals who had MPNs, with MBL being correlated with a shorter localization duration compared with CL.

Background Preoperative computed tomography (CT)-guided localization has been used to guide the video-assisted thoracoscopic surgery (VATS) sublobar (wedge or segmental) resection for pulmonary nodules (PNs). We aimed to assess the relative efficacy and safety of CT-guided methylene blue (MB)- and coil-based approaches to the preoperative localization of multiple PNs (MPNs). Methods Between January 2015 and December 2020, 31 total cases suffering from MPNs at our hospital underwent CT-guided localization and subsequent VATS resection in our hospital, of whom 15 and 16 respectively underwent MB localization (MBL) and coil localization (CL). The clinical effectiveness and complication rates were compared between 2 groups. Results The PN- and patient-based technical success rates in the MBL group were both 100%, whereas in the CL group they were 97.2% (35/36) and 93.8% (15/16), respectively, with no substantial discrepancies between groups. Patients in the MBL group illustrated a substantially shorter CT-guided localization duration compared with the CL group (20.1 min vs. 32.5 min, P < 0.001). Pneumothorax rates (P = 1.000) and lung hemorrhage (P = 1.000) were comparable in both groups. In the MBL and CL groups, the mean interval between localization and VATS was 1.2 h and 11.7 h, respectively (P < 0.001). One-stage VATS sublobar resection of the target nodules was successfully performed in all patients from both groups. Conclusion Both CT-guided MBL and CL can be readily and safely utilized for preoperative localization in individuals who had MPNs, with MBL being correlated with a shorter localization duration compared with CL.

Background: To assess relative safety and diagnostic performance for low- and standard-dose computed tomography (CT)-guided core needle biopsy (CNB) for lung nodules (LNs).Materials and Methods: This is a prospective randomized controlled trial (RCT) from a single-center. From June 2020 to December 2020, consecutive patients with LNs were randomly assigned into low- or standard-dose groups. The primary outcome was diagnosis accuracy, while secondary outcomes encompassed technical success, diagnostic yield, operative time, radiation dose, and CNB-related complications. This RCT was listed within ClinicalTrials.gov (NCT04217655), registered 3 January 2020. Results: A total of 200 patients were randomly assigned to low-dose (n = 100) and standard-dose (n = 100) groups. All patients achieved technical success of CT-guided CNB and the definite final diagnoses. No significant difference was found for operative times (n = 0.231) between 2 groups. The mean dose-length product was markedly reduced within low-dose group in comparison to standard-dose group (34.6 ± 11.1 vs. 351.4 ± 107.4 mGy-cm, P < 0.001). Within low-dose group, the diagnostic yield, sensitivity, specificity, and diagnosis accuracy were 68%, 91.5%, 100%, and 94%, respectively. Within standard-dose group, the diagnostic yield, sensitivity, specificity, and diagnosis accuracy were 65%, 88.6%, 100%, and 92%, respectively. There were no significances in diagnostic yield (P = 0.653) and diagnostic accuracy (P = 0.579) between 2 groups. No significant differences within rates of pneumothorax (P = 0.836) and lung hemorrhage (P = 0.744) between 2 groups were observed.Conclusions: Compared with standard-dose CT-guided CNB for LNs, low-dose CT can significantly reduce radiation dose, while yield comparable safety and diagnostic accuracy.