A pilot study of intraoperative localization of peripheral small pulmonary tumors by cone-beam computed tomography: sandwich marking technique

Abstract

Background: Intraoperative identification of small pulmonary nodules has been an important technical issue. We aimed to develop a new localization method which is much safer and simple procedure compared with conventional methods.Methods: This was a retrospective study including patients with resected peripheral pulmonary nodules between

Arterial Embolization and Cone-Beam Computed Tomography-Guided Lung Resection for Anomalous Systemic Arterial Blood Supply to Normal Lung: Two Case Reports

“…We have also verified feasibility with X-ray dosimeter. 12) This time we used it to confirm accurate cutting line with metal clip markers to avoid running over emboli with the stapler.…”

Registration of 2D monocular endoscopy to 3D CBCT for video-assisted thoracoscopic surgery

“…However these strategies require an additional pre-or intraoperative procedure with possible complications which significantly increase the length and complexity of the surgery. Intraoperative imaging has become an alternative to preoperative marking using ultrasound 3 or Cone Beam CT (CBCT) 4,5 . When the nodule is difficult to localize, several registration methods have been proposed to map the preoperative nodule location on US or CBCT intraoperative images, and have been evaluated on animals 6 or retrospective clinical cases 7,8 .…”

Cone beam computed tomography—the need for future guidance

“…The current study by Saito and colleagues (12) further improved on the intraoperative localization of small peripheral pulmonary tumors by using a sandwich marking technique in combination with CBCT. In this pilot investigation, metal clips were placed in several places of visceral pleura, where the target lesion was sandwiched by marking clips.…”

“…Shielding alone decreases the absorption of non-scattered radiation by up to 95% ( 17 ). As suggested in the Saito manuscript, more clinical experience could facilitate the identification of target lesions with fewer scans, and thereby reduce the radiation exposure of patients ( 12 ). The authors also recommend additional research to compare radiation exposure among the different marking methods for CBCT.…”