Computed tomography-guided indocyanine green localization of multiple ipsilateral lung nodules.

Abstract

Introduction: Approximately 20% of lung nodule (LN) patients have more than one moderate-to-high malignant risk LNs. When performing one-stage video-assisted thoracoscopic surgery (VATS) in patients with multiple LNs, the ability to simultaneously localize all of these nodules is critical to operative success. Aim: To explore the efficacy and safety of computed tomography (CT)-guided indocyanine green (IG) localization for multiple ipsilateral LNs. Material and methods: This was a retrospective study of 278 LN patients who underwent CT-guided IG localization prior to VATS resection. Of these patients, 68 underwent localization of multiple ipsilateral LNs, whereas 210 underwent localization of a single LN.Results: In total, 160 LNs were localized in 68 patients in the multiple localization group, while one LN was localized for each of the 210 patients in the single localization group. A 100% technical success rate was achieved in both of these groups, and the mean respective localization durations in the multiple and single LN groups were 11.3 ±4.7 min and 6.3 ±2.7 min (p = 0.001). Of the patients in the multiple and single LN groups, 22 and 15, respectively, experienced pneumothorax (p = 0.001), while 14 and 20 experienced lung hemorrhage (p = 0.016). Wedge/segmental LN technical success rates in both of these groups were 100%. Conclusions: The CT-guided IG-mediated localization of multiple ipsilateral LNs is a safe and effective strategy, although it requires a longer operative duration and is associated with higher rates of adverse events as compared to single nodule localization.

Comparison of indocyanine green and blue-stained glue for preoperative localization for pulmonary nodules

“…A range of solid localization materials have been employed for CT-guided PN localization in recent years, including hook-wire, coil, and radiolabeling materials ( 7 , 8 , 13 ). Several reports, however, have emphasized the advantages of utilizing liquid-based localization materials ( 14 , 15 ), as they are less expensive, easier to utilize, and associated with higher localization success rates as well as lower rates of complications as compared to solid materials ( 9 , 10 , 14 ).…”

“…IG-based localization depends strongly on effectively controlling the IG volume ( 14 , 15 ). Injecting excessive liquid volumes can result in the overflow of these materials, while a volume of ~0.3 mL is reportedly sufficient ( 14 , 15 ). Here, 0.15 ml of IG was injected into these patients and this was sufficient to achieve effective localization.…”

“…IG-based localization depends strongly on effectively controlling the IG volume (14,15). Injecting excessive liquid volumes can result in the overflow of these materials, while a volume of ~0.3 mL is reportedly sufficient (14, 15).…”

Comparison of indocyanine green and blue-stained glue for preoperative localization for pulmonary nodules

“…IG-based localization depends strongly on effectively controlling the IG volume [14,15]. Injecting excessive liquid volumes can result in the over ow of these materials, while a volume of ~ 0.3 mL is reportedly su cient [14,15]. Here, 0.15 ml of IG was injected into these patients and this was su cient to effective localization.…”

“…A range solid localization materials have been employed for CT-guided PN localization in recent years, including hook-wire, coil, and radiolabeling materials [7,8,13]. Several reports, however, have emphasized the advantages of utilizing liquid-based localization materials [14,15], as they are less expensive, easier to utilize, and associated with higher localization success rates as well as lower rates of complications as compared to solid materials [9,10,14].…”