Computed tomography-guided localization for lung nodules: methylene-blue versus coil localization

Sun, Shihang; Gao, Jingli; Zeng, Xiangmin; Zhang, Yunfeng

doi:10.1080/13645706.2020.1725579

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…Hook-wire has been widely used for deeper lesions (24), but is not suitable for multiple nodule localization due to high risk of dislodgement [ranged from 2.4 to 7.5% (25,26)], pulmonary hemorrhage and pneumothorax (13), especially when patient reposition is required during localization procedure. Although metallic microcoil allows multiple lesions to be localized, it is technically demanding (27), since intraoperative fluoroscopic guidance would be necessary, increasing radiation exposure to both the patient and the operator (28). In addition, microcoils are more expensive than methylene blue.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography-Guided Methylene Blue Localization: Single vs. Multiple Lung Nodules

et al. 2021

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Background: Preoperative localization for small invisible and impalpable pulmonary nodules is important in single-port video-assisted thoracoscopic surgery (VATS). Localization of multiple pulmonary nodules during VATS resection remains challenging. The aim of our study is to elucidate the efficacy of preoperative CT-guided methylene blue localization of both single and multiple pulmonary nodules.Methods: Consecutive patients undergoing preoperative CT-guided methylene blue dye localization for lung nodules, followed by VATS resection, were retrospectively analyzed between January 2014 and November 2019. Chi-square tests, Fisher's exact test and independent T-test were used to compare variables between the groups. Logistic regression was used to identify risk factors for procedure-related complications.Results: A total of 388 patients, including 337 with single nodule and 51 with multiple nodules, were analyzed. The success rate of preoperative CT-guided methylene blue localization for both single and multiple pulmonary nodules were comparable as 98.8% (333/337) vs. 100% (108/108). The procedure time was longer (23.2 ± 9.4 vs. 7.6 ± 4.8 min, p < 0.001) and risk of pneumothorax was higher (47.1 vs. 25.5%, p = 0.002) in the multiple nodule group. The procedure time (OR 1.079; 95% CI = 1.041–1.118; p < 0.001) was an independent risk factor for pneumothorax. Nodule depth (OR 2.829; 95% CI = 1.259–6.356; p = 0.011) was an independent risk factor for pulmonary hemorrhage.Conclusions: Preoperative CT-guided methylene blue localization for both single and multiple pulmonary nodules is safe, feasible, and effective.

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Section: Discussionmentioning

confidence: 99%

Computed Tomography-Guided Methylene Blue Localization: Single vs. Multiple Lung Nodules

et al. 2021

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“…There are a number of possible reasons for the shorter procedure time. First, dye injection is easier than the placement of metallic devices such as coils, which may be technically demanding [ 22 ]. Second, our patients did not change positions in the simultaneous method.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Patent Blue Dye Injections Aid in the Preoperative CT-Guided Localization of Multiple Pulmonary Nodules

et al. 2022

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Background and Objectives: Clinically, a major challenge of multiple nodule localization is puncture-related pneumothorax, which may hamper the successful localization. This study aims to investigate and compare the efficacy and safety of the simultaneous and sequential patent blue dye (PBD) injections for identifying multiple pulmonary nodules during preoperative CT-guided localization. Materials and Methods: Sixty-one consecutive patients with multiple pulmonary nodules who underwent preoperative CT-guided localization with PBD injections between January 2020 and December 2020 were retrospectively enrolled. Of these patients, 31 patients with 64 nodules who underwent simultaneous injections were designated as the simultaneous group; the remaining 30 patients with 63 nodules who underwent sequential punctures were designated as the sequential group. The clinical and radiological features, technical information, pathological results, and procedure-related variables and complications of the two groups were reviewed and analyzed. Results: The localization success rate of the simultaneous group was higher than that of the sequential group (100% [64/64] vs. 93.7% [59/63], p = 0.041). The incidences of pneumothorax (32.3 vs. 33.3%, p = 0.929) and pulmonary hemorrhage (6.3 vs. 3.0%, p = 1) were not significantly different between the two groups, and all cases were minor, which did not require further intervention. Additionally, a significantly lower radiation dose (2.7 vs. 3.5 mSv, p = 0.001) and a shorter procedure time (20.95 vs. 25.28 min, p = 0.001) were observed in the simultaneous group than in the sequential group. Conclusions: Compared with the sequential method, simultaneous PBD injections may improve the localization success rate with a shorter procedure time and less radiation exposure if the patient with multiple pulmonary nodules can be approached in a single position. Further prospective studies are needed to validate these results.

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“…It is not clear which of these or other procedures are the most effective and safe. [44][45][46][47][48] The majority of comparative trials show them to be equivalent with possibly more side-effects from wire insertion but a shorter surgical time. 45,49 Most of the comparative trials have been in the context of localising small subsolid lesions where resection is often not indicated unless the lesion is part-solid and growing.…”

Section: Management Of Incidental Findingsmentioning

confidence: 99%

An update on CT screening for lung cancer: the first major targeted cancer screening programme

Baldwin

Callister

2020

BJR

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Screening for lung cancer with low radiation dose CT has been shown to be effective in reducing lung cancer mortality by two major randomised controlled trials. Lung cancer screening is set to become the largest targeted cancer screening programme globally, but the effectiveness of the programme is dependent on many different factors. This article describes the key evidence for lung cancer screening, the key factors important for optimisation and the progress towards implementation.

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Computed tomography-guided localization for lung nodules: methylene-blue versus coil localization

Cited by 12 publications

References 17 publications

Computed Tomography-Guided Methylene Blue Localization: Single vs. Multiple Lung Nodules

Computed Tomography-Guided Methylene Blue Localization: Single vs. Multiple Lung Nodules

Simultaneous Patent Blue Dye Injections Aid in the Preoperative CT-Guided Localization of Multiple Pulmonary Nodules

An update on CT screening for lung cancer: the first major targeted cancer screening programme

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