CT localization for a patient with a ground-glass opacity pulmonary nodule expecting thoracoscopy: a mixture of lipiodol and India ink

Abstract

Small and deeply seated pure ground-glass opacity (GGO) pulmonary nodules (PNs) are not discernible during video-assisted thoracoscopic surgery (VATS). Moreover, pathologists have difficulty in detecting these nodules due to insufficient localization. We percutaneously injected a mixture of lipiodol and India ink during preoperative CT-guided localization in a 52-year-old female patient presenting with a pure GGO PN. A black-pigmented tattoo lesion was clearly identified, and thoracoscopic wedge resection was performed without difficulty. Pathologic results were also discernible, thus allowing the target lesion to be identified without interruption for microscopic analysis. We introduce a novel method using a mixture of lipiodol and India ink with satisfactory results for preoperative localization of GGO PNs prior to VATS.

Phase Transition Nanoparticles as Multimodality Contrast Agents for the Detection of Thrombi and for Targeting Thrombolysis: in Vitro and in Vivo Experiments

“…As an optical absorber of the droplets, India ink has been extensively used in the clinic owing to its intrinsic properties, which include outstanding stability, easy accessibility, low cost, and nontoxicity. , India ink exhibits strong absorption in the visible and near-infrared regions. Owing to its large absorption coefficient, India ink can offer excellent PA contrast .…”

The feasibility of electromagnetic navigational bronchoscopic localization with fluorescence and radiocontrast dyes for video-assisted thoracoscopic surgery resection

“…Although percutaneous localization with dye (methylene blue) showed more than 80-90% success rate in published series (23,37), there have been unsolved problems, such as limited time interval between dye injection and operation (within 3 hours) to minimize dye diffusion, and lack of information about the accurate depth of the resection margin. CTguided localization using hook wire or microcoils (38,39), radiolabeled aggregates (40,41), and lipiodol (42,43) also showed approximately 90-100% success rate with acceptable outcomes in randomized trials; however, these procedures are associated with a risk of procedure-related complications, namely pneumothorax, hemothorax, or for lipiodol, embolism. Microcoils or hook wires might also be displaced or dislodged in about 2-10% of cases (44).…”

Localization Technique Using Mixture of Indigo Carmine and Lipiodol of Pulmonary Nodule via Bronchoscopic Navigation

“…Because hydrophobic and hydrophilic liquids cannot be easily commingled together, the MIL was made using a three-way stopcock and two syringes, and it was mixed 50 times to commingle the liquids together [30][31][32]. As the interval duration increased, the mixtures became separated, followed by the problem of excessive diffusion of the dye.…”