Identification of Small Lung Nodules: Technique of Radiotracer-Guided Thoracoscopic Biopsy

Grogan, Eric L.; Jones, David R.; Kozower, Benjamin D.; Simmons, Winsor; Daniel, Thomas M.

doi:10.1016/j.athoracsur.2007.10.105

Cited by 76 publications

(60 citation statements)

References 10 publications

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“…Based on the outcome of this study a comparative or a randomised study could be set up to evaluate this technique further and before it can be recommended for routine use in patients presenting with small lung nodules. Finally, our findings are in keeping with the conclusions of larger studies available in the international literature (16)(17)(18).…”

Section: Discussionsupporting

confidence: 79%

99mTechnetium and methylene blue guided pulmonary nodules resections: preliminary British experience

et al. 2018

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Background: Subcentimetre pulmonary nodules can be challenging to locate either during video-assisted thoracoscopic surgery (VATS) or by open techniques. In an era of increasing computed tomography scan availability the number of nodules that are identified that are suspicious for malignancy is rising, and thoracic surgeons require a reliable method to locate these nodules intraoperatively.Methods: Our aim was to evaluate, for the first time in the UK, resection of pulmonary nodules using radioactive dye labelling. Local research ethics approval was obtained and the study was submitted to the Integrated Research Application System (IRAS). All data were prospectively collected in our dedicated thoracic surgical database and analyzed at the conclusion of the study. This represents a consecutive series of patients, from January 2016 and until April 2017, who underwent this procedure at our institution: James Cook University Hospital, Middlesbrough, United Kingdom. The primary outcome measured was successful resection rate of the target nodules.Results: Twenty-three patients underwent radiolabeled excision of pulmonary nodules, their average age was 61 years (range, 28-79 years), 13 women and 10 men. The average maximum diameter of the nodule was 8 mm (range, 3-16 mm). All patients underwent successful excision of the target lesion (success rate 100%).One patient (4.3%) sustained pneumothorax following the CT-guided injection of the radio-labelled dye and this required chest drainage prior to general anesthesia. Conclusions:We conclude that technetium guided pulmonary nodule resection is a very reliable method for localization and resection of subcentimetre nodules which may be otherwise be difficult to identify.

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Section: Discussionsupporting

confidence: 79%

99mTechnetium and methylene blue guided pulmonary nodules resections: preliminary British experience

et al. 2018

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“…1 A CT scan of a typical lesion that requires preoperative marking. B After CT-guided injection, the correct placement of the radiotracer within the nodule is confirmed by contrast material enhancement Mean resection margin (range) 13 mm (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) allow localization of the target. Post-CT-guided injection pneumothorax occurred in this patient, and it was probably responsible for such an unsuccessful case.…”

Section: Resultsmentioning

confidence: 99%

Radio-guided thoracoscopic surgery (RGTS) of small pulmonary nodules

et al. 2011

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“…To overcome this difficulty, various percutaneous techniques have been developed to localize SPNs, such as computed tomography (CT)-guided radiotracer injection [6], CT-guided wire localization [7], CT-guided fiducial placement and fluoroscopic localization [8], ultrasonography [9], or CT-guided methylene blue injection [10]. Because these percutaneous localization techniques are often performed in radiology departments located far from the operating room (OR), coordination between radiologists, anesthesiologists, and thoracic surgeons is crucial.…”

Section: Introductionmentioning

confidence: 99%

Pleural Dye Marking Using Radial Endobronchial Ultrasound and Virtual Bronchoscopy before Sublobar Pulmonary Resection for Small Peripheral Nodules

et al. 2018

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Background: Minimally invasive surgery of pulmonary nodules allows suboptimal palpation of the lung compared to open thoracotomy. Objective: The objective of this study was to assess endoscopic pleural dye marking using radial endobronchial ultrasound (r-EBUS) and virtual bronchoscopy to localize small peripheral lung nodules immediately before minimally invasive resection. Methods: The endoscopic procedure was performed without fluoroscopy, under general anesthesia in the operating room immediately before minimally invasive surgery. Then, 1 mL of methylene blue (0.5%) was instilled into the guide sheath, wedged in the subpleural space. Wedge resection or segmentectomy were guided by visualization of the dye on the pleural surface. Contribution of dye marking to the surgical procedure was rated by the surgeon. Results: Twenty-five nodules, including 6 ground glass opacities, were resected in 22 patients by video-assisted thoracoscopic wedge resection (n = 11) or robotic-assisted thoracoscopic surgery (10 segmentectomies and 1 wedge resection). The median greatest diameter of nodules was 8 mm. No conversion to open thoracotomy was needed. The endoscopic procedure added an average 10 min to surgical resection. The dye was visible on the pleural surface in 24 cases. Histological diagnosis and free margin resection were obtained in all cases. Median skin-to-skin operating time was 90 min for robotic segmentectomy and 40 min for video-assisted wedge resection. The same operative precision was considered impossible by the surgeon without dye marking in 21 cases. Conclusions: Dye marking using r-EBUS and virtual bronchoscopy can be easily and safely performed to localize small pulmonary nodules immediately before minimally invasive resection.

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Identification of Small Lung Nodules: Technique of Radiotracer-Guided Thoracoscopic Biopsy

Cited by 76 publications

References 10 publications

99mTechnetium and methylene blue guided pulmonary nodules resections: preliminary British experience

99mTechnetium and methylene blue guided pulmonary nodules resections: preliminary British experience

Radio-guided thoracoscopic surgery (RGTS) of small pulmonary nodules

Pleural Dye Marking Using Radial Endobronchial Ultrasound and Virtual Bronchoscopy before Sublobar Pulmonary Resection for Small Peripheral Nodules

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