Preoperative Computed Tomography-Guided Pulmonary Lesion Marking in Preparation for Fluoroscopic Wedge Resection—Rates of Success, Complications, and Pathology Outcomes

Olaiya, Babatunde; Gilliland, Charles A.; Force, Seth D.; Fernández, Félix G.; Sancheti, Manu S.; Small, William

doi:10.1067/j.cpradiol.2017.10.012

Cited by 6 publications

(16 citation statements)

References 17 publications

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“…In cases with an increasing number of nodules, therapeutic or diagnostic resection needs to be considered. Although CT-assisted percutaneous marking using lipiodol or wire might be most commonly used for non-palpable nodules located more than 1 cm deep within the visceral pleura, pneumothorax could occur in about 15% of cases, and lipiodol could be spilled into pleural cavity, which might cause pleuritic chest pain and the wire could become dislodged (3,6,(10)(11)(12)(13)(14). With lipiodol marking, exposure of radiation cannot be avoidable for the patient and operating team (12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Since peripheral lung lesions located more than 1 cm deep within the visceral pleura can be frequently visualized on computed tomography (CT), various methods of localization for thoracoscopic surgery have been developed, such as transthoracic needle localization or dye injection through bronchoscopy (1)(2)(3)(4)(5)(6)(7). With the methods that use transthoracic percutaneous localization, the occurrence of post-procedural complications, such as pneumothorax or bleeding, is possible (1,3,6). In the case of transbronchial dye injection (TDI) via bronchoscopy, the aforementioned Original Article complications do not occur based on several articles (7,8); however, there can be difficulties with dye visualization through the thoracoscope depending on early disappearance of the dye due to diffusion before field exposure (1,(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of factors affecting the visualization of dye after transbronchial dye injection: an animal experiment

et al. 2020

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Background: Since peripheral lung lesions can be frequently visualized on computed tomography (CT), various methods of localization for thoracoscopic surgery have been developed. In the case of transbronchial dye injection (TDI), there can be difficulties with dye visualization through the thoracoscope depending on early disappearance of the dye due to diffusion before field exposure. Herein, we performed an animal experiment to determine the appropriate dye amount and the duration of visualization.Methods: Twelve pigs were experimented as following four groups (n=3): group 1 received 0.6 mL of dye; group 2 as 0.8 mL; and group 3 as 1.0 mL, all followed by 2.0 mL of air injection and group 4, with 1.0 mL of dye followed no air injection to evaluate the utility of air injection. The detection, the peak time, the washout time were measured. Results:The mean detection times, the peak time, and the mean wash-out times for 0.6, 0.8, and 1.0 mL of dye were not significantly different (P=0.195, 0.092, 0.06). However, regardless of the injected amount, it usually lasts in 2 hours. Comparing with non-air injection group, the peak time and wash-out time were statistically significantly different in injected group; P=0.07 and 0.001. Conclusions:The marking could be identified clearly at about 2 hours after TDI regardless of the amount of indigo carmine injected. However, in cases with longer duration to exposure, especially in cases with severe adhesions, it might be necessary to discover the mixture of dye which will last longer for visualization of lung nodules.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of factors affecting the visualization of dye after transbronchial dye injection: an animal experiment

et al. 2020

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“…The use of minimally invasive, parenchymal-sparing surgery for the resection of small nodules has caused a paradigm shift, with the emergence of both image-guided and bronchoscopic techniques to aid in localization. To our knowledge, this is the largest study of preoperative CT-guided gold fiducial marker placement, a technique reported by only a couple of other institutions (10,11). Other studies have reported the use of percutaneously placed gold fiducial markers for nodule localization prior to radiation (12)(13)(14)(15)(16); however, the precise marker placement in or near the targeted nodule may not be as essential for radiation guidance as it is for surgical resection.…”

Section: Discussionmentioning

confidence: 94%

“…We had one case of embolization of a fiducial marker into the left ventricle via a peripheral pulmonary vein, without any long-term adverse effects. Although systemic embolization presents risks and should be prevented by avoiding the transgression of pulmonary venous structures, four other cases of embolization of fiducial markers have been described at other centers, without clinical consequences, including cases of migration to the heart and a coronary artery (10,11,24). We had four cases of inadvertent deployment of one or more fiducial marker(s) into the pleural space at the time of placement.…”

Section: Discussionmentioning

confidence: 99%

Preoperative CT-guided Fiducial Marker Placement for Surgical Localization of Pulmonary Nodules

McDermott

Frenk

Fintelmann

et al. 2022

Radiology: Cardiothoracic Imaging

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A dvances in CT technology, the greater use of CT in emergency departments, the implementation of lung cancer screening programs, and the more frequent depiction of nodules on any given scan (1) have resulted in an increased number of detected small pulmonary nodules that require surgery for diagnostic resection and treatment. Minimally invasive techniques for surgical resection, including videoassisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS), are associated with decreased morbidity and reduced recovery time and hospital stay without compromising patient care when compared with open thoracotomy (2-4). However, the surgical access ports used for VATS and RATS impede bimanual palpation of the lung parenchyma that facilitates nodule identification. Failed resection or conversion to open thoracotomy are the consequences of nodule localization failure (5). The need for the accurate localization of nodules has created an opportunity for interventional radiologists to aid in minimally invasive surgical resection. Preoperative localization of small, subsolid, or deep pulmonary nodules is performed through the image-guided placement of liquid or metal markers in or adjacent to the lung nodule (6).The percutaneous insertion of rodlike, gold fiducial markers is an easily implementable technique that is well tolerated by patients and can be performed on a separate day to surgical excision. The aim of this study was to evaluate the success rate of CT-guided percutaneous fiducial marker placement for nodule localization prior to surgical resection. The secondary aims were to evaluate the complication rates of fiducial marker placement and the rate of successful fiducial marker-guided, minimally invasive resection. Materials and MethodsThis Health Insurance Portability and Accountability Act-compliant, retrospective cohort study was performed at an academic medical center. Institutional review board approval was obtained for chart review, and the need for written informed consent was waived. Study SampleOver a 6-year period (September 18, 2014, to September 17, 2020, a search of the thoracic interventional radiology database identified 198 CT-guided fiducial marker placement procedures performed in 190 patients to localize 205 nodules prior to surgical resection, all of which were included in our study. The decision to request preoperative nodule localization was at the discretion of the This copy is for personal use only. To order printed copies, contact

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Efficacy of the tract embolization technique with gelatin sponge slurry to reduce pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy

Renier

Gérard

Lamborelle

et al. 2019

Cardiovasc Intervent Radiol

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Background and purpose: Radiation recall pneumonitis (RRP) is a delayed radiation-induced lung toxicity triggered by systemic agents, typically anticancer drugs. Immune checkpoint inhibitors (ICIs) have recently been identified as potential causal agents of RRP but its real incidence and potential risk factors remain unknown. Materials and methods: Medical records and CTs of patients treated with programmed death 1 (PD-1) or programmed death ligand 1 (PD-L1) inhibitors for advanced lung cancer between 2014 and 2019 at our tertiary center, and who had a previous history of lung irradiation were retrospectively analyzed. We identified RRP as lung CT modifications occurring in the irradiation field >6 months after conventionally fractionated radiotherapy completion and >1 year after stereotactic body radiation therapy. Clinical and dosimetric data were analyzed to identify potential risk factors for RRP. Results: Among 348 patients treated with ICIs, data from 80 eligible patients were analyzed (median age, 69 years [interquartile range, 11]; 45 men). Fifteen patients (18.8%) presented with RRP. Median time between end of radiotherapy and RRP was 450 days (range, 231-1859). No risk factor was significantly associated with RRP. ICI-related pneumonitis was associated with RRP in 33.3% of cases (p = 0.0021), developing either concomitantly or after RRP. Incidence of grade ! 3 pneumonitis in the RRP population was 13.3 %. Conclusion:We demonstrated a high incidence of RRP (18.8%) in our population of previously irradiated patients treated with ICIs for lung cancer. We identified no risk factors for RRP, but an association was noted between RRP and ICI-related pneumonitis.

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Preoperative Computed Tomography-Guided Pulmonary Lesion Marking in Preparation for Fluoroscopic Wedge Resection—Rates of Success, Complications, and Pathology Outcomes

Cited by 6 publications

References 17 publications

Evaluation of factors affecting the visualization of dye after transbronchial dye injection: an animal experiment

Evaluation of factors affecting the visualization of dye after transbronchial dye injection: an animal experiment

Preoperative CT-guided Fiducial Marker Placement for Surgical Localization of Pulmonary Nodules

Efficacy of the tract embolization technique with gelatin sponge slurry to reduce pneumothorax and chest tube placement after percutaneous CT-guided lung biopsy

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