Simultaneous preoperative computed tomography–guided microcoil localizations of multiple pulmonary nodules

Hu, Libao; Gao, Jingli; Hong, Nan; Liu, Huixin; Chen, Chen; Zhi, Xiao; Sui, Xizhao

doi:10.1007/s00330-021-07772-6

Cited by 17 publications

(33 citation statements)

References 22 publications

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“…Another study yielded a 2.4% (8/331) technical failure rate in microcoil localization, which was similar to the incidence of hookwire dislodgement in this study. 15 In cases of dislodgement, surgeons can determine the area of resection according to the puncture bleeding point of the visceral pleura and the distance from the lesion to the surface of the pleura shown on CT images to achieve the goal of complete excision of the target nodule. Rare complications, such as air embolism and migration of a hookwire into the splenic artery, have been reported, 25 , 26 , 29 , 30 but similar serious complications were not observed in this study.…”

Section: Discussionmentioning

confidence: 99%

Single-Stage Pulmonary Resection via a Combination of Single Hookwire Localization and Video-Assisted Thoracoscopic Surgery for Synchronous Multiple Pulmonary Nodules

Jin

Wang

Chen

et al. 2021

Technol Cancer Res Treat

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Purpose: To retrospectively analyze the incidence and predictors of complications related to hookwire localization in patients with single and multiple nodules, and to evaluate the usefulness of a single-stage surgical method of single hookwire localization combined with video-assisted thoracoscopic surgery (VATS) in synchronous multiple pulmonary nodules (SMPNs). Methods: A total of 200 patients who underwent computed tomography (CT)-guided hookwire localization and subsequent VATS resection were enrolled in this study. For each patient, only 1 indeterminate nodule was implanted with a hookwire. There were 145 patients in the single-nodule group (Group S) and 55 in the multiple-nodule group (Group M). Univariate and binary logistic regression analyses were used to assess incidence and predictors of complications associated with hookwire localization. Results: The technical success rate of hookwire implantation was 97.5%. The incidence of pneumothorax and hookwire dislodgement was 17.0% and 2.5%, respectively. Binary logistic regression analysis showed that 1 transpleural puncture through the pleura (odds ratio [OR] = 0.433, P = .033) was the only independent protective factor for pneumothorax, and pneumothorax (OR = 26.114, P < .01) was the only independent risk factor for dislodgement. The volume of blood loss during VATS was significantly higher in group M than in group S, and the time of postoperative hospitalization was significantly longer in group M than in group S. About 44 patients in group M with additional 58 nodules without localization had undergone direct surgical resection simultaneously, and bilateral surgery was performed in 13 patients (29.5%). The intrathoracic recurrence rate was 4.8% during follow-up CT. Conclusion: Single-stage surgery via an approach of single hookwire localization combined with VATS is feasible and safe for SMPNs.

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Section: Discussionmentioning

confidence: 99%

Single-Stage Pulmonary Resection via a Combination of Single Hookwire Localization and Video-Assisted Thoracoscopic Surgery for Synchronous Multiple Pulmonary Nodules

Jin

Wang

Chen

et al. 2021

Technol Cancer Res Treat

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“…The latest development of radiofrequency ablation (RFA) [ 13 ] can treat patients with lung nodules who have lost surgical treatment opportunities or are not suitable for surgical treatment to a certain extent. It can directly kill tumor cells in the patient while avoiding the impact on the patient's lung function.…”

Section: Introductionmentioning

confidence: 99%

Deep Learning-Based Computed Tomography Imaging to Diagnose the Lung Nodule and Treatment Effect of Radiofrequency Ablation

Guo

Li²,

Yang³

et al. 2021

Journal of Healthcare Engineering

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This study aimed to detect and diagnose the lung nodules as early as possible to effectively treat them, thereby reducing the burden on the medical system and patients. A lung computed tomography (CT) image segmentation algorithm was constructed based on the deep learning convolutional neural network (CNN). The clinical data of 69 patients with lung nodules diagnosed by needle biopsy and pathological comprehensive diagnosis at hospital were collected for specific analysis. The CT image segmentation algorithm was used to distinguish the nature and volume of lung nodules and compared with other computer aided design (CAD) software (Philips ISP). 69 patients with lung nodules were treated by radiofrequency ablation (RFA). The results showed that the diagnostic sensitivity of the CT image segmentation algorithm based on the CNN was obviously higher than that of the Philips ISP for solid nodules <5 mm (63 cases vs. 33 cases) ( P < 0.05 ); it was the same result for the subsolid nodule <5 mm (33 case vs. 5 cases) ( P < 0.05 ) that was slightly higher for solid and subsolid nodules with a diameter of 5–10 mm (37 cases vs. 28 cases) ( P < 0.05 ). In addition, the CNN algorithm can reach all detection for calcified nodules and pleural nodules (7 cases; 5 cases), and the diagnostic sensitivities were much better than those of Philips ISP (2 cases; 3 cases) ( P < 0.05 ). Patients with pulmonary nodules treated by RFA were in good postoperative condition, with a half-year survival rate of 100% and a one-year survival rate of 72.4%. Therefore, it could be concluded that the CT image segmentation algorithm based on the CNN could effectively detect and diagnose the lung nodules early, and the RFA could effectively treat the lung nodules.

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“…This result reflected that the advantage of the simultaneous puncture technique-the potential to avoid the interference of the pneumothorax which further disrupted subsequent localization-might have contributed to the high success rate. Furthermore, the median procedure time in the simultaneous group was 20.95 min, shorter than the range of 24 to 56 min in prior studies [10][11][12][13]20]. There are a number of possible reasons for the shorter procedure time.…”

Section: Discussionmentioning

confidence: 67%

“…Preoperative CT-guided nodule localization is a widely adopted approach to aid in the VATS resection for lung nodules and has been shown to have a high success rate and few complications [ 7 , 8 , 9 ]. With the increase in the number of multiple nodules detected, multiple nodule localization is being performed more frequently [ 10 , 11 , 12 , 13 , 14 ]. In our institute, the patent blue dye (PBD) injections we adopted are clinically useful for pulmonary nodule localization [ 8 , 15 ] and may be applied to multiple nodule localization due to the simplicity of performing them promptly.…”

Section: Introductionmentioning

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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Simultaneous preoperative computed tomography–guided microcoil localizations of multiple pulmonary nodules

Cited by 17 publications

References 22 publications

Single-Stage Pulmonary Resection via a Combination of Single Hookwire Localization and Video-Assisted Thoracoscopic Surgery for Synchronous Multiple Pulmonary Nodules

Single-Stage Pulmonary Resection via a Combination of Single Hookwire Localization and Video-Assisted Thoracoscopic Surgery for Synchronous Multiple Pulmonary Nodules

Deep Learning-Based Computed Tomography Imaging to Diagnose the Lung Nodule and Treatment Effect of Radiofrequency Ablation

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

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