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CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection

  • Interventional
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Abstract

Objectives

To describe and assess the localization of small peripheral pulmonary nodules prior to video-assisted thoracoscopic surgical (VATS) resection using the implantation of microcoils.

Methods

Ninety-two patients with 101 pulmonary nodules underwent computed tomography (CT)-guided implantation of microcoils proximal to each nodule. Patients were randomly assigned to undergo entire microcoil or leaving-microcoil-end implantations. The complications and efficacy of the two implantation methods were evaluated. VATS resection of lung tissue containing each pulmonary lesion and microcoil were performed in the direction of the microcoil marker. Histopathological analysis was performed for the resected pulmonary lesions.

Results

CT-guided microcoil implantation was successful in 99/101 cases, and the placement of microcoils within 1 cm of the nodules was not disruptive. There was no difference in the complications and efficacy associated with the entire implantation method (performed for 51/99 nodules) versus the leaving-microcoil-end implantation method (performed for 48/99 nodules). All nodules were successfully removed using VATS resection. Asymptomatic pneumothorax occurred in 16 patients and mild pulmonary haemorrhage occurred in nine patients. However, none of these patients required further surgical treatment.

Conclusions

Preoperative localization of small pulmonary nodules using a refined percutaneous microcoil implantation method was found to be safe and useful prior to VATS resection.

Key Points

• An increasing number of small, indeterminate pulmonary lesions need to be characterized.

• Entire microcoil and leaving-microcoil-end implantation methods were described for nodule localization.

• Adjacent microcoil localization prior to video-assisted thoracoscopic surgical resection involved minimal intervention.

• Preoperative microcoil localization facilitates the definitive resection of small pulmonary nodules.

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Acknowledgments

The scientific guarantors of this publication are Long Jin and Wen He. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study received funding from Capital Clinical Characteristic Applied Research program of the Beijing Municipal Science and Technology Commission (No. Z141107002514175). No complex statistical methods were necessary for this paper. Institutional Review Board approvals from Beijing Friendship Hospital and Peking University People’s Hospital were obtained. Written informed consent was obtained from each patient in this study. Some study subjects or cohorts have been previously reported in Long Jin et al., Chinese Journal of Interventional Therapy, 2014; ‘CT-guided localization of small lung nodules before video-assisted thoracoscopic surgical resection’. Methodology: Randomized controlled trial and observational, multicentre study.

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    Authors and Affiliations

    1. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 YongAn Road, Xicheng District, Beijing, 100050, China

      Tian-Hao Su, Long Jin & Wen He

    2. Department of Interventional Therapy, The First Affiliated Hospital, Xiamen University, 55 Zhenhai Road, Xiamen, Fujian, 361003, China

      Yue-Feng Fan

    3. Department of Radiology, Peking University People’s Hospital, 11 Xizhimen South Street, Xicheng District, Beijing, 100044, China

      Li-Bao Hu

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    1. Tian-Hao Su
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    Correspondence to Long Jin or Wen He.

    Additional information

    Tian-Hao Su and Yue-Feng Fan contributed equally to this work.

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    Su, TH., Fan, YF., Jin, L. et al. CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection. Eur Radiol 25, 2627–2633 (2015). https://doi.org/10.1007/s00330-015-3676-5

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    • DOI: https://doi.org/10.1007/s00330-015-3676-5

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