Skip to main content
SpringerLink
Log in

Radioguided Surgery of Small Pulmonary Nodules

  • Chapter
  • First Online:
Radioguided Surgery

  • 799 Accesses

Abstract

The incidence of pulmonary nodules discovered by imaging is increasing. These pulmonary nodules may be discovered incidentally or through a computed tomography (CT) scan screening program. Small lesions suspicious for lung cancer may require tissue, and surgical resection may be necessary to rule out malignancy. Due to the small size of these lesions, intraoperative localization with minimally invasive surgical techniques may be challenging and require lesion localization prior to resection. Radioguided surgery using a radiotracer and a handheld gamma probe technology facilitates real-time pulmonary nodule localization and surgical resection. Most commonly, this involves two steps. First, a radiotracer (usually injectable technetium-99m) is preoperatively and percutaneously delivered into or immediately deep to the pulmonary nodule under CT guidance. Second, a handheld gamma probe is used to localize the pulmonary nodule for thoracoscopic resection. Alternatively, a radiotracer can be given intravenously, such as radiolabeled monoclonal antibodies, 18F-fluorodeoxyglucose (FDG), bleomycin derivatives, or DOTATATE (i.e., a highly selective somatostatin analog). These other techniques remain experimental. Radioguidance with transthoracic technetium-99m injection and intraoperative gamma probe detection offers several advantages over CT-guided hookwires or markers, locally administered radiopaque contrast and blue dyes, and thoracoscopic ultrasound. These techniques may be employed alone or in combination with radioguidance. Precise localization of small pulmonary nodules will become more pressing as national lung cancer CT screening guidelines are implemented.

Dr. Maiga is supported by the Office of Academic Affiliations, Department of Veterans Affairs (VA) National Quality Scholars Program. Dr. Grogan is a recipient of the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service Career Development Award (10–024). The views expressed in this chapter are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. TNLSTR Team. Reduced lung-cancer mortality with Low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409.

    Article  Google Scholar 

  2. Force USPST. Lung Cancer: Screening 2013 [7/17/2015]. Available from: http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening.

  3. Bureau UDoCC. National Cancer Institute-sponsored Tobacco Use Supplement to the Current Population Survey (2010–11): http://appliedresearch.cancer.gov/tus-cps/. 2012.

  4. Wallace JM, Deutsch AL. Flexible fiberoptic bronchoscopy and percutaneous needle lung aspiration for evaluating the solitary pulmonary nodule. Chest. 1982;81(6):665–71.

    Article  CAS  PubMed  Google Scholar 

  5. Levine MS, Weiss JM, Harrell JH, Cameron TJ, Moser KM. Transthoracic needle aspiration biopsy following negative fiberoptic bronchoscopy in solitary pulmonary nodules. Chest. 1988;93(6):1152–5.

    Article  CAS  PubMed  Google Scholar 

  6. Ohno Y, Hatabu H, Takenaka D, Higashino T, Watanabe H, Ohbayashi C, et al. CT-guided transthoracic needle aspiration biopsy of small (≤20 mm) solitary pulmonary nodules. Am J Roentgenol. 2003;180(6):1665–9.

    Article  Google Scholar 

  7. Tsukada H, Satou T, Iwashima A, Souma T. Diagnostic accuracy of CT-guided automated needle biopsy of lung nodules. Am J Roentgenol. 2000;175(1):239–43.

    Article  CAS  Google Scholar 

  8. Coleman RE, Laymon CM, Turkington TG. FDG imaging of lung nodules: a phantom study comparing SPECT, camera-based PET, and dedicated PET. Radiology. 1999;210(3):823–8.

    Article  CAS  PubMed  Google Scholar 

  9. Bunyaviroch T, Coleman RE. PET evaluation of lung cancer. J Nucl Med. 2006;47(3):451–69.

    PubMed  Google Scholar 

  10. Gould MK, Fletcher J, Iannettoni MD, Lynch WR, Midthun DE, Naidich DP, et al. Evaluation of patients with pulmonary nodules: when is it lung cancer?: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):108S–30.

    Article  PubMed  Google Scholar 

  11. Jaklitsch MT, Jacobson FL, Austin JHM, Field JK, Jett JR, Keshavjee S, et al. The American association for thoracic surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 2012;144(1):33–8.

    Article  PubMed  Google Scholar 

  12. Daniel TM. A proposed diagnostic approach to the patient with the subcentimeter pulmonary nodule: techniques that facilitate video-assisted thoracic surgery excision. Semin Thorac Cardiovasc Surg. 2005;17(2):115–22.

    Article  PubMed  Google Scholar 

  13. Suzuki K, Nagai K, Yoshida J, Ohmatsu H, Takahashi K, Nishimura M, et al. Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules*: Indications for preoperative marking. Chest. 1999;115(2):563–8.

    Article  CAS  PubMed  Google Scholar 

  14. Chella A, Lucchi M, Ambrogi MC, Menconi G, Melfi FMA, Gonfiotti A, et al. A pilot study of the role of TC-99 radionuclide in localization of pulmonary nodular lesions for thoracoscopic resection. Eur J Cardiothorac Surg. 2000;18(1):17–21.

    Article  CAS  PubMed  Google Scholar 

  15. Burdine J, Joyce LD, Plunkett MB, Inampudi S, Kaye MG, Dunn DH. Feasibility and value of video-assisted thoracoscopic surgery wedge excision of small pulmonary nodules in patients with malignancy*. Chest. 2002;122(4):1467–70.

    Article  PubMed  Google Scholar 

  16. Sugi K, Kaneda Y, Hirasawa K, Kunitani N. Radioisotope marking under ct guidance and localization using a handheld gamma probe for small or indistinct pulmonary lesions*. Chest. 2003;124(1):155–8.

    Article  PubMed  Google Scholar 

  17. Daniel TM, Altes TA, Rehm PK, Williams MB, Jones DR, Stolin AV, et al. A novel technique for localization and excisional biopsy of small or Ill-defined pulmonary lesions. Ann Thorac Surg. 2004;77(5):1756–62.

    Article  PubMed  Google Scholar 

  18. Stiles BM, Altes TA, Jones DR, Shen KR, Ailawadi G, Gay SB, et al. Clinical experience with radiotracer-guided thoracoscopic biopsy of small, indeterminate lung nodules. Ann Thorac Surg. 2006;82(4):1191–7.

    Article  PubMed  Google Scholar 

  19. Grogan EL, Jones DR, Kozower BD, Simmons WD, Daniel TM. Identification of small lung nodules: technique of radiotracer-guided thoracoscopic biopsy. Ann Thorac Surg. 2008;85(2):S772–7.

    Article  PubMed  Google Scholar 

  20. Bellomi M, Veronesi G, Trifirò G, Brambilla S, Bonello L, Preda L, et al. Computed tomography-guided preoperative radiotracer localization of nonpalpable lung nodules. Ann Thorac Surg. 2010;90(6):1759–64.

    Article  PubMed  Google Scholar 

  21. Bertolaccini L, Terzi A, Spada E, Acchiardi F, Ghirardo D. Not palpable? Role of radio-guided video-assisted thoracic surgery for nonpalpable solitary pulmonary nodules. Gen Thorac Cardiovasc Surg. 2012;60(5):280–4.

    Article  PubMed  Google Scholar 

  22. Ambrogi M, Melfi F, Zirafa C, Lucchi M, De Liperi A, Mariani G, et al. Radio-guided thoracoscopic surgery (RGTS) of small pulmonary nodules. Surg Endosc. 2012;26(4):914–9.

    Article  PubMed  Google Scholar 

  23. Wang Y-Z, Boudreaux JP, Dowling A, Woltering EA. Percutaneous localisation of pulmonary nodules prior to video-assisted thoracoscopic surgery using methylene blue and TC-99. Eur J Cardiothorac Surg. 2010;37(1):237–8.

    Article  PubMed  Google Scholar 

  24. Doo K, Yong H, Kim H, Kim S, Kang E-Y, Choi Y. Needlescopic resection of small and superficial pulmonary nodule after computed tomographic fluoroscopy-guided dual localization with radiotracer and hookwire. Ann Surg Oncol. 2015;22(1):331–7.

    Article  PubMed  Google Scholar 

  25. Gobardhan PD, Djamin RS, Romme PJHJ, de Wit PEJ, de Groot HGW, Adriaensen T, et al. The use of iodine seed (I-125) as a marker for the localisation of lung nodules in minimal invasive pulmonary surgery. Eur J Surg Oncol (EJSO). 2013;39(9):945–50.

    Article  CAS  Google Scholar 

  26. Povoski S, Neff R, Mojzisik C, O'Malley D, Hinkle G, Hall N, et al. A comprehensive overview of radioguided surgery using gamma detection probe technology. World J Surg Oncol. 2009;7(1):11.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Grazia M, Bini A, Stella F, Pagani D, Bazzocchi R. Radioimmunoguided surgery and intraoperative lung cancer staging. Semin Surg Oncol. 1998;15(4):215–9.

    Article  CAS  PubMed  Google Scholar 

  28. Mansi L, Di Lieto E, Rambaldi PF, Bergaminelli C, Fallanca F, Vicidomini G, et al. Preliminary experience with radioimmuno-guided surgery of primary neoplasms of the lung. Minerva Chir. 1998;53(5):369–72.

    CAS  PubMed  Google Scholar 

  29. Wang Y, Sun Y, Gao A. The experimental study of radioimmunoguided surgery for lung cancer. Zhongguo Fei Ai Za Zhi. 2000;3(1):46–9.

    CAS  PubMed  Google Scholar 

  30. Kelloff GJ, Hoffman JM, Johnson B, Scher HI, Siegel BA, Cheng EY, et al. Progress and promise of FDG-PET imaging for cancer patient management and oncologic drug development. Clin Cancer Res. 2005;11(8):2785–808.

    Article  CAS  PubMed  Google Scholar 

  31. Nwogu C, Fischer G, Tan D, Glinianski M, Lamonica D, Demmy T. Radioguided detection of lymph node metastasis in Non-small cell lung cancer. Ann Thorac Surg. 2006;82(5):1815–20.

    Article  PubMed  Google Scholar 

  32. Moffatt-Bruce SD, Povoski SP, Sharif S, Hall NC, Ross Jr P, Johnson MA, et al. A novel approach to positron emission tomography in lung cancer. Ann Thorac Surg. 2008;86(4):1355–7.

    Article  PubMed  Google Scholar 

  33. Woolfenden JM, Nevin WS, Barber HB, Donahue DJ. Lung cancer detection using a miniature sodium iodide detector and cobalt-57 bleomycin. Chest. 1984;85(1):84–8.

    Article  CAS  PubMed  Google Scholar 

  34. Wang YQ, Sun YE, Zhang JM, Liu X. Clinical practice of 99mTc-peplimycin imaging and radio guided surgery for lung neoplasms. Ai Zheng. 2003;22(7):749–52.

    PubMed  Google Scholar 

  35. Reubi JC, Laissue J, Krenning E, Lamberts SW. Somatostatin receptors in human cancer: incidence, characteristics, functional correlates and clinical implications. J Steroid Biochem Mol Biol. 1992;43(1–3):27–35.

    Article  CAS  PubMed  Google Scholar 

  36. Blum J, Handmaker H, Lister-James J, Rinne N. A multicenter trial with a somatostatin analog (99m)Tc depreotide in the evaluation of solitary pulmonary nodules. Chest. 2000;117(5):1232–8.

    Article  CAS  PubMed  Google Scholar 

  37. Grewal RK, Dadparvar S, Yu JQ, Babaria CJ, Cavanaugh T, Sherman M, et al. Efficacy of Tc-99m depreotide scintigraphy in the evaluation of solitary pulmonary nodules. Cancer J. 2002;8(5):400–4.

    Article  PubMed  Google Scholar 

  38. Miliziano JS, Bradley YC. Soft tissue metastases and lung cancer recurrence detected by Tc-99m depreotide scintigraphy. Clin Nucl Med. 2002;27(6):410–2.

    Article  PubMed  Google Scholar 

  39. Menda Y, Kahn D. Somatostatin receptor imaging of non-small cell lung cancer with 99mTc depreotide. Semin Nucl Med. 2002;32(2):92–6.

    Article  PubMed  Google Scholar 

  40. Kahn D, Menda Y, Kernstine K, Bushnell D, McLaughlin K, Miller S, et al. The utility of 99mTc depreotide compared with F-18 fluorodeoxyglucose positron emission tomography and surgical staging in patients with suspected non-small cell lung cancer. Chest. 2004;125(2):494–501.

    Article  CAS  PubMed  Google Scholar 

  41. Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000;27(3):273–82.

    Article  CAS  PubMed  Google Scholar 

  42. Haug AR, Cindea-Drimus R, Auernhammer CJ, Reincke M, Wängler B, Uebleis C, et al. The role of 68Ga-DOTATATE PET/CT in suspected neuroendocrine tumors. J Nucl Med. 2012;53(11):1686–92.

    Article  CAS  PubMed  Google Scholar 

  43. Kayani I, Conry BG, Groves AM, Win T, Dickson J, Caplin M, et al. A comparison of 68Ga-DOTATATE and 18F-FDG PET/CT in pulmonary neuroendocrine tumors. J Nucl Med. 2009;50(12):1927–32.

    Article  PubMed  Google Scholar 

  44. Callister MEJ, Baldwin DR, Akram AR, Barnard S, Cane P, Draffan J, et al. British thoracic society guidelines for the investigation and management of pulmonary nodules. Thorax. 2015;70 Suppl 2:ii1–54.

    Article  PubMed  Google Scholar 

  45. Paci M, Annessi V, Giovanardi F, Ferrari G, De Franco S, Casali C, et al. Preoperative localization of indeterminate pulmonary nodules before videothoracoscopic resection. Surg Endosc. 2002;16(3):509–11.

    Article  CAS  PubMed  Google Scholar 

  46. Saito H, Minamiya Y, Matsuzaki I, Tozawa K, Taguchi K, Nakagawa T, et al. Indication for preoperative localization of small peripheral pulmonary nodules in thoracoscopic surgery. J Thorac Cardiovasc Surg. 2002;124(6):1198–202.

    Article  PubMed  Google Scholar 

  47. Suzuki K, Shimohira M, Hashizume T, Ozawa Y, Sobue R, Mimura M, et al. Usefulness of CT-guided hookwire marking before video-assisted thoracoscopic surgery for small pulmonary lesions. J Med Imaging Radiat Oncol. 2014;58(6):657–62.

    Article  PubMed  Google Scholar 

  48. Huang W, Ye H, Wu Y, Xu W, Tang X, Liang Y, et al. Hook wire localization of pulmonary pure ground-glass opacities for video-assisted thoracoscopic surgery. Thorac Cardiovasc Surg. 2014;62(02):174–8.

    PubMed  Google Scholar 

  49. Dendo S, Kanazawa S, Ando A, Hyodo T, Kouno Y, Yasui K, et al. Preoperative localization of small pulmonary lesions with a short hook wire and suture system: experience with 168 procedures. Radiology. 2002;225(2):511–8.

    Article  PubMed  Google Scholar 

  50. Ciriaco P, Negri G, Puglisi A, Nicoletti R, Del Maschio A, Zannini P. Video-assisted thoracoscopic surgery for pulmonary nodules: rationale for preoperative computed tomography-guided hookwire localization. Eur J Cardiothorac Surg. 2004;25(3):429–33.

    Article  PubMed  Google Scholar 

  51. Miyoshi K, Toyooka S, Gobara H, Oto T, Mimura H, Sano Y, et al. Clinical outcomes of short hook wire and suture marking system in thoracoscopic resection for pulmonary nodules. Eur J Cardiothorac Surg. 2009;36(2):378–82.

    Article  PubMed  Google Scholar 

  52. Yoshida Y, Inoh S, Murakawa T, Ota S, Fukayama M, Nakajima J. Preoperative localization of small peripheral pulmonary nodules by percutaneous marking under computed tomography guidance. Interact Cardiovasc Thorac Surg. 2011;13(1):25–8.

    Article  PubMed  Google Scholar 

  53. Partik BL, Leung AN, Müller MR, Breitenseher M, Eckersberger F, Dekan G, et al. Using a dedicated lung-marker system for localization of pulmonary nodules before thoracoscopic surgery. Am J Roentgenol. 2003;180(3):805–9.

    Article  Google Scholar 

  54. Eichfeld U, Dietrich A, Ott R, Kloeppel R. Video-assisted thoracoscopic surgery for pulmonary nodules after computed tomography-guided marking with a spiral wire. Ann Thorac Surg. 2005;79(1):313–6.

    Article  PubMed  Google Scholar 

  55. Gonfiotti A, Davini F, Vaggelli L, De Francisci A, Caldarella A, Gigli PM, et al. Thoracoscopic localization techniques for patients with solitary pulmonary nodule: hookwire versus radio-guided surgery. Eur J Cardiothorac Surg. 2007;32(6):843–7.

    Article  PubMed  Google Scholar 

  56. Powell TI, Jangra D, Clifton JC, Lara-Guerra H, Church N, English J, et al. Peripheral lung nodules: fluoroscopically guided video-assisted thoracoscopic resection after computed tomography-guided localization using platinum microcoils. Ann Surg. 2004;240(3):481–9.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Mayo JR, Clifton JC, Powell TI, English JC, Evans KG, Yee J, et al. Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology. 2009;250(2):576–85.

    Article  PubMed  Google Scholar 

  58. Moon SW, Cho DG, Do Cho K, Kang CU, Seop Jo M, Park HJ. Fluoroscopy-assisted thoracoscopic resection for small intrapulmonary lesions after preoperative computed tomography-guided localization using fragmented platinum microcoils. Thorac Cardiovasc Surg. 2012;60(06):413–8.

    Article  PubMed  Google Scholar 

  59. Koyama H, Noma S, Tamaki Y, Goto K, Kitamura E, Maeda T, et al. CT localisation of small pulmonary nodules prior to thorascopic resection: evaluation of a point marker system. Eur J Radiol. 2008;65(3):468–72.

    Article  PubMed  Google Scholar 

  60. Horan TA, Pinheiro PM, Araújo LM, Santiago FF, Rodrigues MR. Massive gas embolism during pulmonary nodule hook wire localization. Ann Thorac Surg. 2002;73(5):1647–9.

    Article  PubMed  Google Scholar 

  61. Moon S-W, Wang Y-P, Jo K-H, Kwack M-S, Kim S-W, Kwon O-K, et al. Fluoroscopy-aided thoracoscopic resection of pulmonary nodule localized with contrast media. Ann Thorac Surg. 1999;68(5):1815–20.

    Article  CAS  PubMed  Google Scholar 

  62. Nomori H, Horio H, Naruke T, Suemasu K. Fluoroscopy-assisted thoracoscopic resection of lung nodules marked with lipiodol. Ann Thorac Surg. 2002;74(1):170–3.

    Article  PubMed  Google Scholar 

  63. Kim YD, Jeong YJ, Hoseok I, Cho JS, Lee JW, Kim HJ, et al. Localization of pulmonary nodules with lipiodol prior to thoracoscopic surgery. Acta Radiol. 2011;52(1):64–9.

    Article  PubMed  Google Scholar 

  64. Watanabe K, Nomori H, Ohtsuka T, Kaji M, Naruke T, Suemasu K. Usefulness and complications of computed tomography-guided lipiodol marking for fluoroscopy-assisted thoracoscopic resection of small pulmonary nodules: Experience with 174 nodules. J Thorac Cardiovasc Surg. 2006;132(2):320–4.

    Google Scholar 

  65. Okumura T, Kondo H, Suzuki K, Asamura H, Kobayashi T, Kaneko M, et al. Fluoroscopy-assisted thoracoscopic surgery after computed tomography-guided bronchoscopic barium marking. Ann Thorac Surg. 2001;71(2):439–42.

    Article  CAS  PubMed  Google Scholar 

  66. Partrick DA, Bensard DD, Teitelbaum DH, Geiger JD, Strouse P, Harned RK. Successful thoracoscopic lung biopsy in children utilizing preoperative CT-guided localization. J Pediatr Surg. 2002;37(7):970–3.

    Article  PubMed  Google Scholar 

  67. Vandoni RE, Cuttat J-F, Wicky S, Suter M. CT-guided methylene-blue labelling before thoracoscopic resection of pulmonary nodules. Eur J Cardiothorac Surg. 1998;14(3):265–70.

    Article  CAS  PubMed  Google Scholar 

  68. Lenglinger FX, Schwarz CD, Artmann W. Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue. Am J Roentgenol. 1994;163(2):297–300.

    Article  CAS  Google Scholar 

  69. Bolton WD, Richey J, Ben-Or S, Hale AL, Ewing JA, Stephenson JE. Electromagnetic navigational bronchoscopy: a safe and effective method for fiducial marker placement in lung cancer patients. Am Surg. 2015;81(7):659–62.

    PubMed  Google Scholar 

  70. Weiser TS, Hyman K, Yun J, Litle V, Chin C, Swanson SJ. Electromagnetic navigational bronchoscopy: a Surgeon’s perspective. Ann Thorac Surg. 2008;85(2):S797–801.

    Article  PubMed  Google Scholar 

  71. Bolton WD, Howe Iii H, Stephenson JE. The utility of electromagnetic navigational bronchoscopy as a localization tool for robotic resection of small pulmonary nodules. Ann Thorac Surg. 2014;98(2):471–6.

    Article  PubMed  Google Scholar 

  72. Okuda K, Yano M, Sasaki H, Moriyama S, Hikosaka Y, Shitara M, et al. A safe method for marking small pulmonary nodules with crystal violet. Surg Today. 2015;45(7):871–5.

    Article  PubMed  Google Scholar 

  73. Santambrogio R, Montorsi M, Bianchi P, Mantovani A, Ghelma F, Mezzetti M. Intraoperative ultrasound during thoracoscopic procedures for solitary pulmonary nodules. Ann Thorac Surg. 1999;68(1):218–22.

    Article  CAS  PubMed  Google Scholar 

  74. Sortini A, Carrella G, Sortini D, Pozza E. Single pulmonary nodules: localization with intrathoracoscopic ultrasound — a prospective study. Eur J Cardiothorac Surg. 2002;22(3):440–2.

    Article  CAS  PubMed  Google Scholar 

  75. Mattioli S, D’Ovidio F, Daddi N, Ferruzzi L, Pilotti V, Ruffato A, et al. Transthoracic endosonography for the intraoperative localization of lung nodules. Ann Thorac Surg. 2004;79(2):443–9.

    Article  Google Scholar 

  76. Kondo R, Yoshida K, Hamanaka K, Hashizume M, Ushiyama T, Hyogotani A, et al. Intraoperative ultrasonographic localization of pulmonary ground-glass opacities. J Thorac Cardiovasc Surg. 2009;138(4):837–42.

    Article  PubMed  Google Scholar 

  77. Gow KW, Saad DF, Koontz C, Wulkan ML. Minimally invasive thoracoscopic ultrasound for localization of pulmonary nodules in children. J Pediatr Surg. 2008;43(12):2315–22.

    Article  PubMed  Google Scholar 

  78. Sortini D, Feo CV, Carrella G, Bergossi L, Soliani G, Carcoforo P, et al. Thoracoscopic localization techniques for patients with a single pulmonary nodule and positive oncological anamnesis: a prospective study. J Laparoendosc Adv Surg Tech. 2003;13(6):371–5.

    Article  Google Scholar 

  79. Sortini D, Feo CV, Carcoforo P, Carrella G, Pozza E, Liboni A, et al. Thoracoscopic localization techniques for patients with solitary pulmonary nodule and history of malignancy. Ann Thorac Surg. 2005;79(1):258–62.

    Article  PubMed  Google Scholar 

  80. Yoshida J, Nagai K, Nishimura M, Takahashi K. Computed tomography-fluoroscopy guided injection of cyanoacrylate to mark a pulmonary nodule for thoracoscopic resection. Jpn J Thorac Caridovasc Surg. 1999;47(5):210–3.

    Article  CAS  Google Scholar 

  81. Kojima F, Sato T, Takahata H, Okada M, Sugiura T, Oshiro O, et al. A novel surgical marking system for small peripheral lung nodules based on radio frequency identification technology: feasibility study in a canine model. J Thorac Cardiovasc Surg. 2014;147(4):1384–9.

    Article  PubMed  Google Scholar 

  82. Okusanya OT, Holt D, Heitjan D, Deshpande C, Venegas O, Jiang J, et al. Intraoperative near-infrared imaging can identify pulmonary nodules. Ann Thorac Surg. 2014;98(4):1223–30.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Grogan EL, Stukenborg GJ, Nagji AS, Simmons W, Kozower BD, Jones DR, et al. Radiotracer-guided thoracoscopic resection is a cost-effective technique for the evaluation of subcentimeter pulmonary nodules. Ann Thorac Surg. 2008;86(3):934–40.

    Article  PubMed  Google Scholar 

  84. Kawanaka K, Nomori H, Mori T, Ikeda K, Ikeda O, Tomiguchi S, Yamashita Y. Marking of small pulmonary nodules before thoracoscopic resection: injection of lipiodol under CT-fluoroscopic guidance. Acad Radiol. 2009;16(1):39–45.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA

    Amelia W. Maiga MD, MPH

  2. Department of Surgery, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA

    Amelia W. Maiga MD, MPH

  3. Department of Thoracic Surgery, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA

    Eric L. Grogan MD, MPH, FACS

  4. Department of Thoracic Surgery, Vanderbilt University Medical Center, 609 Oxford House, 1313 21st Ave. South, Nashville, TN, 37232, USA

    Eric L. Grogan MD, MPH, FACS

Authors
  1. Amelia W. Maiga MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric L. Grogan MD, MPH, FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eric L. Grogan MD, MPH, FACS .

Editor information

Editors and Affiliations

  1. Universitätsklinikum Würzburg, Department of Nuclear Medicine, Würzburg, Germany

    Ken Herrmann

  2. The University of Sydney, Melanoma Institute Australia, North Sydney, New South Wales, Australia

    Omgo E. Nieweg

  3. Arthur G. James Canc Hosp Richard J. Sol, The Ohio State Univ Comp Canc CTR, Columbus, Ohio, USA

    Stephen P. Povoski

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Maiga, A.W., Grogan, E.L. (2016). Radioguided Surgery of Small Pulmonary Nodules. In: Herrmann, K., Nieweg, O., Povoski, S. (eds) Radioguided Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-26051-8_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26051-8_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26049-5

  • Online ISBN: 978-3-319-26051-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation