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Facilitating combined biopsy and percutaneous microwave ablation of pulmonary ground-glass opacities using lipiodol localisation

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Abstract

Objectives

Whether preoperative localisation is necessary and valuable for the microwave ablation (MWA) of small pulmonary lesions with ground-glass opacity (GGO) remains unclear. This study aimed to explore the role of the Chiba needle and lipiodol localisation techniques in facilitating MWA and biopsy.

Methods

This retrospective before–after study included patients with GGOs who underwent conventional MWA and biopsy treatment in our hospital between January 2018 and December 2019 (group A) or who underwent the Chiba needle and lipiodol localisation treatment before MWA and biopsy between January 2020 and December 2020 (group B). The characteristics of each patient and GGO lesion were collected and analysed to evaluate the safety and effectiveness of the localisation technique.

Results

A total of 122 patients with 152 GGOs and 131 patients with 156 GGOs underwent MWA and biopsy in groups A and B, respectively. The primary technique efficacy rate of MWA differed significantly between the two groups (A vs. B: 94.1% vs. 99.4%; p = 0.009). The positive biopsy rate in the two groups was determined by the difference (A vs. B: 93.4% vs. 98.1%; p = 0.042). The incidence of complications did not increase in group B.

Conclusions

Compared with the unmarked group, the Chiba needle and lipiodol localisation technique improved the positive rate of biopsy and the initial effective rate of MWA, without significantly increasing the complication rate.

Key Points

• The localisation of the Chiba needle and lipiodol could improve the positive biopsy rate and the initial effective rate of MWA.

• The localisation of the Chiba needle and lipiodol does not affect the subsequent MWA and biopsy and does not increase the incidence of pneumothorax and haemorrhage.

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Abbreviations

AAH:

Atypical adenomatous hyperplasia

AIS:

Adenocarcinoma in situ

CT:

Computed tomography

GGO:

Ground-glass opacity

IAC:

Invasive adenocarcinoma

MIA:

Minimally invasive adenocarcinoma

MWA:

Microwave ablation

References

  1. Kobayashi Y, Mitsudomi T (2013) Management of ground-glass opacities: should all pulmonary lesions with ground-glass opacity be surgically resected? Transl Lung Cancer Res 2(5):354–363

  2. Callister MEJ, Baldwin DR, Akram AR et al (2015) British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE. Thorax 70(Suppl 2):1–54

    Article  Google Scholar 

  3. Zhang Y, Fu F, Chen H (2020) Management of ground-glass opacities in the lung cancer spectrum. Ann Thorac Surg 6(110):1796–1804

    Article  Google Scholar 

  4. Wood DE, Kazerooni EA, Baum SL et al (2018) Lung cancer screening version 3.2018 NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 16(4):412–441

  5. Karki A, Shah R, Fein A (2017) Multiple pulmonary nodules in malignancy. Curr Opin Pulm Med 23(4):285–289

    Article  PubMed  Google Scholar 

  6. Chi J, Wang Z, Ding M et al (2021) Technical safety and efficacy of a blunt-tip microwave ablation electrode for CT-guided ablation of pulmonary ground-glass opacity nodules. Eur Radiol 31:7484–7490

    Article  PubMed  Google Scholar 

  7. Wang J, Ni Y, Yang X et al (2019) Diagnostic ability of percutaneous core biopsy immediately after microwave ablation for lung ground-glass opacity. J Cancer Res Ther 15(4):755–759

    Article  PubMed  Google Scholar 

  8. McDermott S, Fintelmann FJ, Bierhals AJ et al (2019) Image-guided preoperative localization of pulmonary nodules for video-assisted and robotically assisted surgery. Radiographics 39(5):1264–1279

    Article  PubMed  Google Scholar 

  9. Nguyen DM, Villamizar N (2020) Commentary: Preoperative localization of” hard-to-find” pulmonary ground-glass opacity: there are more than one way to find the target. J Thorac Cardiovasc Surg 159(4):1581–1583

    Article  PubMed  Google Scholar 

  10. Kawanaka K, Nomori H, Mori T et al (2009) Marking of small pulmonary nodules before thoracoscopic resection: injection of lipiodol under CT-fluoroscopic guidance. Acad Radiol 16(1):39–45

    Article  PubMed  Google Scholar 

  11. Lee JW, Park CH, Lee SM et al (2019) Planting seeds into the lung: image-guided percutaneous localization to guide minimally invasive thoracic surgery. Korean J Radiol 20(11):1498–1514

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ahmed M, Solbiati L, Brace CL et al (2014) Image-guided tumor ablation: standardization of terminology and reporting criteria—a 10-year update. Radiology 273(1):241–260

    Article  PubMed  Google Scholar 

  13. Nomori H, Horio H, Naruke T et al (2002) Fluoroscopy-assisted thoracoscopic resection of lung nodules marked with lipiodol. Ann Thorac Surg 74(1):170–173

    Article  PubMed  Google Scholar 

  14. Hattori A, Suzuki K, Takamochi K et al (2021) Prognostic impact of a ground-glass opacity component in clinical stage IA non–small cell lung cancer. J Thorac Cardiovasc Surg 161(4):1469–1480

    Article  PubMed  Google Scholar 

  15. Gao JW, Rizzo S, Ma LH et al (2017) Pulmonary ground-glass opacity: computed tomography features, histopathology and molecular pathology. Transl Lung Cancer Res 6(1):68–75

  16. Iguchi T, Hiraki T, Gobara H et al (2015) Percutaneous radiofrequency ablation of lung cancer presenting as ground-glass opacity. Cardiovasc Intervent Radiol 38(2):409–415

    Article  PubMed  Google Scholar 

  17. Cazzato RL, Garnon J, Shaygi B et al (2017) Performance of a new blunt-tip coaxial needle for percutaneous biopsy and drainage of “hard-to-reach” targets. Cardiovasc Intervent Radiol 40(9):1431–1439

    Article  PubMed  Google Scholar 

  18. Lu CH, Hsiao CH, Chang YC et al (2012) Percutaneous computed tomography-guided coaxial core biopsy for small pulmonary lesions with ground-glass attenuation. J Thorac Oncol 7(1):143–150

    Article  PubMed  Google Scholar 

  19. Kodama H, Yamakado K, Hasegawa T et al (2014) Radiofrequency ablation for ground-glass opacity–dominant lung adenocarcinoma. J Vasc Interv Radiol 25(3):333–339

    Article  PubMed  Google Scholar 

  20. Yang X, Ye X, Lin Z et al (2018) Computed tomography-guided percutaneous microwave ablation for treatment of peripheral ground-glass opacity–Lung adenocarcinoma: A pilot study. J Cancer Res Ther 14(4):764–771

    Article  PubMed  Google Scholar 

  21. Huang G, Yang X, Li W et al (2020) A feasibility and safety study of computed tomography-guided percutaneous microwave ablation: a novel therapy for multiple synchronous ground-glass opacities of the lung. Int J Hyperth 37(1):414–422

    Article  Google Scholar 

  22. de Bazelaire C, Farges C, Mathieu O et al (2009) Blunt-tip coaxial introducer: a revisited tool for difficult CT-guided biopsy in the chest and abdomen. AJR Am J Roentgenol 193(2):W144–W148

  23. Kong F, Wang C, Li Y et al (2021) Advances in study of the sequence of lung tumor biopsy and thermal ablation. Thoracic Cancer 12(3):279–286

    Article  CAS  PubMed  Google Scholar 

  24. Detterbeck FC, Homer RJ (2011) Approach to the Ground-Glass Nodule. Clin Chest Med 32(4):799–810

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors declare that they have no conflict of interest. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.

Funding

The authors state that this work has not received any funding.

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Author notes

  1. Xia Yang and Xin Ye contribute equally to this work.

Authors and Affiliations

  1. Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwuweiqi Road, Jinan, 250021, Shandong Province, China

    Min Meng, Guanghui Huang, Jiao Wang, Wenhong Li, Yang Ni, Tiehong Zhang, Xiaoying Han, Jianjian Dai, Zhigeng Zou & Xia Yang

  2. Department of Oncology, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, Shandong Province, China

    Xin Ye

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  1. Min Meng
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  2. Guanghui Huang
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  5. Yang Ni
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  10. Xia Yang
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  11. Xin Ye
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Corresponding authors

Correspondence to Xia Yang or Xin Ye.

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Guarantor

The scientific guarantor of this publication is Xia Yang.

Conflict of interest

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.

Statistics and biometry

Zhenwang Bi kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

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Institutional Review Board approval was obtained.

Methodology

•Retrospective

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Meng, M., Huang, G., Wang, J. et al. Facilitating combined biopsy and percutaneous microwave ablation of pulmonary ground-glass opacities using lipiodol localisation. Eur Radiol 33, 3124–3132 (2023). https://doi.org/10.1007/s00330-023-09486-3

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  • DOI: https://doi.org/10.1007/s00330-023-09486-3

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