Skip to main content

Advertisement

SpringerLink
Log in

CT-guided microcoil localization for pulmonary nodules before VATS: a retrospective evaluation of risk factors for pleural marking failure

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To summarize the experiences of CT-guided microcoil localization before video-assisted thoracoscopic surgery (VATS) and to investigate the risk factors associated with pleural marking failure.

Methods

Totally, 249 consecutive patients with 279 pulmonary nodules who underwent CT-guided microcoil localization prior to VATS were enrolled in this study. According to intraoperative observation, all the nodules were divided into two groups. The clinical characteristics and microcoil localization procedure-related variables of the nodules were analyzed by univariate analysis and multivariate logistic regression analysis to screen the independent factors associated with procedure results.

Results

Among the 279 nodules, 28 failed to observe the proximal end of the microcoil deployed on visceral pleura during VATS. The logistic regression revealed that needle-pleura angle (≤ 30°: OR = 39.022, p = 0.003), pleura-microcoil distance (≤ 10 mm: OR = 87.054, p < 0.001; 10~20 mm: OR = 10.088, p = 0.010), and presence of pleural indentation (OR = 21.623, p < 0.001) were independent risk factors for pleural marking failure.

Conclusions

CT-guided microcoil localization for pulmonary nodules is a safe and effective procedure. Small needle-pleura angle (≤ 30°), pleura-microcoil distance (≤ 20 mm), and the presence of pleural indentation during the procedure are significant risk factors contributing to microcoil pleura marking failure.

Key Points

• CT-guided microcoil localization for pulmonary nodules was a safe and effective procedure.

• CT-guided microcoil localization for pulmonary nodules yielded low complication rates.

• Small needle-pleura angle, short pleura-microcoil distance, and the presence of pleural indentation were contributing to pleura marking failure.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

ATS:

American Thoracic Society

CI:

Confidence interval

ERS:

European Respiratory Society

FEV1.0/FVC:

Forced expiratory volume at 1 s/forced vital capacity

GGO:

Ground glass opacity

IASLC:

The International Association for the Study of Lung Cancer

IQR:

Interquartile range

LLL:

Left lower lobe

LUL:

Left upper lobe

OR:

Odds ratio

PACS:

Picture archiving and communication system

Ref.:

Reference value

RLL:

Right lower lobe

RML:

Right middle lobe

RUL:

Right upper lobe

SD:

Standard deviation

VATS:

Video-assisted thoracoscopic surgery

WHO:

World Health Organization

References

  1. National Lung Screening Trial Research Team, Aberle DR, Adams AM et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365(5):395–409

    Article  Google Scholar 

  2. Mayo JR, Clifton JC, Powell TI et al (2009) Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection. Radiology. 250(2):576–585

    Article  Google Scholar 

  3. Powell T, Jangra D, Kalloger S et al (2003) Peripheral lung nodules: CT-guided insertion of platinum microcoil markers to aid thoracoscopic resection. Lung Cancer 41(2 Suppl):s9

    Article  Google Scholar 

  4. Powell TI, Jangra D, Clifton JC et al (2004) Peripheral lung nodules: fluoroscopically guided video-assisted thoracoscopic resection after computed tomography-guided localization using platinum microcoils. Ann Surg 240(3):481–488

    Article  Google Scholar 

  5. Liu L, Zhang LJ, Chen B et al (2014) Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study. Acta Radiol 55(6):699–706

    Article  Google Scholar 

  6. Su TH, Fan YF, Jin L, He W, Hu LB (2015) CT-guided localization of small pulmonary nodules using adjacent microcoil implantation prior to video-assisted thoracoscopic surgical resection. Eur Radiol 25(9):2627–2633

    Article  Google Scholar 

  7. Finley RJ, Mayo JR, Grant K et al (2015) Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial. J Thorac Cardiovasc Surg 149(1):26–31

    Article  Google Scholar 

  8. Sui X, Zhao H, Yang F, Li JL, Wang J (2015) Computed tomography guided microcoil localization for pulmonary small nodules and ground-glass opacity prior to thoracoscopic resection. J Thorac Dis 7(9):1580–1587

    PubMed  PubMed Central  Google Scholar 

  9. Donahoe LL, Nguyen ET, Chung TB et al (2016) CT-guided microcoil VATS resection of lung nodules: a single-centre experience and review of the literature. J Thorac Dis 8(8):1986–1994

    Article  Google Scholar 

  10. Park CH, Han K, Hur J et al (2017) Comparative effectiveness and safety of preoperative lung localizationfor pulmonary nodules: a systematic review and meta-analysis. Chest. 151(2):316–328

    Article  Google Scholar 

  11. Lempel JK, Raymond DP, Ahmad U et al (2018) Video-assisted thoracic surgery resection without intraoperative fluoroscopy after CT-guided microcoil localization of peripheral pulmonary nodules. J Vasc Interv Radiol 29(10):1423–1428

    Article  Google Scholar 

  12. McGuire AL, Vieira A, Grant K et al (2019) Computed tomography-guided platinum microcoil lung surgery: a cross-sectional study. J Thorac Cardiovasc Surg 158(2):594–600

    Article  Google Scholar 

  13. Rostambeigi N, Scanlon P, Flanagan S et al (2019) CT fluoroscopic-guided coil localization of lung nodules prior to video-assisted thoracoscopic surgical resection reduces complications compared to hook wire localization. J Vasc Interv Radiol 30(3):453–459

    Article  Google Scholar 

  14. Bommart S, Bourdin A, Marin G et al (2014) Impact of preoperative marking coils on surgical and pathologic management of impalpable lung nodules. Ann Thorac Surg 97(2):414–418

    Article  Google Scholar 

  15. Travis WD, Brambilla E, Noguchi M et al (2011) International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society International Multidisciplinary Classification of Lung Adenocarcinoma. J Thorac Oncol 6(2):244–285

    Article  Google Scholar 

  16. Seo JM, Lee HY, Kim HK et al (2012) Factors determining successful computed tomography-guided localization of lung nodules. J Thorac Cardiovasc Surg 143:809–814

    Article  Google Scholar 

  17. Ichinose J, Kohno T, Fujimori S, Harano T, Suzuki S (2013) Efficacy and complications of computed tomography-guided hook wire localization. Ann Thorac Surg 96(4):1203–1208

  18. Heran MK, Sangha BS, Mayo JR, Blair G, Skarsgard ED (2011) Lung nodules in children: video-assisted thoracoscopic surgical resection after computed tomography-guided localization using a microcoil. J Pediatr Surg 46(6):1292–1297

    Article  Google Scholar 

  19. Kim HJ, Cho JY, Lee YJ et al (2019) Clinical significance of pleural attachment and indentation of subsolid nodule lung cancer. Cancer Res Treat 51(4):1540–1548

    Article  Google Scholar 

  20. Hu L, Gao J, Chen C, Zhi X, Liu H, Hong N (2019) Comparison between the application of microcoil and hookwire for localizing pulmonary nodules. Eur Radiol 29(8):4036–4043

    Article  Google Scholar 

  21. Chao YK, Fang HY, Wen YW, Hsieh MJ, Wen CT (2019) Intraoperative computed tomography-guided pulmonary tumor localization: a thoracic surgeon’s learning curve. Eur J Cardiothorac Surg 55(3):421–426

    Article  Google Scholar 

Download references

Funding

The authors state that this work has received funding from the Beijing Municipal Science and Technology Commission (No. Z181100001718099), National Natural Science Foundation of China (81501469).

Author information

Author notes

  1. Yanyan Xu and Lingchuan Ma have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China

    Yanyan Xu, Hongliang Sun, Zhenguo Huang, Chuandong Li & Sheng Xie

  2. Department of Radiology, The People’s Hospital of Wenshan Prefecture, Wenshan, 663099, China

    Lingchuan Ma

  3. Department of Thoracic Surgery, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing, 100029, China

    Zhenrong Zhang, Fei Xiao & Qianli Ma

  4. Department of Radiology, The First Hospital of Fangshan District, Beijing, 102400, China

    Xiaomeng Zhang

Authors
  1. Yanyan Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lingchuan Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hongliang Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zhenguo Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zhenrong Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fei Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Qianli Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Chuandong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Xiaomeng Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sheng Xie
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hongliang Sun.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Dr. Hongliang Sun.

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

One of the authors has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

  • Retrospective

  • Observational study

  • Performed at one institution

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xu, Y., Ma, L., Sun, H. et al. CT-guided microcoil localization for pulmonary nodules before VATS: a retrospective evaluation of risk factors for pleural marking failure. Eur Radiol 30, 5674–5683 (2020). https://doi.org/10.1007/s00330-020-06954-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-020-06954-y

Keywords

Search

Navigation