Do Kyung Kim, Presenter: Nothing to Disclose

Yeon Joo Jeong MD, Abstract Co-Author: Nothing to Disclose

Kun-Il Kim MD, Abstract Co-Author: Nothing to Disclose

Chang Won Kim MD, Abstract Co-Author: Nothing to Disclose

Yeong Dae Kim, Abstract Co-Author: Nothing to Disclose

To evaluate the effectiveness of localization of pulmonary nodules with lipiodol before video-assisted thoracoscopic surgery.

After institutional review board approval and informed consent were obtained, lipiodol marking was performed under CT guidance in 35 patients (17 men and 18 women, mean age; 57 years) with 36 nodules. All nodules were marked with 0.5 to 0.7 mL lipiodol under CT guidance on the day of surgery. The size of the targeted nodule and its distance to the closet pleural surface were measured. The composition of nodules (pure GGO, partly solid, solid) was also evaluated. Lipiodol accumulation of the targeted nodule was scored by using a four-point scale (0; none, 1: within 1 cm around the nodule, 2: partly accumulation within nodule, 3; total accumulation within nodule). Note was made of any complications after localization of nodules.

The average nodule size was 11.5 mm (range, 3-24 mm) and the average distance to the pleural surface was 10.9 mm (range, 0-39.2 mm). Of 36 nodules, 26 (72%) were solid nodules, 9 (25%) were partly solid nodules, and the remaining one (3%) was pure GGO nodule. The scores of lipiodol accumulation of nodules were as follows: score 3 (n=7, 19%), score 2 (n=23, 64%), score 1 (n=4, 11%), and score 0 (n=2, 6%). Small pneumothoraces after localization occurred in 13 (36%) patients. Spillage of lipiodol into pleural space occurred in two (5%) patients.

Lipiodol marking under CT guidance is a useful and safe procedure for the intraoperative localization of pulmonary nodules.

This technique facilitates a one-stop diagnosis of small lung nodules by means of image-guided VATS excision biopsy and immediate frozen-section histopathologic examination.

Kim, D, Jeong, Y, Kim, K, Kim, C, Kim, Y, Localization of Pulmonary Nodules with Lipiodol before Rhoracoscopic Surgery.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8009964.html