Tianhao Su, Presenter: Nothing to Disclose

Long Jin, Abstract Co-Author: Nothing to Disclose

To describe and optimize small peripheral pulmonary nodule localization method prior to video-assisted surgical (VATS) resection.

This study enrolled 92 patients with 101 pulmonary nodules. Microcoils were placed next to the nodules using two random methods (with or without leaving microcoil end on the surface of pleura) under computed tomography guidance. The complications and efficacy of the implantation were evaluated. VATS resection of lung tissue containing pulmonary lesion and microcoil were performed by the direction of the microcoil marker. Histopathologic analyses of the pulmonary lesions were documented.

CT-guided microcoil implantation were successful in 99 (99/101, 98.0%) nodules within 1cm from the nodules but without disrupting them, while 2 (2/101, 2%) microcoils were found to be dislodged during operation. There were no difference between entire implantation (58/99, 58.6%) and leaving-microcoil-end implantation (41/99, 41.4%) method for the complications and efficacy. All nodules were removed by VATS successfully. Asymptomatic pneumothorax occurred in 16 patients, and mild pulmonary hemorrhage occurred in 9 patients, none of these patients needed further surgical treatment. The histopathologic results of the pulmonary lesions included adenocarcinomas (n =77), neuroendocrine carcinoma (n =1), metastatic carcinoma (n =1). atypical hyperplasia (n =11), hamartoma (n =1), granuloma (n =1), reactive lymph node (n =5), fibrotic hyperplasia (n =2), carbon power deposit (n =2).

Preoperative localization of small pulmonary nodules using percutaneous CT-guided microcoils implantation was useful and safe in successful VATS resection of pulmonary lesion.

A refined localization method of pulmonary nodule using microcoil is a minimal and safe interventional approach, and is recommended prior to VATS in order to make definitive resection easy and possible.

Su, T, Jin, L, CT-guided Localization of Small Pulmonary Nodules Using Microcoils prior to Video-assisted Thoracoscopic Surgical Resection.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007141.html