Taeho Kim MD, Presenter: Nothing to Disclose

Chang Min Park MD, PhD, Abstract Co-Author: Nothing to Disclose

Sang Min Lee, Abstract Co-Author: Nothing to Disclose

Hyun-Ju Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Jin Mo Goo MD, PhD, Abstract Co-Author: Research Grant, Guerbet SA

To describe out initial experience with cone-beam CT virtual navigation guided percutaneous Lipiodol localization of small pulmonary nodules in 31 consecutive cases.

From February 2013 to August 2013, 29 consecutive patients (15 male, 14 female; mean age, 61 years) with 31 small pulmonary nodules (mean size, 14.14mm; range, 4.8-35mm) underwent preoperative Lipiodol localization under CBCT virtual-navigation guidance system and included our study population. Lipiodol (mean amount, 0.19 mL; range, 0.15-0.2 mL) was injected around the pulmonary nodules through 21-gauge needle. Procedure details—including radiation dose, diagnostic accuracy and complication rates of CBCT virtual-navigation-guided percutaneous Lipiodol localization—were described.

All nodules were localized within 12 mm (mean distance, 2.26 mm; range, 0-12mm) from the lipiodol marking (mean diameter, 10.83 mm; range, 6-19 mm). The CT findings of pulmonary nodules were 16 pure groud glass nodules, 13 part solid nodules, and 2 solid nodules. The mean number of CT acquisitions, total procedure time, and estimated radiation exposure during lipiodol marking were 3.5, 15.9 minutes, and 5.72 mSv ± 2.64, respectively. Post-procedural complications occurred in 4 (12.9%) cases, all of which was pneumothorax. All lipiodol markings were easily visible on intraoperative fluoroscopy, and all the target nodules were completely resected. There were no difficulties on pathologic examination and their results of the target nodules included 19 invasive adenocarcinoma, 5 adenocarcinoma-in-situ, 4 atypical adenomatous hyperplasia, 1 metastatic chondrosarcoma and 2 benign lesions.

CBCT virtual-navigation-guided percutaneous lipiodol marking can be accurate, effective and safety pre-operative localization procedure, enabling highly accurate resection and safe diagnosis of small or faint pulmonary nodules.  

Cone-beam CT virtual navigation guided percutaneous transthoracic localization of small pulmonary nodule could accurately and effectively play an important role before the video assisted thoracic surgery.

Kim, T, Park, C, Lee, S, Lee, H, Goo, J, C-arm Cone-Beam CT Virtual Navigation Guided Percutaneous Transthoracic Localization of Small Pulmonary Nodule.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14018438.html