Nour-Eldin Abdelrehim Nour-Eldin MD, MSc, Presenter: Nothing to Disclose

Nagy Naguib Naeem Naguib MD, MSc, Abstract Co-Author: Nothing to Disclose

Thomas Lehnert MD, Abstract Co-Author: Nothing to Disclose

Martin Beeres MD, Abstract Co-Author: Nothing to Disclose

Boris Bodelle MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, PhD, Abstract Co-Author: Nothing to Disclose

To assess the feasibility and safety of CT-guided pulmonary nodule-marker using hooked guide wire immediately before thoracoscopic resection

A retrospective study design. In 79 consecutive patients (49 males, 30 females; mean age: 56.6, range: 29–71 years, in the period between: January 2011 and January 2014) a total of 82 pulmonary nodules were marked with a hooked 22-F guide-wire under CT-guidance under local anesthesia.  Immediately after the procedure, the patient was transferred to the operating room and thoracoscopic pulmonary wedge resection was performed. The position of the guide wire was demonstrated to the thoracic surgeon before surgical resection. In the current study the following parameters were assessed: lesion size, lesion distance to the pleura, the time of intervention, complications, and thoracoscopic success rate. Technical success was defined as the positioning of the tip of the hooked guide wire within 1 cm from the lesion.

Mean lesion size was 6 mm (range 4–18 mm) and mean lesional distance to the pleura was 15 mm (range 2–40 mm). The hooked pulmonary nodule guide wire was positioned successfully in all 82 pulmonary nodules within 4–12 min (mean 8 min). Minimal pneumothoraces were observed in 5 patients (7.6%) with no requirements of chest drains. Focal perilesional pulmonary hemorrhage was developed in 3%. Both hemorrhage and pneumothorax were correlated to subcentemetric lesions (p= 0.02). All 82 pulmonary nodules could be resected thoracoscopically. However, in one patient (1.3%), the guide-wire was dislocated during thoracoscopy. The position of the lesion was identified intraoperatively by the focal pleural puncture. The resection volume was significantly correlated to the guide-wire position (p= 0.04).

CT-guided pulmonary nodule localization prior to thoracoscopic resection could allow a safe and accurate surgical guidance guide for the localization of small pulmonary nodules during thoracoscopic resection.

This technique could facilitate the identification and allow adequate resection of small pulmonary nodules during thoracoscopic resection.

Nour-Eldin, N, Naguib, N, Lehnert, T, Beeres, M, Bodelle, B, Vogl, T, CT-Guided Pulmonary Nodule Localization Prior to Thoracoscopic Resection.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045639.html