A novel technique for localization of small pulmonary nodules.
BACKGROUND
To show the safety and accuracy of a new marking technique using an image-guided technique for preoperative localization of a small pulmonary nodule.


METHODS
CT data of a patient with a peripheral pulmonary nodule < 20 mm were transmitted to a surgical navigation system (StealthStation Treon Treatment Guidance System; Medtronic; Louisville, KY). To match preoperative CT image data to the physical space occupied by the patient during surgery, five to six superficial skin fiducials were used for registration. A 16-gauge needle attached by a positioning sensor was advanced into or immediately adjacent to the nodule for injection of methylene blue under guidance of the StealthStation system. Then the lesion marked by the methylene was thoracoscopically resected.


RESULTS
Seventeen patients (12 men and 5 women; mean age, 51.3 years) underwent this procedure, and all the nodules were identified due to the precise location of the probe. They were resected with sufficient margins. There were no surgical complications. The average time of registration was 4.8 +/- 0.9 min (+/- SD). Registration error was on average 2.7 +/- 0.2 mm.


CONCLUSIONS
Image-guided navigation is useful, accurate, and safe in the localization of small peripheral lung lesions.
Chen
Weisheng
W
Department of Thoracic and Cardiovascular Surgery, Fuzhou General Hospital, No. 156 # Xierhuan, Fuzhou, China 350025.
Chen
Long
L
Yang
Shengsheng
S
Chen
Ziqian
Z
Qian
Gengnian
G
Zhang
Suxun
S
Jing
Junjie
J
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007202:Indicators and Reagents / Q000008:administration & dosage; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage; D008875:Middle Aged; D010865:Pilot Projects; D012984:Software; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
D007202:Indicators and Reagents; D008751:Methylene Blue