title: Lung tattooing combined with immediate video-assisted thoracoscopic resection (IVATR) as a single procedure in a hybrid room: our institutional experience in a pediatric population.
abstract: BACKGROUND
  Analysis of small pulmonary nodules in children poses an important diagnostic and therapeutic challenge for clinicians.
  
  
  OBJECTIVE
  To review our experience of lung tattooing with immediate video-assisted thoracoscopic resection (IVATR) performed as a single procedure in a hybrid room for technical difficulties, complications and diagnostic yield of the procedure.
  
  
  METHODS
  Retrospective analysis of 31 children (16 boys, 15 girls) who underwent lung tattooing of various lesions from January 2001 to July 2011. Data were collected from the Interventional Radiology database, Electronic Patient Chart (EPC) and PACS.
  
  
  RESULTS
  A total of 34 lesions were treated in 31 children. Tattooing was performed on lung lesions with median size 3 mm and median depth 2 mm from pleura. Technical success was 91.1% and diagnostic yield was 100%. In seven children, it was combined with other interventional radiologic procedures. The median procedure time for lung tattooing and IVATR was 197 min.
  
  
  CONCLUSIONS
  Lung tattooing with IVATR as a single procedure in a hybrid room is safe and effective in children with several inherent advantages, including avoiding the need to move the child from the interventional radiology suite to the operating room.
authors.affiliation: Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Canada. nrssbabu@gmail.com
authors.forename: Surendra
authors.initials: S
authors.lastname: Narayanam
authors.forename: Ted
authors.initials: T
authors.lastname: Gerstle
authors.forename: Joao
authors.initials: J
authors.lastname: Amaral
authors.forename: Philip
authors.initials: P
authors.lastname: John
authors.forename: Dimitri
authors.initials: D
authors.lastname: Parra
authors.forename: Michael
authors.initials: M
authors.lastname: Temple
authors.forename: Bairbre
authors.initials: B
authors.lastname: Connolly
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004396:Coloring Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007223:Infant; D015552:Injections, Intralesional; D008168:Lung / Q000473:pathology; D008297:Male; D015641:Radiography, Interventional / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000175:diagnosis* / Q000601:surgery*; D013653:Tattooing / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D004396:Coloring Agents