title: Computed tomography guided percutaneous injection of a mixture of lipiodol and methylene blue in rabbit lungs: evaluation of localization ability for video-assisted thoracoscopic surgery.
abstract: Preoperative localization is necessary prior to video assisted thoracoscopic surgery for the detection of small or deeply located lung nodules. We compared the localization ability of a mixture of lipiodol and methylene blue (MLM) (0.6 mL, 1:5) to methylene blue (0.5 mL) in rabbit lungs. CT-guided percutaneous injections were performed in 21 subjects with MLM and methylene blue. We measured the extent of staining on freshly excised lung and evaluated the subjective localization ability with 4 point scales at 6 and 24 hr after injections. For MLM, radio-opacity was evaluated on the fluoroscopy. We considered score 2 (acceptable) or 3 (excellent) as appropriate for localization. The staining extent of MLM was significantly smaller than methylene blue (0.6 vs 1.0 cm, P<0.001). MLM showed superior staining ability over methylene blue (2.8 vs 2.2, P=0.010). Excellent staining was achieved in 17 subjects (81%) with MLM and 8 (38%) with methylene blue (P=0.011). An acceptable or excellent radio-opacity of MLM was found in 13 subjects (62%). An appropriate localization rate of MLM was 100% with the use of the directly visible ability and radio-opacity of MLM. MLM provides a superior pulmonary localization ability over methylene blue.
authors.affiliation: Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Kwang Nam
authors.initials: KN
authors.lastname: Jin
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Tae Jung
authors.initials: TJ
authors.lastname: Kim
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Yong Sub
authors.initials: YS
authors.lastname: Song
authors.affiliation: Department of Pathology, Green Cross Laboratories, Yongin, Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Kim
mesh_terms: D000818:Animals; D004998:Ethiodized Oil / Q000008:administration & dosage*; D005471:Fluoroscopy; D007279:Injections, Subcutaneous; D008168:Lung / Q000000981:diagnostic imaging* / Q000601:surgery; D008751:Methylene Blue / Q000008:administration & dosage*; D011300:Preoperative Care; D011817:Rabbits; D003074:Solitary Pulmonary Nodule / Q000601:surgery*; D013194:Staining and Labeling / Q000379:methods; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D013906:Thoracoscopy / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D004998:Ethiodized Oil; D008751:Methylene Blue
keywords: Ethiodized Oil; Lung; Methylene Blue; Radiology, Interventional; Tomography, X-Ray Computed