title: Lipiodol lOcalization for Ground-glass opacity mInimal Surgery: Rationale and design of the LOGIS trial.
abstract: OBJECTIVE
  The diagnosis and treatment of ground-glass opacity (GGO) lesions have become important issues because subsolid nodules including GGO are known to frequently represent the histologic spectrum of lung adenocarcinoma. Because small GGO lesions cannot usually be palpated or visualized during surgery, several marking techniques have been reported for localization during thoracoscopic surgery, such as lipiodol and hook-wire localization. This study is designed to demonstrate the usefulness and safety of the lipiodol localization technique for individuals undergoing GGO VATS resection compared to the hook-wire localization technique.
  
  
  METHODS
  Two hundred fifty participants will be prospectively enrolled in a 1:1 manner to the lipiodol or hook-wire group according to the inclusion criteria. All study participants will undergo preoperative lung localization using either the lipiodol or hook-wire method. Thoracoscopic surgery will be performed by experienced thoracoscopic surgeons within several hours after marking under general anesthesia. The primary endpoint is the procedure success rate, and the secondary endpoints are the procedure complication rate, procedure time, surgery time and the margin from the lesion in the resected specimen.
  
  
  RESULTS
  Patient enrollment will be completed within 2years. We will analyze the procedure success rate and the presence of complications with regard to the CT results. In addition, the procedure and surgery times, and the safety margin will be also compared between the 2 techniques.
  
  
  CONCLUSIONS
  If the aims of this study are achieved, then the use of lipiodol localization technique will be widespread in the localization of non-palpable pulmonary lesions that are indicated for surgical resection. (ClinicalTrials.gov: NCT02180568).
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: khuhz@yuhs.ac.
authors.forename: Jin
authors.initials: J
authors.lastname: Hur
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan, Republic of Korea.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Seo
authors.affiliation: Department of Radiology, Dankook University Hospital, Cheonan, Chungnam Province, Republic of Korea.
authors.forename: Kye Ho
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Radiology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Woo Cheol
authors.initials: WC
authors.lastname: Kwon
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Choi
mesh_terms: D004998:Ethiodized Oil / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D012107:Research Design; D003074:Solitary Pulmonary Nodule / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed
chemical_list: D004998:Ethiodized Oil
keywords: Ground-glass opacity (GGO); Hook-wire; Lipiodol; Localization; Video-assisted thoracic surgery (VATS)