Safety and Efficacy of Modified Preoperative Lung Nodule Microcoil Localization Without Pleural Marking: A Pilot Study.
OBJECTIVE
The purpose of this pilot study was to evaluate the safety and efficacy of preoperative computed tomography (CT)-guided percutaneous microcoil lung nodule localization without pleural marking compared with the established technique with pleural marking.


METHODS
Sixty-three consecutive patients (66.7% female, mean age 61.6±11.4 y) with 64 lung nodules resected between October 2008 and January 2014 were retrospectively evaluated. Of the nodules, 29.7% (n=19) had microcoil deployment with pleural marking (control group) and 70.3% (n=45) had microcoil deployment without pleural marking (pilot group). Clinical, pathologic, and imaging characteristics, radiation dose, CT procedure and operating room time, and complete resection and complication rates were compared between the pilot and control groups.


RESULTS
There was no significant difference in nodule size (P=0.552) or distance from the pleural surface (P=0.222) between the pilot and control groups. However, mean procedure duration (53.6±18.3 vs. 72.8±25.3 min, P=0.001) and total effective radiation dose (5.1±2.6 vs. 7.1±4.9 mSv, P=0.039) were significantly lower in the pilot group compared with the control group. CT procedure-related complications (P=0.483) [including pneumothoraces (P=0.769) and pulmonary hemorrhage (P=1.000)], operating room time (P=0.926), complete resection rates (P=0.520), intraoperative complications (P=0.549), and postoperative complications (P=1.000) were similar between the pilot and control groups.


CONCLUSIONS
Preoperative CT-guided lung nodule microcoil localization performed without visceral pleural marking appears to decrease the CT procedure time and radiation dose while maintaining equivalent complete resection rates and procedural and surgical complications, when compared with microcoil localization performed with pleural marking.
*Department of Medical Imaging †Division of Thoracic Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, ON ‡Department of Thoracic and Cardiovascular Imaging, Vancouver General Hospital, Vancouver, BC, Canada.
Lan-Chau T
LC
Kha
Kate
K
Hanneman
Laura
L
Donahoe
Taebong
T
Chung
Andrew F
AF
Pierre
Kazuhiro
K
Yasufuku
Shafique
S
Keshavjee
John R
JR
Mayo
Narinder S
NS
Paul
Elsie T
ET
Nguyen
D005260:Female; D057918:Fiducial Markers; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010994:Pleura; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging*; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*