title: Localizing small lung lesions in video-assisted thoracoscopic surgery via radiofrequency identification marking.
abstract: To facilitate accurate localization of small lung lesions in thoracoscopic surgery, we employed a micro-radiofrequency identification tag designed to be delivered through the 2-mm working channel of a flexible bronchoscope. This report presents the results of preclinical studies of our novel localizing technique in a canine model.
  
  
  
  To evaluate functional placement, three types of tags [Group A, tag alone (n = 18); Group B, tag + resin anchor (n = 15); and Group C, tag + NiTi coil anchor (n = 15)] were bronchoscopically placed in subpleural areas and subsegmental bronchi via our new delivery device; tags were examined radiographically on days 0-7 and day 14. In addition, eight tags, which were placed at a mean depth of 13.3 mm (range 9-15.7 mm) from visceral pleura in bronchi with a mean diameter of 1.46 mm (range 0.9-2.3 mm), were recovered by partial lung resection under video-assisted thoracoscopic surgery using a 13.56-MHz wand-shaped probe with a 30-mm communication range.
  
  
  
  Peripheral airway placement: Group C had a significantly higher retention rate than the other two groups (retention rate at day 14: Group A, 11.1 %; Group B, 26.7 %; Group C, 100.0 %; P < 0.0001). Central airway placement: Overall retention rate was 73.3 % in Group C, and placement was possible in bronchi of up to 3.3 mm in diameter. Outcomes of partial resection: Tag recovery rate was 100 %, mean time required for tag detection was 10.8 s (range 8-15 s), and mean surgical margin from the delivered tag was 9.13 mm (range 6-13 mm).
  
  
  
  Radiofrequency identification marking enabled accurate localization with depth, which could ensure effective deep resection margins.
authors.affiliation: Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yojiro
authors.initials: Y
authors.lastname: Yutaka
authors.affiliation: Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. tsato@kuhp.kyoto-u.ac.jp.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. tsato@kuhp.kyoto-u.ac.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.affiliation: Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Jitian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Hogy Medical Co., Ltd., 2-7-7 Akasaka, Minato-ku, Tokyo, 107-8615, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Asahi Intecc Co., Ltd., 1703 Wakita-cho, Moriyama-ku, Nagoya-shi, Aichi, 463-0024, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Aiba
authors.affiliation: Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Muranishi
authors.affiliation: Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Sakaguchi
authors.affiliation: Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Teruya
authors.initials: T
authors.lastname: Komatsu
authors.affiliation: Department of Thoracic Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 101-8560, Japan.
authors.forename: Fumitsugu
authors.initials: F
authors.lastname: Kojima
authors.affiliation: Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.|Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000818:Animals; D001999:Bronchoscopy / Q000379:methods; D004285:Dogs; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D023421:Models, Animal; D057233:Radio Frequency Identification Device; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Localization; Radiofrequency identification tag; Small lung lesion; Surgical navigation; Video-assisted thoracoscopic surgery; Wedge resection