title: Agar blue localization of small pulmonary nodules and ground glass opacifications for thoracoscopic resection.
abstract: BACKGROUND
  Screening for lung cancer using high resolution computed tomography (CT) has produced encouraging early results. Extremely small nodules and non-palpable areas of opacifications are able to be detected, but pose a challenge to the thoracic surgeon trying to resect these areas.
  
  
  METHODS
  Forty five patients with ground glass opacifications (GGOs) or small pulmonary nodules underwent pre-operative CT-guided placement of methylene blue dyed agar and/or hook wire needle localization prior to thoracoscopic resection. Progel was applied to any intraoperative air leaks observed after successful resection.
  
  
  RESULTS
  All lesions were successfully excised thoracoscopically. The blue agar aided in localization of these areas and did not affect the histological architecture during pathologic evaluation.
  
  
  CONCLUSIONS
  Careful pre-operative evaluation and planning, including use of selective CT-guided blue agar localization and hook wire placement, may greatly assist in thoracoscopically locating and resecting these often difficult-to-visualize lesions.
authors.affiliation: Departments of Thoracic Surgery, Sharp/Scripps Hospitals, San Diego, California, USA.
authors.forename: Ara S
authors.initials: AS
authors.lastname: Klijian
keywords: Needle localization; agar; guided lung biopsy; methylene blue