Methylene Blue/Collagen Mixture for CT-Guided Presurgical Lung Nodule Marking: High Efficacy and Safety.

Autor:	Aoun HD; Department of Radiology/Interventional Oncology, Karmanos Cancer Institute and Wayne State University, 4100 John R, Detroit, MI, 48201. Electronic address: aounh@karmanos.org., Littrup PJ; Department of Radiology, McLaren North Oakland, Pontiac, Michigan; Department of Radiology, Ascension Providence Rochester Hospital, Rochester, Michigan; Karmanos Cancer Institute and Wayne State University, Detroit, Michigan., Heath KE; Bloomfield Hills High School, Bloomfield Hills, Michigan., Adam B; Department of Radiology/Interventional Oncology, Karmanos Cancer Institute and Wayne State University, 4100 John R, Detroit, MI, 48201., Prus M; Department of Radiology/Interventional Oncology, Karmanos Cancer Institute and Wayne State University, 4100 John R, Detroit, MI, 48201., Beydoun R; Department of Pathology, Karmanos Cancer Institute and Wayne State University, Detroit, Michigan., Baciewcz F; Thoracic Surgery, Karmanos Cancer Institute and Wayne State University, Detroit, Michigan.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2020 Oct; Vol. 31 (10), pp. 1682.e1-1682.e7. Date of Electronic Publication: 2020 Aug 29.
DOI:	10.1016/j.jvir.2020.04.028
Abstrakt:	Purpose: To assess outcomes of computed tomography (CT)-guided methylene blue/collagen marking of preoperative lung nodules before video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery (RATS). Materials and Methods: A retrospective cohort study assessing 25 methylene blue/collagen solution CT-guided lung nodule localization procedures on 26 nodules in 25 patients was performed. The procedures were performed by a fellowship-trained radiologist 1-2 hours before scheduled surgery under local anesthesia. Approximately 4-6 ml of methylene blue/collagen solution was injected in a perinodular location under CT guidance with a 19-gauge trocar needle and along the track to the visceral pleural surface. Post-procedural CT images confirmed appropriate lung nodule location marking. Results: Perinodular CT-guided trocar needle placement was achieved in all marking procedures (n = 26/26). Increased consolidation near the target nodule was also demonstrated in all patients on the post-procedural localized CT scans. One patient with moderate emphysema developed a small to moderate-sized pneumothorax (∼20%-30%), and an 8-Fr thoracentesis catheter was placed under CT guidance before surgery. There was no bleeding or hemoptysis in any patient. Methylene blue/collagen solution was readily visible by the thoracic surgeon in association with all target nodules. One patient required conversion to open procedure due to the proximal portion of the right lower lobe pulmonary artery segmental branch. Of the 26 identified nodules, pathology specimens confirmed the adequacy of nodule resection in all cases. Conclusions: Preoperative CT-guided methylene blue/collagen solution injection offers a safe and highly effective technique for marking subpleural lung nodules undergoing VATS or RATS. (Copyright © 2020 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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