Safety and Efficacy of Modified Preoperative Lung Nodule Microcoil Localization Without Pleural Marking: A Pilot Study
| Autor: | Shafique Keshavjee, Kate Hanneman, Laura Donahoe, Taebong Chung, John R. Mayo, Lan-Chau T. Kha, Narinder Paul, Elsie T. Nguyen, Kazuhiro Yasufuku, Andrew Pierre |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Percutaneous Time Factors Pilot Projects Microcoil Radiation Dosage Radiography Interventional Preoperative care 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Postoperative Complications Fiducial Markers Preoperative Care medicine Humans Radiology Nuclear Medicine and imaging Intraoperative Complications Lung Retrospective Studies Solitary pulmonary nodule business.industry Thoracic Surgery Video-Assisted Solitary Pulmonary Nodule Nodule (medicine) Middle Aged medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis Pleura Female Radiology Pulmonary hemorrhage medicine.symptom Complication business Tomography X-Ray Computed |
| Zdroj: | Journal of thoracic imaging. 31(1) |
| ISSN: | 1536-0237 |
| Popis: | Purpose 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. Materials and 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. |
| Databáze: | OpenAIRE |
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