Safety and feasibility comparison between three different CT-guided localization techniques under systemic approach algorithm

Wen Chi Hsu, Kuei An Chen, Kuang Tse Pan, Po Chun Chang, Ching Feng Wu, Jui Ying Fu, Ming Ju Hsieh, Yun Hen Liu, Ching Yang Wu*

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

摘要

INTRODUCTION: In the era of lung cancer screening, more and more sub-centimeter indeterminate lung lesions are being identified. It is difficult to approach these lesions and obtain tissue to confirm diagnosis. CT-guided navigation followed by surgical resection is the best way to overcome this difficulty. The aim of this study is to compare the safety and feasibility of wire and dye-tattoo CT-guided localization techniques.

MATERIALS AND METHODS: From September 2019 to August 2021, 418 patients who presented with single lung lesion and received single CT-guided localization were included in this study. Procedure details, navigation results, and related complications were compared.

RESULTS: For patients who received wire localization, majority (98.3 %) had perihilar lesions. In addition, 68 (57.1 %) patients received tangential approach because of lesions were blocked by bony or vital structure, abutting major fissure, or previous approach failure. The characteristics of lesion location was quite different than dye-tattooing technique (p = 0.033). As regards persistence of the target lesion localization, the interval between localization and surgery using ICG tattooing was 829.0 ± 552.9 min; much longer than the other two navigation techniques (p < 0.0001). As regards safety, patients who received wire localization had a higher rate of pneumothorax (p = 0.042) and pulmonary hemorrhage (p < 0.001) than the dye-tattooing techniques.

DISCUSSION: CT-guided navigation techniques are safe and feasible. Wire localization is suitable for centrally located lesions but the wire needs to be fixed properly and symptomatic pneumothorax monitored for. Dye-tattooing is more suitable for peripheral lesions, while ICG localization persists longer than other techniques.

原文英語
文章編號111322
頁(從 - 到)111322
期刊European Journal of Radiology
172
DOIs
出版狀態已出版 - 03 2024

文獻附註

Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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