Preoperative Computed Tomography-guided Soft Hook-wire Localization for Multiple Pulmonary Nodules

Overview

Journal Front Oncol

Specialty Oncology

Date 2025 Mar 10

PMID 40061898

Authors

Guang-Chao Li

Zheng-Long Wu

Yi-Bing Shi

Jing-Ya Wang

Yu-Fei Fu

Affiliations

Soon will be listed here.

Abstract

Background: While there have been prior reports on pulmonary nodule (PN) localization through computed tomography (CT)-guided soft hook-wire (SHW) placement, there remains a dearth of studies specifically focused on the CT-guided SHW localization of multiple PNs. This study was thus designed to specifically evaluate the efficacy and safety of this localization strategy in patients with multiple PNs.

Methods: In total, 43 consecutive patients with multiple PNs underwent CT-guided SHW localization followed by video-assisted thoracoscopic surgery (VATS) to resent these PNs in our hospital between January 2022 and December 2022. A control group consisting of 140 individuals who underwent the CT-guided SHW localization of a single PN during the same interval was also selected. Both groups were analyzed retrospectively for safety and efficacy outcomes.

Results: The final study population included 43 patients (94 PNs) in the multiple PN group, and 140 patients (140 PNs) in the single PN group, with all patients having undergone CT-guided SHW localization of these PNs. A one-stage procedure was employed for the localization of multiple PNs. The respective rates of technical success for SHW localization in the multiple and single PN groups were 98.9% and 100% (P = 0.402). The duration of localization in the multiple PN group was significantly longer than that in the single PN group (P = 0.001). The respective pneumothorax rates in the multiple and single PN groups were 32.5% (14/43) and 15.7% (22/140) (P = 0.015), while the corresponding lung hemorrhage incidence rates were 48.8% (21/43) and 36.4% (51/140) (P = 0.145). All PNs successfully underwent limited VATS resection, with a one-stage VATS procedure having been used for the resection of multiple PNs in a given patient.

Conclusions: CT-guided SHW localization is a safe and effective means of localizing multiple PNs in a single patient. This simultaneous localization of multiple PNs can provide effective guidance for the subsequent one-stage limited VATS resection of these nodules.

References

Kadeer X, Wang L, Zhang L, Shi W, Chen C . Modified hook-wire placement technique for localizing multiple pulmonary nodules. J Surg Oncol. 2018; 118(7):1188-1193. DOI: 10.1002/jso.25261. View

Wang S, Gao X, Hui H, Li N, Zhou Y, Yin H . Comparison between preoperative hook-wire and liquid material localization for pulmonary nodules: a meta-analysis. Wideochir Inne Tech Maloinwazyjne. 2023; 18(3):401-409. PMC: 10585457. DOI: 10.5114/wiitm.2023.130330. View

Xu L, Wang J, Liu L, Shan L, Zhai R, Liu H . Computed tomography-guided cyanoacrylate injection for localization of multiple ipsilateral lung nodules. Eur Radiol. 2021; 32(1):184-193. DOI: 10.1007/s00330-021-08101-7. View

Huang Y, Liu X, Shi Y, Wang T . Preoperative computed tomography-guided localization for lung nodules: localization needle versus coil. Minim Invasive Ther Allied Technol. 2022; 31(6):948-953. DOI: 10.1080/13645706.2022.2034647. View

Liu G, Wang S, Liu H, Liu Y, Fu Y, Shi Y . Computed Tomography-Guided Biopsy for Small (≤20 mm) Lung Nodules: A Meta-Analysis. J Comput Assist Tomogr. 2020; 44(6):841-846. DOI: 10.1097/RCT.0000000000001071. View

Fu Y, Gao Y, Zhang M, Wang T, Shi Y, Huang Y . Computed tomography-guided simultaneous coil localization as a bridge to one-stage surgery for multiple lung nodules: a retrospective study. J Cardiothorac Surg. 2019; 14(1):43. PMC: 6390604. DOI: 10.1186/s13019-019-0870-6. View

Zhang Z, Wang H, Liu X, Xia F, Fu Y . Methylene Blue versus Coil-Based Computed Tomography-Guided Localization of Lung Nodules. Thorac Cardiovasc Surg. 2020; 68(6):540-544. DOI: 10.1055/s-0040-1708836. View

Wang J, Xia F, Dong A, Lu Y . Comparison between coil and hook-wire localization before video-assisted thoracoscopic surgery for lung nodules: a systematic review and meta-analysis. Wideochir Inne Tech Maloinwazyjne. 2022; 17(3):441-449. PMC: 9511916. DOI: 10.5114/wiitm.2022.116396. View

Aoun H, Littrup P, Heath K, Adam B, Prus M, Beydoun R . Methylene Blue/Collagen Mixture for CT-Guided Presurgical Lung Nodule Marking: High Efficacy and Safety. J Vasc Interv Radiol. 2020; 31(10):1682.e1-1682.e7. DOI: 10.1016/j.jvir.2020.04.028. View

10.

Fu Y, Zhang M, Wu W, Wang T . Coil Localization-Guided Video-Assisted Thoracoscopic Surgery for Lung Nodules. J Laparoendosc Adv Surg Tech A. 2017; 28(3):292-297. DOI: 10.1089/lap.2017.0484. View

11.

Prokop M . Lung cancer screening: the radiologist's perspective. Semin Respir Crit Care Med. 2014; 35(1):91-8. DOI: 10.1055/s-0033-1363455. View

12.

Lin J, Wang L, Wu A, Teng F, Xian Y, Han R . Computed tomography-guided indocyanine green localization of multiple ipsilateral lung nodules. Wideochir Inne Tech Maloinwazyjne. 2023; 18(2):305-312. PMC: 10481448. DOI: 10.5114/wiitm.2023.124272. View

13.

Wang T, Ma S, Yan T, Song J, Wang K, He W . [Computed Tomography Guided Hook-wire Precise Localization and Minimally Invasive Resection of Pulmonary Nodules]. Zhongguo Fei Ai Za Zhi. 2015; 18(11):680-5. PMC: 6000314. DOI: 10.3779/j.issn.1009-3419.2015.11.04. View

14.

Tang X, Jian H, Guan Y, Miao J, Liang X . Computed tomography-guided localization for multiple pulmonary nodules: a meta-analysis. Wideochir Inne Tech Maloinwazyjne. 2021; 16(4):641-647. PMC: 8669986. DOI: 10.5114/wiitm.2021.104199. View

15.

Aberle D, Adams A, Berg C, Black W, Clapp J, Fagerstrom R . Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365(5):395-409. PMC: 4356534. DOI: 10.1056/NEJMoa1102873. View

16.

Zhou W, Chen G, Huang Y, Peng P, Lv P, Lv J . Preoperative computed tomography-guided localization for pulmonary nodules: comparison between hook-wire and anchored needle localization. Wideochir Inne Tech Maloinwazyjne. 2024; 19(1):91-99. PMC: 11223539. DOI: 10.5114/wiitm.2023.134158. View

17.

Church T, Black W, Aberle D, Berg C, Clingan K, Duan F . Results of initial low-dose computed tomographic screening for lung cancer. N Engl J Med. 2013; 368(21):1980-91. PMC: 3762603. DOI: 10.1056/NEJMoa1209120. View

18.

MacMahon H, Naidich D, Goo J, Lee K, Leung A, Mayo J . Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society 2017. Radiology. 2017; 284(1):228-243. DOI: 10.1148/radiol.2017161659. View

19.

Ai M, Xu J . Computed tomography-guided simultaneous coil localization of multiple pulmonary nodules before video-assisted thoracoscopic surgery. Wideochir Inne Tech Maloinwazyjne. 2022; 17(1):245-251. PMC: 8886457. DOI: 10.5114/wiitm.2021.105683. View