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. 2022 Nov 8;35(6):ivac234.
doi: 10.1093/icvts/ivac234.

Ultrasound location of ground-glass opacity during thoracoscopic surgery

Gaetana Messina  1 , Mary Bove  1 , Giovanni Natale  1 , Antonio Noro  1 , Mario Martone  1 , Giorgia Opromolla  1 , Vincenzo Di Filippo  1 , Beatrice Leonardi  1 , Morena Fasano  2 , Rita Polito  3 , Alfonso Fiorelli  1 , Mario Santini  1 , Giovanni Vicidomini  1
Affiliations

Ultrasound location of ground-glass opacity during thoracoscopic surgery

Gaetana Messina et al. Interact Cardiovasc Thorac Surg. .

Abstract

Objectives: Application of video-assisted thoracoscopy brought lung surgery into the minimally invasive era; the lack of tactile feedback using VATS, remains a disadvantage because surgeons are unable to locate lesions with a finger or device. This study aimed to investigate the effectiveness, the applicability and the utility of intraoperative ultrasound (IU), for the localization of small ground-glass opacity (GGO) lesions in the parenchyma, as a guide in finding their margins in a deflated lung.

Materials and methods: We included 15 consecutive patients undergoing diagnostic resection of GGOs via VATS in the Thoracic Surgery Unit of the University of 'Luigi Vanvitelli' of Naples from November 2019 to December 2021. They were under general anaesthesia, when the lung had been collapsed, the probe was placed in the region where the target lesion was thought to reside on the basis of low-dose computed tomography scanning. GGO could be identified their sizes, echo levels and posterior echo was recorded by IU when the lung was completely deflated.

Results: We conducted a retrospective single-centre study. All GGOs were identified by IU. The mean size and depth were 14.1 ± 0.5 and 4.8 ± 0.3 mm, respectively. Six (40%) lesions had hyperechoic patterns, 9 (60%) had mixed echogenicity where the hyperechoic patterns were irregularly mixed with hypoechoic patterns. The final diagnoses included 2 (15%) atypical adenomatous hyperplasia; 2 (15%) adenocarcinomas in situ; 3 (23%) minimally invasive adenocarcinomas and 6 (46%) invasive adenocarcinomas.

Conclusions: The results of our study showed that IU could safely and effectively detect GGOs.

Keywords: Ground-glass opacity pattern; Thoracic surgery; Ultrasound.

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Figures

Figure 1:
Figure 1:
The probe was placed in the region of the target lesion. The ultrasound consents to distinguish the ground-glass opacity from the lung parenchyma.
Figure 2:
Figure 2:
Intraoperative ultrasound can detect accurately the location and can define the characteristics of Ground-glass opacities.
Figure 3:
Figure 3:
Lesion with a greater diameter was easier to find.
Figure 4:
Figure 4:
Lesion less deep from the visceral pleura was easier to find.
Figure 5:
Figure 5:
Atypical adenomatous hyperplasia.
Figure 6:
Figure 6:
Lepidic adenocarcinoma.
Figure 7:
Figure 7:
Invasive adenocarcinomas.
None
See this image and copyright information in PMC

References

    1. Nakata M, Saeki H, Takata I, Segawa Y, Mogami H, Mandai K. et al. Focal ground-glass opacity detected by low-dose helical CT. Chest 2002;121:1464–7. - PubMed
    1. Kobayashi Y, Mitsudomi T.. Management of ground-glass opacities: should all pulmonary lesions with ground-glass opacity be surgically resected? Transl Lung Cancer Res 2013;2:63. - PMC - PubMed
    1. Kondo R, Yoshida K, Hamanaka K, Hashizume M, Ushiyama T, Hyogotani A. et al. Intraoperative ultrasonographic localization of pulmonary groundglass opacities. J Thorac Cardiovasc Surg 2009;138:837–42. - PubMed
    1. Infante M, Lutman RF, Imparato S, Di Rocco M, Ceresoli GL, Torri V. et al. Differential diagnosis and management of focal ground-glass opacities. Eur Respir J 2009;33:7. - PubMed
    1. Fiorelli A, Carlucci A, Natale G, Bove M, Freda C, Noro A. et al. Survival after video-assisted thoracoscopic surgery for lung metastasectomy. Video-Assist Thorac Surg 2021;6:2–10.

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