Preoperative localization for pulmonary nodules: a meta-analysis of coil and liquid materials

Abstract

Purpose: This study was designed to conduct pooled comparisons of the relative clinical efficacy and safety of computed tomography (CT)-guided localization for pulmonary nodules (PNs) using either coil- or liquid material-based approaches.

Material and methods: Relevant articles published as of July 2023 were identified in the Web of Science, PubMed, and Wanfang databases, and pooled analyses of relevant endpoints were then conducted.

Results: Six articles that enrolled 287 patients (341 PNs) and 247 patients (301 PNs) that had respectively undergone CT-guided localization procedures using coil- and liquid material-based approaches prior to video-assisted thoracic surgery (VATS) were included in this meta-analysis. The liquid material group exhibited a significantly higher pooled successful localization rate as compared to the coil group (p = 0.01), together with significantly lower pooled total complication rates (p = 0.0008) and pneumothorax rates (p = 0.01). Both groups exhibited similar rates of pulmonary hemorrhage (p = 0.44) and successful wedge resection (p = 0.26). Liquid-based localization was also associated with significant reductions in pooled localization and VATS procedure durations (p = 0.004 and 0.007).

Conclusions: These data are consistent with CT-guided localization procedures performed using liquid materials being safer and more efficacious than coil-based localization in patients with PNs prior to VATS resection.

Keywords: Localization; coil; liquid; pulmonary nodules.