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. 2024 Jun;19(2):178-186.
doi: 10.5114/wiitm.2024.139198. Epub 2024 Apr 24.

Preoperative computed tomography-guided localization for pulmonary nodules: a randomized controlled trial of coil and anchored needle localization

Ya-Nan Lv  1 , Wen-Tao Zhang  2 , Ying Wang  3 , Gang Wang  3
Affiliations

Preoperative computed tomography-guided localization for pulmonary nodules: a randomized controlled trial of coil and anchored needle localization

Ya-Nan Lv et al. Wideochir Inne Tech Maloinwazyjne. 2024 Jun.

Abstract

Introduction: In patients with pulmonary nodules (PNs), computed tomography (CT)-guided localization is commonly performed prior to the resection of these nodules through video-assisted thoracic surgery (VATS).

Aim: To evaluate the relative clinical efficacy of coil and anchored needle (AN) insertion as approaches to preoperative CT-guided PN localization.

Material and methods: This single-center, prospective, open-label, randomized controlled trial (registration number: NCT05183945) enrolled consecutive patients from January 2022 to July 2022, assigning these patients at random to undergo either coil or AN localization prior to VATS. Efficacy and safety outcomes in these two groups were then compared.

Results: This study enrolled in total 100 patients with 120 PNs who were assigned at random to the coil (patients = 50; PNs = 60) and AN (patients = 50; PNs = 60) localization groups. The respective technical success rates for coil and AN localization were 98.3% (59/60) and 100% (60/60), with no significant difference between the groups (p = 1.000). The coil group had a significantly longer median duration of localization relative to the AN group (16.0 min vs. 8.0 min, p < 0.001). Similar rates of localization-related pneumothorax (8.3% vs. 5.0%, p = 0.715) and pulmonary hemorrhage (5.0% vs. 13.3%, p = 0.110) were observed in both groups. In addition, the VATS resection procedures achieved 100% technical success rates in both of these localization groups.

Conclusions: Both coil- and AN-based localization approaches can be successfully employed to localize PNs prior to VATS resection, with the AN localization procedure requiring less time to complete on average as compared to the coil-based approach.

Keywords: anchored needle; coil; localization; pulmonary nodule.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of this study
Photo 1
Photo 1
Procedures of CT-guided coil localization. A – Preoperative CT showed the PN (arrow) at the right lower lobe. B – The coil (arrow) was localized near the PN. C – The coil tail (arrows) could be visualized during VATS
Photo 2
Photo 2
Procedures of CT-guided AN localization. A – Preoperative CT showed the PN (arrow) at the left upper lobe. B – The tip of AN (arrow) was localized near the PN. C – The tri-colored marker suture (arrows) was visualized during the VATS
See this image and copyright information in PMC

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