Radiotracer localization of nonpalpable pulmonary nodules: A single-center experience

Starnes, Sandra L.; Wolujewicz, Michael; Guitron, Julian; Williams, Valerie; Scheler, Jennifer; Ristagno, Ross L.

doi:10.1016/j.jtcvs.2018.03.152

Cited by 22 publications

(24 citation statements)

References 17 publications

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“…tumor border to the nearest visceral pleura as the tumor depth, with a nodule with a depth of ≥20 mm considered as deep (18). Several studies have reported that localization of a nodule with a depth of approximately 20-25 mm could be feasible and effective (9,(18)(19)(20). Nodules with a depth of >3 mm are usually considered deep and an anticipated lobectomy was required (9).…”

Section: Discussionmentioning

confidence: 99%

“…However, methylene blue has certain limitations; it can easily diffuse over the pleural surface, rendering it difficult to identify alongside extensive anthracotic pleural pigments. Moreover, methylene blue does not mark the depth of a lesion (19). Lin et al were the first to report using of PBV dye instead of methylene blue for localization (14), with a high success rate and safety.…”

Section: Management Of a Deep-situated Pulmonary Nodule Is Challenginmentioning

confidence: 99%

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Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery

Tsai

Chiang

Liao³

et al. 2019

Ann. Transl. Med

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Background: Increased lung cancer screening of asymptomatic adults using low-dose computed tomography (CT) with high-resolution imaging modalities has increased the identification of small and deeply situated pulmonary nodules. This study aimed to evaluate the role of preoperative patient blue vital (PBV) dye localization for an undiagnosed nodule deeply situated in the lung parenchyma followed by minimally invasive lung resection. Methods: From July 2013 to December 2016, 27 consecutive patients (16 women, median age: 62 years) with small undiagnosed pulmonary nodules at a depth of more than 30 mm underwent preoperative CTguided PBV dye localization followed by thoracoscopic diagnostic resection of the nodule at National Taiwan University Hospital. The clinical characteristics were collected retrospectively to evaluate the efficacy and safety of the procedure. Results: The median size of pulmonary nodule in preoperative CT images was 11 mm with a median depth of 31.6 mm (range, 30.0-48.6 mm). Of the 27 nodules, 8 were pure ground-glass nodules, 3 were pure solid nodules, and 16 were partially solid nodules. The diagnostic yield of CT-guided dye localization following diagnostic wedge resection was 100%. The final pathological diagnoses were: primary adenocarcinoma of the lung (n=20), adenocarcinoma in situ (n=1), and benign nodules (n=6). Only asymptomatic complications were noted after localization, and the median hospital stay was 3 days [interquartile range (IQR), 3-4 days]. All of 21 patients were cancer-free after a median follow-up of 39.0 months (IQR, 29.5-50.0 months). Conclusions: This study indicated that preoperative, percutaneous CT-guided PBV dye localization for undiagnosed nodules at a depth of more than 30 mm could be a safe and feasible procedure. Furthermore, it was considerably advantageous for preserving the lung parenchyma, especially for benign nodules.

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Section: Discussionmentioning

confidence: 99%

Section: Management Of a Deep-situated Pulmonary Nodule Is Challenginmentioning

confidence: 99%

Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery

Tsai

Chiang

Liao³

et al. 2019

Ann. Transl. Med

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“…Gamma-emitting radioisotopes (99mTc) attached to large albumin molecules can be used for localization under CT guidance (28)(29)(30). On the day of the operation, 0.2 mL of 99mTc-labeled human serum albumin microspheres is injected as close to the lesion as possible through the thoracic wall with a 22-gauge needle under local anesthesia (30). Some centers add 0.1-0.2 mL of nonionic contrast to the radiotracer to confirm the presence of radiotracer within the nodule on post-procedure CT scans (28,31).…”

Section: Localization With Radiotracersmentioning

confidence: 99%

Planting Seeds into the Lung: Image-Guided Percutaneous Localization to Guide Minimally Invasive Thoracic Surgery

et al. 2019

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Image-guided localization materials are constantly evolving, providing options for the localization of small pulmonary nodules to guide minimally invasive thoracic surgery. Several preoperative methods have been developed to localize small pulmonary lesions prior to video-assisted thoracic surgery. These localization techniques can be categorized into 4 groups according to the materials used: localization with metallic materials (hook-wire, microcoil, or spiral coil), localization with dye (methylene blue or indigo carmine), localization with contrast agents (lipiodol, barium, or iodine contrast agents), and radiotracers (technetium-99m). However, the optimal localization method has not yet been established. In this review article, we discuss the various localization techniques and the advantages and disadvantages of localization techniques as well as the available safety and efficacy data on these techniques.

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“…Such markers are therefore intensively explored for preoperative and intraoperative target localization and navigation. Examples of currently available markers for surgical guidance include hook wires, iodinated oils (Lipiodol) and 99m Tc-labeled nanoparticles that are visible in ultrasonography, CT or SPECT imaging, respectively [3][4][5]. Marker-associated complications are however common, e.g.…”

Section: Introductionmentioning

confidence: 99%

Carbohydrate based biomarkers enable hybrid near infrared fluorescence and ⁶⁴Cu based radio-guidance for improved surgical precision

Wang¹,

Hansen²,

Sun³

et al. 2021

Nanotheranostics

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Increasing numbers of lung tumors are identified at early disease stages by diagnostic imaging in screening programs, but difficulties in locating these during surgical intervention has prevented an improved treatment outcome. Surgical biomarkers that are visible on diagnostic images, and that provide the surgeon with real-time image guidance during the intervention are thus highly warranted to bridge diagnostic precision into enhanced therapeutic outcome. In this paper, a liquid soft tissue marker for near infrared fluorescence and radio-guidance is presented. The biocompatible marker is based on the carbohydrate ester, sucrose acetate isobutyrate, ethanol, and a multifunctional naphthalocyanine dye, which enable near infrared fluorescence image-guided resection at short, medium and long tissue depths. Naphthalocyanine dyes have high quantum yields and may further act as chelators of radionuclides. Upon injection of the liquid marker, a gel-like depot is formed in situ at the site of injection, wherein the fluorescent dye and radionuclide is retained. The radiolabeled markers were optimized for minimal fluorescence quenching and high retention of the positron emission tomography radionuclide 64 Cu. The performance of the radiolabeled marker was tested in vivo in mice, where it displayed high photostability over a period of 4 weeks, and high retention of 64 Cu for 48 hours. The retention and biodistribution of 64 Cu was quantified via PET/CT, and the fluorescence emission by an in vivo imaging system. The presented data demonstrate proof-of-concept for naphthalocyanine markers as multimodal imaging agents that can bridge the precision of diagnostic imaging into surgical interventions.

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Radiotracer localization of nonpalpable pulmonary nodules: A single-center experience

Abstract: Radiotracer localization is a simple and effective technique for intraoperative identification of small pulmonary nodules.

Cited by 22 publications

References 17 publications

Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery

Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery

Planting Seeds into the Lung: Image-Guided Percutaneous Localization to Guide Minimally Invasive Thoracic Surgery

Carbohydrate based biomarkers enable hybrid near infrared fluorescence and ⁶⁴Cu based radio-guidance for improved surgical precision

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Radiotracer localization of nonpalpable pulmonary nodules: A single-center experience

Abstract: Radiotracer localization is a simple and effective technique for intraoperative identification of small pulmonary nodules.

Cited by 22 publications

References 17 publications

Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery

Computed tomography-guided dye localization for deeply situated pulmonary nodules in thoracoscopic surgery

Planting Seeds into the Lung: Image-Guided Percutaneous Localization to Guide Minimally Invasive Thoracic Surgery

Carbohydrate based biomarkers enable hybrid near infrared fluorescence and 64Cu based radio-guidance for improved surgical precision

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Product

Resources

About

Carbohydrate based biomarkers enable hybrid near infrared fluorescence and ⁶⁴Cu based radio-guidance for improved surgical precision