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High-resolution computed tomography features and CT-guided microcoil localization of subcentimeter pulmonary ground-glass opacities: radiological processing prior to video-assisted thoracoscopic surgery.
J Thorac Dis. 2018 May; 10(5):2676-2684.JT

Abstract

Background

With the rapid development of high-resolution computed tomography (HRCT), low-dose CT scanning and video-assisted thoracoscopic surgery (VATS), smaller pulmonary nodules can be detected. Subcentimeter ground-glass opacities (GGOs) are extremely difficult to diagnose and accurately locate during VATS and in surgically resected specimens.

Methods

From September 2013 to September 2017, 42 subcentimeter GGO lesions (≤1 cm) in 31 patients who underwent CT-guided microcoil insertion followed by VATS resection were included. All HRCT images were assessed by two experienced radiologists, and CT-guided microcoil localization procedures were performed by two experienced interventional radiologists.

Results

A total of 42 subcentimeter GGOs included 28 malignancies (66.7%) and 14 benign lesions (33.3%). The diameter of malignant GGOs (8.52±1.46 mm) was significantly larger than that of benign lesions (7.04±1.52 mm) (P<0.05). Seven patients had more than one GGO nodule. There were no significant differences in the location, composition, shape, margins, presence of air bronchograms, presence of the pleural indentation sign and presence of the vascular convergence sign between benign and malignant GGOs (P>0.05). All the localization procedures were performed successfully. A small pneumothorax occurred in 9 patients (21.4%), and minor hemorrhage in the lung parenchyma occurred in 8 patients (19.0%). All GGOs were easily identified during VATS and were definitively diagnosed.

Conclusions

Common HRCT features cannot be used as criteria for the differential diagnosis of subcentimeter benign and malignant pulmonary GGOs. CT-guided microcoil marking of these lesions prior to VATS is a feasible, safe, and effective procedure for the localization of subcentimeter pulmonary GGOs.

Authors+Show Affiliations

Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao 266000, China.Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao 266000, China.Department of Thoracic Surgery, Qingdao Municipal Hospital, Qingdao 266000, China.Department of Radiology, Qingdao Municipal Hospital, Qingdao 266000, China.Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao 266000, China.Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao 266000, China.Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao 266000, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29997929

Citation

Wang, Zi-Xuan, et al. "High-resolution Computed Tomography Features and CT-guided Microcoil Localization of Subcentimeter Pulmonary Ground-glass Opacities: Radiological Processing Prior to Video-assisted Thoracoscopic Surgery." Journal of Thoracic Disease, vol. 10, no. 5, 2018, pp. 2676-2684.
Wang ZX, Li L, Zhang Z, et al. High-resolution computed tomography features and CT-guided microcoil localization of subcentimeter pulmonary ground-glass opacities: radiological processing prior to video-assisted thoracoscopic surgery. J Thorac Dis. 2018;10(5):2676-2684.
Wang, Z. X., Li, L., Zhang, Z., Wang, G. H., Kong, D. M., Wang, X. D., & Wang, F. (2018). High-resolution computed tomography features and CT-guided microcoil localization of subcentimeter pulmonary ground-glass opacities: radiological processing prior to video-assisted thoracoscopic surgery. Journal of Thoracic Disease, 10(5), 2676-2684. https://doi.org/10.21037/jtd.2018.04.87
Wang ZX, et al. High-resolution Computed Tomography Features and CT-guided Microcoil Localization of Subcentimeter Pulmonary Ground-glass Opacities: Radiological Processing Prior to Video-assisted Thoracoscopic Surgery. J Thorac Dis. 2018;10(5):2676-2684. PubMed PMID: 29997929.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-resolution computed tomography features and CT-guided microcoil localization of subcentimeter pulmonary ground-glass opacities: radiological processing prior to video-assisted thoracoscopic surgery. AU - Wang,Zi-Xuan, AU - Li,Lin, AU - Zhang,Zhe, AU - Wang,Guo-Hua, AU - Kong,De-Mao, AU - Wang,Xu-Dong, AU - Wang,Fa, PY - 2018/7/13/entrez PY - 2018/7/13/pubmed PY - 2018/7/13/medline KW - Ground-glass opacity (GGO) KW - high-resolution computed tomography (HRCT) KW - localization KW - microcoil KW - pulmonary nodules SP - 2676 EP - 2684 JF - Journal of thoracic disease JO - J Thorac Dis VL - 10 IS - 5 N2 - Background: With the rapid development of high-resolution computed tomography (HRCT), low-dose CT scanning and video-assisted thoracoscopic surgery (VATS), smaller pulmonary nodules can be detected. Subcentimeter ground-glass opacities (GGOs) are extremely difficult to diagnose and accurately locate during VATS and in surgically resected specimens. Methods: From September 2013 to September 2017, 42 subcentimeter GGO lesions (≤1 cm) in 31 patients who underwent CT-guided microcoil insertion followed by VATS resection were included. All HRCT images were assessed by two experienced radiologists, and CT-guided microcoil localization procedures were performed by two experienced interventional radiologists. Results: A total of 42 subcentimeter GGOs included 28 malignancies (66.7%) and 14 benign lesions (33.3%). The diameter of malignant GGOs (8.52±1.46 mm) was significantly larger than that of benign lesions (7.04±1.52 mm) (P<0.05). Seven patients had more than one GGO nodule. There were no significant differences in the location, composition, shape, margins, presence of air bronchograms, presence of the pleural indentation sign and presence of the vascular convergence sign between benign and malignant GGOs (P>0.05). All the localization procedures were performed successfully. A small pneumothorax occurred in 9 patients (21.4%), and minor hemorrhage in the lung parenchyma occurred in 8 patients (19.0%). All GGOs were easily identified during VATS and were definitively diagnosed. Conclusions: Common HRCT features cannot be used as criteria for the differential diagnosis of subcentimeter benign and malignant pulmonary GGOs. CT-guided microcoil marking of these lesions prior to VATS is a feasible, safe, and effective procedure for the localization of subcentimeter pulmonary GGOs. SN - 2072-1439 UR - https://www.unboundmedicine.com/medline/citation/29997929/High_resolution_computed_tomography_features_and_CT_guided_microcoil_localization_of_subcentimeter_pulmonary_ground_glass_opacities:_radiological_processing_prior_to_video_assisted_thoracoscopic_surgery_ L2 - https://doi.org/10.21037/jtd.2018.04.87 DB - PRIME DP - Unbound Medicine ER -
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