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Image-guided Preoperative Localization of Pulmonary Nodules for Video-assisted and Robotically Assisted Surgery.
Radiographics 2019 Sep-Oct; 39(5):1264-1279R

Abstract

Video-assisted thoracic surgery (VATS) and robotically assisted surgery are used increasingly for minimally invasive diagnostic and therapeutic resection of pulmonary nodules. Unsuccessful localization of small, impalpable, or deep pulmonary nodules can necessitate conversion from VATS to open thoracotomy. Preoperative localization techniques performed by radiologists have improved the success rates of VATS resection for small and subsolid nodules. Any center at which VATS diagnostic resection of indeterminate pulmonary nodules is performed should be supported by radiologists who offer preoperative nodule localization. Many techniques have been described, including image-guided injection of radioisotopes and radiopaque liquids and placement of metallic wires, coils, and fiducial markers. These markers enable the surgeon to visualize the position of an impalpable nodule intraoperatively. This article provides details on how to perform each percutaneous localization technique, and a group of national experts with established nodule localization programs describe their preferred approaches. Special reference is made to equipment required, optimization of marker placement, prevention of technique-specific complications, and postprocedural treatment. This comprehensive unbiased review provides valuable information for those who are considering implementation or optimization of a nodule localization program according to workflow patterns, surgeon preference, and institutional resources in a particular center. ©RSNA, 2019.

Authors+Show Affiliations

From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).From the Division of Thoracic Imaging and Intervention (S.M., F.J.F., M.C.P., J.O.S., A.S.) and the Department of Thoracic Surgery (H.C.O.), Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114; Cardiothoracic Imaging Section, Mallinckrodt Institute of Radiology, St Louis, Mo (A.J.B.); Department of Interventional Radiology, Yale New Haven Hospital, New Haven, Conn (D.D.S.); and Department of Medical Imaging, Vancouver General Hospital, Vancouver, British Columbia, Canada (J.R.M.).

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31419188

Citation

McDermott, Shaunagh, et al. "Image-guided Preoperative Localization of Pulmonary Nodules for Video-assisted and Robotically Assisted Surgery." Radiographics : a Review Publication of the Radiological Society of North America, Inc, vol. 39, no. 5, 2019, pp. 1264-1279.
McDermott S, Fintelmann FJ, Bierhals AJ, et al. Image-guided Preoperative Localization of Pulmonary Nodules for Video-assisted and Robotically Assisted Surgery. Radiographics. 2019;39(5):1264-1279.
McDermott, S., Fintelmann, F. J., Bierhals, A. J., Silin, D. D., Price, M. C., Ott, H. C., ... Sharma, A. (2019). Image-guided Preoperative Localization of Pulmonary Nodules for Video-assisted and Robotically Assisted Surgery. Radiographics : a Review Publication of the Radiological Society of North America, Inc, 39(5), pp. 1264-1279. doi:10.1148/rg.2019180183.
McDermott S, et al. Image-guided Preoperative Localization of Pulmonary Nodules for Video-assisted and Robotically Assisted Surgery. Radiographics. 2019;39(5):1264-1279. PubMed PMID: 31419188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Image-guided Preoperative Localization of Pulmonary Nodules for Video-assisted and Robotically Assisted Surgery. AU - McDermott,Shaunagh, AU - Fintelmann,Florian J, AU - Bierhals,Andrew J, AU - Silin,Douglas D, AU - Price,Melissa C, AU - Ott,Harald C, AU - Shepard,Jo-Anne O, AU - Mayo,John R, AU - Sharma,Amita, Y1 - 2019/08/16/ PY - 2019/8/17/pubmed PY - 2019/8/17/medline PY - 2019/8/17/entrez SP - 1264 EP - 1279 JF - Radiographics : a review publication of the Radiological Society of North America, Inc JO - Radiographics VL - 39 IS - 5 N2 - Video-assisted thoracic surgery (VATS) and robotically assisted surgery are used increasingly for minimally invasive diagnostic and therapeutic resection of pulmonary nodules. Unsuccessful localization of small, impalpable, or deep pulmonary nodules can necessitate conversion from VATS to open thoracotomy. Preoperative localization techniques performed by radiologists have improved the success rates of VATS resection for small and subsolid nodules. Any center at which VATS diagnostic resection of indeterminate pulmonary nodules is performed should be supported by radiologists who offer preoperative nodule localization. Many techniques have been described, including image-guided injection of radioisotopes and radiopaque liquids and placement of metallic wires, coils, and fiducial markers. These markers enable the surgeon to visualize the position of an impalpable nodule intraoperatively. This article provides details on how to perform each percutaneous localization technique, and a group of national experts with established nodule localization programs describe their preferred approaches. Special reference is made to equipment required, optimization of marker placement, prevention of technique-specific complications, and postprocedural treatment. This comprehensive unbiased review provides valuable information for those who are considering implementation or optimization of a nodule localization program according to workflow patterns, surgeon preference, and institutional resources in a particular center. ©RSNA, 2019. SN - 1527-1323 UR - https://www.unboundmedicine.com/medline/citation/31419188/Image-guided_Preoperative_Localization_of_Pulmonary_Nodules_for_Video-assisted_and_Robotically_Assisted_Surgery L2 - http://pubs.rsna.org/doi/10.1148/rg.2019180183?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -