A convenient method for identifying a small pulmonary nodule using a dyed swab and geometric mapping

Area of Science:

• Pulmonology
• Surgical Oncology
• Medical Imaging

Background:

• Computed tomography (CT)-guided lung needle marking is crucial for identifying pulmonary nodules.
• Existing methods carry risks of severe complications, including mortality.
• A novel, safe, and convenient dye-marking technique using gentian violet is presented.

Purpose of the Study:

• To present a safe and convenient method for identifying small pulmonary nodules using gentian violet dye.
• To detail the technique for precise localization of pulmonary nodules prior to resection.

Main Methods:

• A CT-guided "magic marker" identifies the skin above the nodule.
• A needle loop retractor is used to puncture the chest wall at the marked site.
• A silk thread carrying a gentian violet-saturated swab is passed through the loop, leaving a visible dye stamp on the lung surface.

Main Results:

• The technique was successfully applied to 51 lesions in 50 patients between 2013 and 2015.
• The mean tumor diameter was 7 mm.
• All lesions were accurately identified, resected with no complications, and located near staple lines.

Conclusions:

• The gentian violet dye-marking technique is simple, rapid, and safe, eliminating concerns about air emboli.
• It does not require hospitalization and accurately defines margins for segmentectomy and guides skin incisions.
• The method is effective for locating impalpable nodules, aiding lung resection and pathology assessment.