Image-guided techniques for localizing pulmonary nodules in thoracoscopic surgery.

Area of Science:

• Pulmonology and Thoracic Surgery
• Medical Imaging
• Oncology

Background:

• Low-dose computed tomography (LDCT) screening enhances detection of small pulmonary nodules with ground-glass opacity (GGO).
• Resection of these peripheral lung nodules via minimally invasive thoracoscopic surgery presents significant challenges for thoracic surgeons.
• Accurate preoperative localization is essential for successful surgical outcomes.

Approach:

• This review examines various image-guided preoperative localization techniques for pulmonary nodules.
• Methods discussed include computed tomography (CT) and bronchoscopy, the primary imaging tools.
• Localization materials such as hookwires, dyes, microcoils, fiducial markers, contrast media, and radiotracers are considered.

Key Points:

• Image-guided localization is mandatory for thoracoscopic resection of small GGO lung nodules.
• Computed tomography (CT) and bronchoscopy are primary localization modalities.
• Various materials (e.g., hookwires, dyes, fiducial markers) and intraoperative tools (ultrasonography, near-infrared imaging) are employed.

Conclusions:

• A comprehensive understanding of different localization techniques, their indications, and limitations is vital.
• Optimizing localization strategies can improve the success rates of minimally invasive lung nodule resection.
• Further advancements in imaging and localization materials are expected to enhance surgical precision.