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Related Experiment Video

Updated: Nov 7, 2025

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
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Computed Tomography-Guided Methylene Blue Localization: Single vs. Multiple Lung Nodules.

Chia-Ying Lin1, Chao-Chun Chang2, Li-Ting Huang1

  • 1Department of Medical Imaging, College of Medical College, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.

Frontiers in Medicine
|May 3, 2021
PubMed
Summary
This summary is machine-generated.

Preoperative CT-guided methylene blue localization is effective for both single and multiple pulmonary nodules, proving safe and feasible for VATS surgery. This technique aids in locating small, impalpable lung nodules, improving surgical outcomes.

Keywords:
computed tomographydyelocalizationlung cancer surgerypulmonary nodule

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Area of Science:

  • Thoracic Surgery
  • Pulmonary Medicine
  • Medical Imaging

Background:

  • Preoperative localization is crucial for single-port video-assisted thoracoscopic surgery (VATS) of small, impalpable pulmonary nodules.
  • Localization of multiple pulmonary nodules during VATS resection presents significant challenges.

Purpose of the Study:

  • To evaluate the efficacy of preoperative CT-guided methylene blue localization for both single and multiple pulmonary nodules.
  • To assess the safety and feasibility of this localization technique in VATS procedures.

Main Methods:

  • Retrospective analysis of 388 patients undergoing CT-guided methylene blue localization followed by VATS resection (January 2014 - November 2019).
  • Comparison of outcomes between single (337 patients) and multiple (51 patients) nodule groups using statistical tests.
  • Logistic regression analysis to identify risk factors for procedure-related complications.

Main Results:

  • Comparable success rates for methylene blue localization: 98.8% for single nodules and 100% for multiple nodules.
  • Multiple nodule group experienced longer procedure times (23.2 vs. 7.6 min) and higher pneumothorax risk (47.1 vs. 25.5%).
  • Procedure time and nodule depth were identified as independent risk factors for pneumothorax and pulmonary hemorrhage, respectively.

Conclusions:

  • Preoperative CT-guided methylene blue localization is a safe, feasible, and effective method for both single and multiple pulmonary nodules.
  • The technique facilitates VATS resection of challenging lung nodules, including those that are multiple or impalpable.