Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

Area of Science:

• Thoracic Surgery
• Medical Imaging
• Pulmonology

Background:

• Increased use of chest computed tomography (CT) leads to more pulmonary nodule detection.
• Minimally invasive surgery is common, but localizing small or subsolid nodules intra-operatively is challenging.
• Electromagnetic transthoracic needle localization offers a solution for improved nodule identification.

Purpose of the Study:

• To delineate the step-by-step protocol for electromagnetic localization of pulmonary nodules.
• To adapt and detail a previously described electromagnetically guided percutaneous biopsy technique.
• To highlight the benefits of this method for intra-operative nodule identification.

Main Methods:

• Pre-operative 3D virtual lung mapping using same-day CT.
• Intra-operative calibration of virtual reconstruction with patient and electromagnetic navigation platform.
• Percutaneous needle insertion, dye injection into the lesion, and continuous dye injection during needle withdrawal to create a visible tract.

Main Results:

• The procedure facilitates intra-operative visualization of target lesions.
• Potential benefits include decreased radiation exposure compared to CT-guided localization.
• Reduced time between dye injection and surgery minimizes dye diffusion, improving localization accuracy.

Conclusions:

• Electromagnetic transthoracic needle localization is an effective method for identifying difficult-to-localize pulmonary nodules.
• This technique overcomes limitations of CT-guided localization and electromagnetic bronchoscopy.
• It offers improved patient wait times and nodule localization accuracy.