Computed Tomography-guided Techniques for Localizing Pulmonary Nodules by Localization Needle versus Methylene Blue

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Imaging

Background:

• Pulmonary nodules require precise localization for effective surgical resection.
• Video-assisted thoracoscopic surgery (VATS) is a common minimally invasive approach for pulmonary nodule removal.
• Choosing the optimal localization technique is crucial for patient outcomes.

Purpose of the Study:

• To compare the clinical value of computed tomography-guided localization needle (LN) and methylene blue (MB) for pulmonary nodule localization prior to VATS.
• To evaluate the efficacy, safety, and procedural characteristics of LN versus MB techniques.

Main Methods:

• A retrospective study involving 547 patients undergoing computed tomography-guided LN (n=171) or MB (n=376) localization followed by VATS resection.
• Comparison of technical success rates, localization times, complication rates (total, chest pain, cough), and VATS procedure times.

Main Results:

• Both LN and MB demonstrated high technical localization success rates (92.98% vs. 88.56%).
• Methylene blue (MB) offered significantly shorter localization times (p < 0.05).
• Localization needle (LN) group showed significantly lower rates of total complications, chest pain, and cough (p < 0.05), and a shorter VATS time (p < 0.05).
• Localization technique was identified as an independent risk factor for complications, particularly chest pain.

Conclusions:

• Both computed tomography-guided localization needle (LN) and methylene blue (MB) are effective for pulmonary nodule localization before VATS.
• While MB provides faster localization, LN is associated with reduced VATS time and fewer complications, notably chest pain.