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

The aim of this study was to evaluate the clinical value of computed tomographyguided localization needle (LN) and methylene blue (MB) for pulmonary nodule localization.

Between November 2019 and January 2022, 547 patients underwent computed tomography-guided LN (n=171) or MB (n=376) localization and video-assisted thoracoscopic surgery (VATS) resection.

In total, 171 and 376 nodules were localized via LN and MB, respectively, with respective technical localization success rates of 92.98 % and 88.56 % (p = 0.111). The pulmonary nodule localization time was significantly shorter for the MB group than for the LN group (p < 0.05). However, the rates of total complication, chest pain, and cough were significantly lower in the LN group (χ² = 8.251/25.092/5.127, all p < 0.05). Furthermore, the LN group had a shorter VATS time than the MB group (p < 0.05). The VATS achieved a 100% operation success rate in both groups, and there was no significance between groups with respect to the types of surgery (p > 0.05) or the blood loss (p > 0.05). Moreover, logistic regression analysis showed that the localization technique was an independent risk factor for total complications and chest pain.

Both techniques can effectively localize pulmonary nodules before VATS. MB had a shorter localization time, but the LN had a shorter VATS time and a lower incidence of complications, especially chest pain.