Computed tomography-guided Sens-cure needle localization for scapular-blocked lung nodules

Area of Science:

• Thoracic Surgery
• Medical Imaging
• Pulmonology

Background:

• Preoperative computed tomography (CT) guided wedge resection (WR) using video-assisted thoracoscopic surgery (VATS) is standard for lung nodules (LNs).
• Scapular obstruction poses a challenge for standard LN localization techniques.
• A trans-scapular approach may be necessary for accurate localization of these scapula-blocked lung nodules (SBLNs).

Purpose of the Study:

• To evaluate the feasibility, safety, and clinical effectiveness of CT-guided Sens-cure needle (SCN) localization for SBLNs.
• To assess the success rate of SCN localization and subsequent VATS wedge resection in patients with SBLNs.

Main Methods:

• A retrospective study of 180 patients undergoing CT-guided SCN localization for LNs between January 2018 and December 2021.
• Analysis focused on 10 patients with SBLNs who underwent a trans-scapular SCN localization approach.
• Outcomes assessed included technical success of localization, complications, and VATS procedure details.

Main Results:

• The trans-scapular SCN localization approach was technically successful in 100% of patients with SBLNs.
• No complications occurred related to scapular puncture.
• The wedge resection success rate was 100%, with 3 patients requiring additional lobectomy for invasive adenocarcinoma.

Conclusions:

• Preoperative CT-guided SCN localization via a trans-scapular approach is a safe and highly effective method for SBLNs.
• This technique facilitates successful VATS-guided wedge resection of lung nodules previously inaccessible due to scapular blockage.
• The study demonstrates the clinical utility of the trans-scapular approach for challenging lung nodule localizations.