Lung Nodule Marking With ICG Dye-Soaked Coil Facilitates Localization and Delayed Surgical Resection

Area of Science:

• Pulmonology
• Thoracic Surgery
• Medical Imaging

Background:

• Surgical resection of pulmonary nodules can lead to unnecessary removal of healthy tissue or excision of benign lesions if localization is difficult.
• Current bronchoscopy-guided marking methods are limited by technology and dye dispersion, especially when surgery is delayed.
• Accurate localization is crucial for effective diagnosis and treatment of pulmonary nodules.

Purpose of the Study:

• To present a novel method for marking pulmonary nodules to improve localization during thoracic surgery.
• To assess the feasibility of using indocyanine green (ICG) dye-soaked fiducial coils for pre-surgical nodule marking.
• To evaluate the durability of ICG dye marking for robotic-assisted bronchoscopy and subsequent surgery.

Main Methods:

• Four patients with lung nodules underwent robot-assisted navigation bronchoscopy.
• Lesions were marked using fiducial coils soaked in indocyanine green (ICG) dye for 10 minutes.
• Subsequent thoracic surgery was performed using the da Vinci robotic system with Firefly fluorescence imaging.

Main Results:

• The ICG dye-soaked fiducial coils allowed clear visualization of lesions multiple days (0-9 days) post-marking.
• No dye dispersion was observed, ensuring accurate localization during surgery.
• All four surgical procedures were completed without complications, demonstrating the safety and efficacy of the method.

Conclusions:

• Improved methods for peripheral pulmonary nodule marking are essential for facilitating surgical resection.
• The use of ICG dye-soaked fiducial coils represents a viable option for lung nodule marking prior to thoracic surgery.
• This novel approach shows promise for accurate and reliable localization of pulmonary nodules, even when surgery is delayed.