Preoperative computed tomography-guided soft hook-wire localization for multiple pulmonary nodules

Area of Science:

• Medical Imaging and Interventional Radiology
• Thoracic Surgery
• Pulmonary Medicine

Background:

• Pulmonary nodules (PNs) require accurate localization for effective resection.
• Previous studies focused on single PN localization; multiple PN localization remains less explored.
• CT-guided soft hook-wire (SHW) placement is an established technique for PN localization.

Purpose of the Study:

• To evaluate the efficacy and safety of CT-guided SHW localization for multiple PNs.
• To assess the feasibility of simultaneous localization for subsequent surgical resection.
• To compare outcomes between multiple PN and single PN localization procedures.

Main Methods:

• Retrospective analysis of 43 patients with multiple PNs undergoing CT-guided SHW localization and VATS.
• Comparison with a control group of 140 patients with single PNs.
• Evaluation of technical success, procedure duration, pneumothorax, and lung hemorrhage rates.

Main Results:

• Technical success rates were high in both groups (98.9% for multiple PNs, 100% for single PN).
• Localization duration was significantly longer for multiple PNs (P = 0.001).
• Higher pneumothorax rates observed in the multiple PN group (32.5% vs. 15.7%, P = 0.015).

Conclusions:

• CT-guided SHW localization is a safe and effective strategy for multiple PNs.
• Simultaneous localization facilitates single-stage VATS resection of multiple PNs.
• The technique provides reliable guidance for complex thoracic interventions.