ArticlePeerJ2025
Analysis of factors influencing hookwire dislodgement in CT-guided hookwire localization: a retrospective study using variable importance analysis with a random forest model.
Article in PeerJ, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- The unified front: a multidisciplinary approach in the Era of uniportal thoracic surgery.Frontiers in surgery · 2026Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive and safe procedure. However, lung deflation during the operation causes anatomic landmark distortion, complicating small nodules detection. Computed tomography (CT)-guided hookwire localization promotes the success rates of VATS, but faces issues with hookwire dislodgement, potentially losing intraoperative tumor reference. This study was conducted to identify the relative importance ranking of potential factors influencing dislodgement in CT-guided hookwire localization. Methods: This retrospective study reviewed 123 cases of CT-guided hookwire localization followed by VATS resection. Variables analyzed included sex, age, nodule size, emphysema, chest wall/muscle/total depth, distance from the nodule (DNP) or wire tip to the pleura (DWP), procedure time, nodule subtypes, multiple localization, post-procedural hemorrhage, pneumothorax, nodule penetration, and time intervals between completion of procedure to initiation of surgery (PS interval). Variables were compared using chi-square tests or Mann-Whitney tests. A random forest model, enhanced with the Synthetic Minority Over-sampling Technique (SMOTE) for oversampling, was employed to determine the relative importance of each variable. The relative importance of variables was presented using the mean decrease Gini and mean decrease accuracy metrics. For sensitivity analysis, relative variable importance was analyzed using extreme gradient boosting (XGBoost) model, and the relative importance of variables was presented using the gain metric. Results: Among the 123 cases, dislodgement occurred in 15. In univariable analysis, only the PS interval was statistically significant (134.1 ± 73.1 Conclusions: The study identified the PS interval as the most critical factor in hookwire dislodgement, along with DNP, DWP, total depth, and age. These results identified the presence of modifiable factors within the hospital and can assist practitioners and surgeons in recognizing the dislodgement risk of procedures based on various patient factors.
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