Evidence map›Paper›PMID 42347901›Full record

ArticleGeneral thoracic and cardiovascular surgery2026

Intraoperative mobile CT and virtual-assisted lung mapping for pulmonary nodule localization: workflow characteristics and radiation dosage in a single-center experience.

Keita Nakao, Takahiro Karasaki, Yue Cong, Takaki Akamine, Masahiro Yanagiya, Masaaki Nagano, Mitsuaki Kawashima, Gouji Toyokawa, Chihiro Konoeda, Masaaki Sato

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Article in General thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Keita NakaoDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.ORCID http://orcid.org/0000-0001-8319-248X
Takahiro KarasakiDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan. karasakit-sur@h.u-tokyo.ac.jp.ORCID http://orcid.org/0000-0001-6863-2360
Yue CongDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Takaki AkamineDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Masahiro YanagiyaDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Masaaki NaganoDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Mitsuaki KawashimaDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Gouji ToyokawaDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Chihiro KonoedaDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.
Masaaki SatoDepartment of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIntraoperative mobile CT (iCT) and virtual-assisted lung mapping (VAL-MAP) are used to localize pulmonary nodules that are difficult to palpate during minimally invasive surgery. Because these techniques differ in workflow structure and timing of image acquisition, their operative time and radiation exposure may differ. We aimed to describe workflow characteristics and radiation exposure associated with newly implemented iCT and to contextualize these findings against our established VAL-MAP practice.

methodsWe retrospectively reviewed 50 consecutive patients who underwent thoracoscopic wedge resection with localization between January 2024 and December 2025. Twenty-four underwent iCT-guided localization using an O-arm system, and 26 underwent VAL-MAP with bronchoscopic dye marking followed by post-mapping CT. Technique selection was based on device availability and surgeon discretion. CT dose metrics and time components related to localization were analyzed.

resultsMedian CT-related dose-length product (DLP) was higher in the iCT group, primarily due to high-definition scans. When performed in standard mode with a limited scan frequency, iCT radiation exposure approximated that of post-VAL-MAP CT. Preparation CT after lateral positioning reduced repeat scans and iCT-related interruption time. Anesthesia and operative times were shorter in the VAL-MAP cohort, reflecting localization outside the operating room. Overall procedural burden appeared modestly different.

conclusionOur single-center retrospective study quantified the total procedural time for VAL-MAP and iCT, finding modest differences in time and radiation exposure. These real-world data aid institutions considering these localization strategies, but do not establish superiority. Definitive comparative conclusions require future prospective evaluations controlling for nodule characteristics and cost.

Indexed as

Computed tomographyIntraoperative imagingPulmonary nodulesThoracic surgeryVideo-assistedVirtual-assisted lung mapping (VAL-MAP)

Identifiers

PMID42347901

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