ArticleThoracic cancer2026
Nodule Dye-Localization Using Interventional Fluoroscopy for Image-Guided Sublobar Lung Resection.
Article in Thoracic cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
backgroundPrecise localization is critical for sublobar resection of small pulmonary nodules. We evaluated the safety, technical efficiency, and clinical outcomes of preoperative percutaneous dye-localization using a cone-beam computed tomography (CBCT)-enabled flat-panel detector interventional fluoroscopy system in a hybrid operating room (HOR).
methodsWe retrospectively reviewed 74 consecutive patients (137 lesions) who underwent image-guided localization followed by video-assisted thoracoscopic surgery (VATS) sublobar resection (wedge resection or segmentectomy) between 2022 and 2023 at Chia-Yi Christian Hospital. Procedural workflow, localization success, surgical margins, and perioperative outcomes were systematically analyzed.
resultsTechnical localization success was achieved in 100% of lesions (mean nodule diameter: 8.59 ± 4.85 mm). The procedure required a mean of 1.31 ± 0.67 puncture attempts per lesion at a mean depth of 5.22 ± 1.86 cm. Procedure-related pneumothorax occurred in 29.7% (22/74) of patients, with 14.9% (11/74) requiring pigtail catheter drainage; pneumothorax occurrence was significantly associated with multiple puncture attempts (p < 0.001) and lower-lobe lesions (p = 0.001). Lower-lobe location was significantly associated with requiring more puncture attempts (p = 0.028). For malignant lesions, the mean pathological resection margin was 17.16 ± 8.73 mm, with 92.31% achieving a margin-to-tumor ratio (MTR) ≥ 1. The mean postoperative hospital stay was 3.04 ± 1.16 days.
conclusionsSingle-stage image-guided dye-localization and VATS sublobar lung resection in an HOR using a biplane CBCT-enabled platform is safe, feasible, and effective. This streamlined workflow ensures high technical success and adequate surgical margins with manageable complications. Further studies are warranted to evaluate long-term oncological outcomes.
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