Preoperative radio-guided localization of lung nodules with I-125 seeds: experience with 32 patients at a single institution.

Interactive cardiovascular and thoracic surgery 2022 Jan 06

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Videothoracoscopic visualization and/or palpation of pulmonary nodules may be difficult due to their location, small size or limited solid component. The purpose of this study is to present our experience with computed tomography (CT)-guided preoperative localization of pulmonary nodules by percutaneous marking with radio-labelled iodine-125 seeds. A total of 34 pulmonary nodules were marked under CT with the placement of 33 radio-labelled iodine-125 seeds in 32 consecutive patients. All patients underwent biportal video-assisted thoracic surgery (VATS) and in no case was conversion to thoracotomy necessary. A total of 88.2% of the lung nodules were successfully resected. In the remaining 11.8%, migration of the seed to the pleural cavity occurred, although these nodules were still resected during VATS. Of all the patients with pneumothorax after the marking procedure, only one required chest tube placement (3.1%). No major postoperative complications were observed. Preoperative marking of pulmonary nodules with I-125 seeds under CT guidance is a feasible and safe technique that allows their intraoperative identification and resection. © The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Citation

Sara Fra-Fernández, Luis Gorospe-Sarasúa, Odile Ajuria-Illarramendi, Percy Enrique Serrano-Carvajal, Gemma María Muñoz-Molina, Alberto Cabañero-Sánchez, Maria Eugenia Rioja-Martin, Nicolás Moreno-Mata. Preoperative radio-guided localization of lung nodules with I-125 seeds: experience with 32 patients at a single institution. Interactive cardiovascular and thoracic surgery. 2022 Jan 06;34(1):91-98