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Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules

BACKGROUND: Some pulmonary nodules are not suitable for computed tomography-guided percutaneous localization. This study aimed to investigate the feasibility and safety of real-time localization for these non-palpable pulmonary nodules using watershed analysis of the target pulmonary artery during t...

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Autores principales: Chu, Xiang-Peng, Chen, Zi-Hao, Lin, Shao-Min, Zhang, Jia-Tao, Qiu, Zhao-Wen, Tang, Wen-Fang, Fu, Rui, Qiu, Zhen-Bin, Yang, Xue-Ning, Wu, Yi-Long, Nie, Qiang, Zhong, Wen-Zhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107747/
https://www.ncbi.nlm.nih.gov/pubmed/34012787
http://dx.doi.org/10.21037/tlcr-20-1281
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author Chu, Xiang-Peng
Chen, Zi-Hao
Lin, Shao-Min
Zhang, Jia-Tao
Qiu, Zhao-Wen
Tang, Wen-Fang
Fu, Rui
Qiu, Zhen-Bin
Yang, Xue-Ning
Wu, Yi-Long
Nie, Qiang
Zhong, Wen-Zhao
author_facet Chu, Xiang-Peng
Chen, Zi-Hao
Lin, Shao-Min
Zhang, Jia-Tao
Qiu, Zhao-Wen
Tang, Wen-Fang
Fu, Rui
Qiu, Zhen-Bin
Yang, Xue-Ning
Wu, Yi-Long
Nie, Qiang
Zhong, Wen-Zhao
author_sort Chu, Xiang-Peng
collection PubMed
description BACKGROUND: Some pulmonary nodules are not suitable for computed tomography-guided percutaneous localization. This study aimed to investigate the feasibility and safety of real-time localization for these non-palpable pulmonary nodules using watershed analysis of the target pulmonary artery during thoracoscopic wedge resection. METHODS: Watershed analysis is a novel technique that can be used to create a specific area on the lung surface for nodule localization. This analysis is performed by temporarily blocking the target pulmonary artery and using indocyanine green fluorescence during surgery. In our study, the surgery was simulated and evaluated preoperatively using a high-precision three-dimensional reconstruction model obtained by multidetector spiral computed tomography. The lung was observed using an infrared thoracoscopy system after an intravenous injection of indocyanine green (2.5 mg/mL), and the white-to-blue transitional zone was marked using electrocautery, after which a wedge resection was performed. RESULTS: A total of 25 out of 26 patients underwent successful wedge resection. The mean tumor size and depth based on computed tomography scans were 13.2±6.4 and 12.2±7.8 mm, respectively. The mean operation duration was 142.6±52.8 min. The mean bleeding volume during surgery was 12.9±9.7 mL. The mean drainage tube indwelling time was 35.6±20.0 h, and the median length of postoperative stay was 3 days (range, 2–6 days). CONCLUSIONS: Our experience showed that the watershed analysis of the target pulmonary artery for nodule localization was safe and feasible. It may become an effective and attractive alternative method for localizing non-palpable pulmonary nodules in selected patients undergoing thoracoscopic wedge resection.
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spelling pubmed-81077472021-05-18 Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules Chu, Xiang-Peng Chen, Zi-Hao Lin, Shao-Min Zhang, Jia-Tao Qiu, Zhao-Wen Tang, Wen-Fang Fu, Rui Qiu, Zhen-Bin Yang, Xue-Ning Wu, Yi-Long Nie, Qiang Zhong, Wen-Zhao Transl Lung Cancer Res Original Article BACKGROUND: Some pulmonary nodules are not suitable for computed tomography-guided percutaneous localization. This study aimed to investigate the feasibility and safety of real-time localization for these non-palpable pulmonary nodules using watershed analysis of the target pulmonary artery during thoracoscopic wedge resection. METHODS: Watershed analysis is a novel technique that can be used to create a specific area on the lung surface for nodule localization. This analysis is performed by temporarily blocking the target pulmonary artery and using indocyanine green fluorescence during surgery. In our study, the surgery was simulated and evaluated preoperatively using a high-precision three-dimensional reconstruction model obtained by multidetector spiral computed tomography. The lung was observed using an infrared thoracoscopy system after an intravenous injection of indocyanine green (2.5 mg/mL), and the white-to-blue transitional zone was marked using electrocautery, after which a wedge resection was performed. RESULTS: A total of 25 out of 26 patients underwent successful wedge resection. The mean tumor size and depth based on computed tomography scans were 13.2±6.4 and 12.2±7.8 mm, respectively. The mean operation duration was 142.6±52.8 min. The mean bleeding volume during surgery was 12.9±9.7 mL. The mean drainage tube indwelling time was 35.6±20.0 h, and the median length of postoperative stay was 3 days (range, 2–6 days). CONCLUSIONS: Our experience showed that the watershed analysis of the target pulmonary artery for nodule localization was safe and feasible. It may become an effective and attractive alternative method for localizing non-palpable pulmonary nodules in selected patients undergoing thoracoscopic wedge resection. AME Publishing Company 2021-04 /pmc/articles/PMC8107747/ /pubmed/34012787 http://dx.doi.org/10.21037/tlcr-20-1281 Text en 2021 Translational Lung Cancer Research. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Chu, Xiang-Peng
Chen, Zi-Hao
Lin, Shao-Min
Zhang, Jia-Tao
Qiu, Zhao-Wen
Tang, Wen-Fang
Fu, Rui
Qiu, Zhen-Bin
Yang, Xue-Ning
Wu, Yi-Long
Nie, Qiang
Zhong, Wen-Zhao
Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
title Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
title_full Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
title_fullStr Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
title_full_unstemmed Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
title_short Watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
title_sort watershed analysis of the target pulmonary artery for real-time localization of non-palpable pulmonary nodules
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107747/
https://www.ncbi.nlm.nih.gov/pubmed/34012787
http://dx.doi.org/10.21037/tlcr-20-1281
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