First clinical application of radiofrequency identification (RFID) marking system—Precise localization of a small lung nodule

OBJECTIVES: Precise small lung nodule resection is challenging in minimally invasive thoracoscopic surgery. Various methods that help surgeons to locate the target nodule have been devised; however, the ideal way that satisfies the demand has not yet been realized. We have developed and applied a novel marking system to localize small lung nodules for the first time in humans. METHODS: A radiofrequency identification tag (1.8 mm in diameter and 7 mm in length) that can communicate with a wand-shaped antenna (10 mm in diameter) from the distance of 3 cm was prepared. The tag was delivered adjacent to a 7-mm subsolid nodule in the right lower lobe of a patient under cone beam computed tomography guidance and video-assisted thoracoscopic surgery wedge resection was subsequently performed. RESULTS: The delivery of the tag was smooth, and the tag was almost immediately detected by the antenna. Wedge resection was successfully performed with the guiding signal from the tag. CONCLUSIONS: We have so far demonstrated that this technology could be applicable for small lung nodule detection in preclinical studies. In this first clinical experience, this system proved to provide accurate positional information of small lung nodules with depth.