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Radioguided Surgery of Solitary Pulmonary Nodules

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Radioguided Surgery

Abstract

A solitary pulmonary nodule is radiologically defined as an intraparenchymal lung lesion smaller than 3 cm in diameter, not associated with atelectasis or with abnormally enlarged lymph nodes (1). More than 150,000 patients per year in the United States present their physicians with the diagnostic dilemma of a solitary pulmonary nodule, and this number has increased further due to incidental findings of lung nodules discovered on computed tomography (CT) of the chest performed for some unrelated medical reason (2).

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References

  1. Tuddenham WI. Glossary of terms for thoracic radiology: recommendations of the Nomenclature Committee of the Fleischner Society. Am J Roentgenol. 1984;43:509–517.

    Google Scholar 

  2. Leef JL 3rd, Klein IS. The solitary pulmonary nodule. Radiol Clin North Am. 2002;40:123–143.

    Article  PubMed  Google Scholar 

  3. Mack MJ, Hazelrigg SR, Landreneau RJ, Acuff TE. Thoracoscopy for the diagnosis of the indetermined solitary pulmonary nodule. Ann Thorac Surg. 1993;56:825–832.

    CAS  PubMed  Google Scholar 

  4. Mountain CF. Revisions in the international system for staging lung cancer. Chest. 1997;111:1710–1717.

    Article  CAS  PubMed  Google Scholar 

  5. Abeloff MD, Annitage IO, Lichter AS, et al. Clinical Oncology. 2nd edition. New York: WB Saunders; 2000:1398–1464.

    Google Scholar 

  6. Yankelvitz DF, Hensche CI. Lung cancer: small solitary pulmonary nodules. Radiol Clin North Am. 2000;38:1–9.

    Article  Google Scholar 

  7. Greenlee RT, Hill-Harmon MB, Murray T, et al. Cancer statistics, 2001. CA Cancer J Clin. 2001;51:15–36.

    Article  CAS  PubMed  Google Scholar 

  8. Jemal A, Murray T, Thun LA. Cancer statistics, 2002. CA Cancer J Clin. 2002;52:23–47.

    Article  PubMed  Google Scholar 

  9. Swanson SI, Iaklitsch MT, Mentzer SI, et al. Management of the solitary pulmonary nodule: role of thoracoscopy in diagnosis and therapy. Chest. 1999;116:523S–524S.

    Article  CAS  PubMed  Google Scholar 

  10. Swenson SI, Silverstein MD, Ilstrup DM, et al. The probability of malignancy in solitary pulmonary nodules: application to small radiologically indeterminate nodules. Arch Intern Med. 1997;57:849–855.

    Article  Google Scholar 

  11. Stitik FP, Tockrnan MS. Radiologic screening in the early detection of lung cancer. Radiol Clin North Am. 1978;16:347–366.

    CAS  PubMed  Google Scholar 

  12. Muhm JR, Miller WE, Fontana RS, et al. Lung cancer detected during a screening program using 4-month chest radiographs. Radiology. 1983;143:609–615.

    Google Scholar 

  13. Heenan RT, Flehinger BJ, Melamed MR, et al. Non-small cell lung cancer: results of the New York screening program. Radiology. 1984;151:289–293.

    Google Scholar 

  14. White P, Adams H, Crane M, et al. Preoperative staging of carcinoma of the bronchus: can computed tomographic scanning reliably identify stage II tumors. Thorax. 1994;49:951–957.

    Article  CAS  PubMed  Google Scholar 

  15. Rolston KV, Rodriguez S, Dholakia N, et al. Pulmonary infections mimicking cancer: a retrospective 3-year review. Support Care Cancer. 1997;5:590–593.

    Article  Google Scholar 

  16. Zwirewich CV, Vedal S, Miller RR, et al. Solitary pulmonary nodule: high resolution CT and radiologic-pathologic correlation. Radiology. 1991;179:469–481.

    CAS  PubMed  Google Scholar 

  17. Shure D, Fedullo PF. Transbronchial needle aspiration of peripheral masses. Am Rev Respir Dis. 1983;728:1090–1092.

    Google Scholar 

  18. Gambhir SS, Czernin J, Schwimmer J, Silverman DH, Coleman RE, Phelps ME. A tabulated summary of the FDG PET literature. J Nucl Med. 2001;4(suppl 5):1S–93S.

    Google Scholar 

  19. Gould MK, Maclean CC, Kuschner WG, et al. Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis. JAMA. 2001;285:914–924.

    Article  CAS  PubMed  Google Scholar 

  20. Herder GJ, Golding RP, Hoekstra OS, et al. The performance of 18F-fluorodeoxyglucose positron emission tomography in small solitary pulmonary nodules. Eur J Nucl Med Mol Imaging. 2004;31:1231–1236.

    Article  PubMed  Google Scholar 

  21. Goldsmith SI, Kostakoglu L. Nuclear medicine imaging of lung cancer. Radiol Clin North Am. 2000;38:511–524.

    Article  CAS  PubMed  Google Scholar 

  22. Yankelevitz DF, Henschke CI, Koizumi JH, et al. CT-guided transthoracic needle biopsy of small solitary pulmonary nodules. Clin Imaging. 1997;21:107–110.

    Article  CAS  PubMed  Google Scholar 

  23. Sanders C. Transthoracic needle aspiration. Clin Chest Med. 1992;13:11–16.

    CAS  PubMed  Google Scholar 

  24. Weisbrod GL. Transthoracic needle biopsy. World J Surg. 1993;17:705–711.

    Article  CAS  PubMed  Google Scholar 

  25. Stringfield JT, Markowitz DJ, Bentz RR, et al. The effect of tumor size and location on diagnosis by fiberoptic bronchoscopy. Chest. 1977;72:474–476.

    Article  CAS  PubMed  Google Scholar 

  26. Arroliga AC, Matthay RA. The role of bronchoscopy in lung cancer. Clin Chest Med. 1993;14:87–98.

    CAS  PubMed  Google Scholar 

  27. Torrington KG, Kern JD. The utility of fiberoptic bronchoscopy in the evaluation of solitary pulmonary nodules. Chest. 1993;104:1021–1024.

    Article  CAS  PubMed  Google Scholar 

  28. American Thoracic Society/European Respiratory Society. Pretreatment evaluation of non-small-cell lung cancer. Am J Respir Crit Care Med. 1997;156:320–332.

    Google Scholar 

  29. Baaklini WA, Reinoso MA, Gorin AB, et al. Diagnostic yield of fiber-optic bronchoscopy in evaluating solitary pulmonary nodules. Chest. 2000;117:1049–1054.

    Article  CAS  PubMed  Google Scholar 

  30. Mack MJ, Hazelrigg SR, Landreneau RJ, Acuff TE. Thoracoscopy for the diagnosis of the indetermined solitary pulmonary nodule. Ann Thorac Surg. 1993;56:825–832.

    Article  CAS  PubMed  Google Scholar 

  31. Shulkin AN. Management of the indetermined solitary pulmonary nodule: a pneumologist’s view. Ann Thorac Surg. 1993;56:743–744.

    Article  CAS  PubMed  Google Scholar 

  32. Shah RM, Spirn PW, Salazar AM, et al. Localization of peripheral pulmonary nodules for thoracoscopic excision: value of CT-guided wire placement. AJR Am J Roentgenol. 1993;161:279–283.

    CAS  PubMed  Google Scholar 

  33. Shepard JO, Mathisen DJ, Muse VV, Bhalla M, McLoud TC. Needle localization of peripheral lung nodules for video-assisted thoracoscopic surgery. Chest. 1994;105:1559–1563.

    Article  CAS  PubMed  Google Scholar 

  34. Asamura H, Kondo H, Naruke T, et al. Computed tomography-guided coil injection and thoracoscopic pulmonary resection under roentgenographic fluoroscopy. Ann Thorac Surg. 1994;58:1542–1544.

    Article  CAS  PubMed  Google Scholar 

  35. Moon S, Wang Y, Jo K, et al. Fluoroscopy-aided thoracoscopic resection of pulmonary nodule localized with contrast media. Ann Thorac Surg. 1999;68:1815–1820.

    Article  CAS  PubMed  Google Scholar 

  36. De Kerviler E, Gossot D, Frija J. Localization techniques for the thoracoscopic resection of pulmonary nodules. Int Surg. 1996;81:241–244.

    PubMed  Google Scholar 

  37. Kunazawa S, Ando A, Yasui K, et al. Localization of pulmonary nodules for thoracoscopic resection: experience with a system using a short hookwire and suture. AJR Am J Roentgenol. 1998;170:332–334.

    Google Scholar 

  38. Horan TA, Pinheiro PM, Araujo LM, Santiago FF, Rodriguez MR. Massive gas embolism during pulmonary nodule hook wire localization. Ann Thorac Surg. 2002;73:1647–1649.

    Article  PubMed  Google Scholar 

  39. Lenglinger FX, Schwarz CD, Artmann W. Localization of pulmonary nodules before thoracoscopic surgery: value of percutaneous staining with methylene blue. AJR Am J Roentgenol. 1994;163:297–300.

    CAS  PubMed  Google Scholar 

  40. Wicky S, Mayor B, Schnyder P. Methylene blue localizations of pulmonary nodules under CT-guidance: a new procedure used before thoracoscopic resections. Int Surg. 1997;82:15–17.

    CAS  PubMed  Google Scholar 

  41. Vandoni RE, Cuttat JF, Wicky S, Suter M. CT-guided methylene-blue labelling before thoracoscopic resection of pulmonary nodules. Eur J Cardio-Thorac Surg 1998;14:265–270.

    Article  CAS  Google Scholar 

  42. Nomori H, Horio H. Colored collagen is a long-lasting point marker for small pulmonary nodules in thoracoscopic operation. Ann Thorac Surg. 1996;61:1070–1073.

    Article  CAS  PubMed  Google Scholar 

  43. Saito H, Minamiya Y, Matsuzaki I, et al. Indication for preoperative localization of small peripheral pulmonary nodules in thoracoscopic surgery. J Thorac Cardiovasc Surg 2002;124:1198–1202.

    Article  PubMed  Google Scholar 

  44. Greenfield AL, Steiner RM, Liu JB, et al. Sonographic guidance for the localization of peripheral pulmonary nodules during thoracoscopy. AJR Am J Roentgenol 1997;168:1057–1060.

    CAS  PubMed  Google Scholar 

  45. Kerviler E, Gossot D, Celerier M, Frija J. Limitations of intraoperative sonography for the localization of pulmonary nodules during thoracoscopy. AJR Am J Roentgenol. 1998;170:214–215.

    PubMed  Google Scholar 

  46. Santambrogio R, Montorsi M, Bianchi P, Mantovani A, Ghelma F, Mezzetti M. Intraoperative ultrasound during thoracoscopic procedures for solitary pulmonary nodules. Ann Thorac Surg. 1999;68:218–222.

    Article  CAS  PubMed  Google Scholar 

  47. Luini A, Zurrida S, Galimberti V, et al. Radioguided surgery of occult breast lesions. Eur J Cancer. 1998;34:204–205.

    Article  CAS  PubMed  Google Scholar 

  48. Luini A, Zurrida S, Paganelli G, et al. Comparison of radioguided excision with wire localisation of occult breast lesions. Br J Surg. 1999;86:522–525.

    Article  CAS  PubMed  Google Scholar 

  49. Boni G, Bellina CR, Grosso M, et al. Gamma probeguided thoracoscopic surgery of small pulmonary nodules. Tumori. 2000;86:364–366.

    CAS  PubMed  Google Scholar 

  50. Chella A, Lucchi M, Ambrogi MC, et al. A pilot study of the role of Tc-99m radionuclide in localization of pulmonary nodular lesions for thoracoscopic resection. Eur J Cardio-Thorac Surg. 2000;18:17–21.

    Article  CAS  Google Scholar 

  51. Sortini D, Feo CV, Carrella G, et al. Thoracoscopic localization techniques for patients with a single pulmonary nodule and positive oncological anamnesis: a prospective study. J Laparoendosc Adv Surg Tech A. 2003;13:371–375.

    Article  PubMed  Google Scholar 

  52. Ambrogi MC, Dini P, Boni G, et al. A strategy for thoracosscopic resection of small pulmonary nodules. Surg Endosc. 2005;19:1644–1647.

    Article  CAS  PubMed  Google Scholar 

  53. Suzuki K, Nagai K, Yoshida J, et al. Video assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest. 1999;115:563–568.

    Article  CAS  PubMed  Google Scholar 

  54. Essner R, Hsueh E-C, Haigh P-I, et al. Application of an 18F-fluorodeoxyglucose-sensitive probe for the intraoperative detection of malignancy. J Surg Res. 2001;96:120–126.

    Article  CAS  PubMed  Google Scholar 

  55. Zervos EE, Desai DC, De Palatis LR, et al. 18F-labeled fluorodeoxyglucose positron emission tomography-guided surgery for recurrent colorectal cancer. J Surg Res. 2001;97:9–13.

    Article  CAS  PubMed  Google Scholar 

  56. Meller B, Sahlmann C, Horstmann O, Gerl J, Bahere M, Meller J. Conventional gamma and high-energy probes for radioguided dissection of metastases in a patient with recurrent thyroid carcinoma with 99mTc-MIBI and 18F-FDG. Nuklearmedizin. 2005;44:N23–N25.

    CAS  PubMed  Google Scholar 

  57. Blum J, Handmaker H, Lister-James J, Rinne N; the NeoTect Solitary Pulmonary Nodule Study Group. A multicenter trial with a somatostatin analog 99mTc Depreotide in the evaluation of solitary pulmonary nodules. Chest. 2000;117:1232–1238.

    Article  CAS  PubMed  Google Scholar 

  58. Kahn D, Menda Y, Kernstine K, et al. The utility of 99mTc-depreotide compared with F-18 Fluorodeoxyglucose positron emission tomography and surgical staging in patients with suspected non-small cell lung cancer. Chest. 2004;125:494–501.

    Article  CAS  PubMed  Google Scholar 

  59. Halley A, Hugentobler A, Icard P, et al. Efficiency of 18F-FDG and 99mTc-depreotide SPECT in the diagnosis of malignancy of solitary pulmonary nodules. Eur J Nucl Med Mol Imaging. 2005;32:1026–1032.

    Article  PubMed  Google Scholar 

  60. Boni G, Melfi FMA, Givigliano F, et al. 99mTc-Depreotide in the surgical patients with pulmonary malignancy: correlation between scintigraphic data and intrasurgical findings [Abstract]. Q J Nucl Med. 2004;48(suppl 1):43.

    Google Scholar 

  61. Boni G, Bertolaccini P, Melfi FMA, et al. Clinical utility of 99mTc-depreotide as diagnostic procedure and intraoperative marker for radioguided surgery in patients with pulmonary malignancy. Eur J Nucl Med Mol Imaging. 2005;32(suppl 1):S49–S50.

    Google Scholar 

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Boni, G., Melfi, F.M.A., Manca, G., Lucchi, M., Mussi, A., Mariani, G. (2008). Radioguided Surgery of Solitary Pulmonary Nodules. In: Mariani, G., Giuliano, A.E., Strauss, H.W. (eds) Radioguided Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-38327-9_25

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  • DOI: https://doi.org/10.1007/978-0-387-38327-9_25

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-33684-8

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