Computed tomography-guided marking using a dye-staining method for preoperative localization of tiny pulmonary lesions in children
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In brief
In brief
Retrospective study of 12 pediatric cancer patients demonstrates that CT-guided dye marking successfully localized 82% of tiny pulmonary nodules for resection, with minimal complications. Combined ICG navigation identified additional occult metastases in hepatoblastoma cases, enhancing intraoperative detection beyond preoperative imaging.
Written by the GCMD Library team from the article.
Abstract
Purpose
It is important to confirm the existence of pulmonary metastases in pediatric patients with malignancies. Therefore, we aimed to investigate if computed tomography CT-guided marking is a feasible and safe method for the identification and resection of tiny pulmonary lesions in pediatric cancer patients.
Methods
We retrospectively reviewed the medical records of pediatric cancer patients who underwent CT-guided marking procedures in our institutions between Jan 2011 and Apr 2020. After 2015, these procedures were combined with an indocyanine green (ICG) navigation-guided surgery for hepatoblastoma cases.
Results
We targeted a total of 22 nodules in 12 patients. Of these, marking was successful in 18 (81.8%) nodules, 10 of which contained viable malignant cells. Complications caused by the marking procedures included mild pneumothorax and mild atelectasis in two patients, respectively. Of the eight resected nodules in patients with hepatoblastoma, four were ICG-positive and contained viable malignant cells. Two additional ICG-positive nodules, which were unidentified before surgery, were observed intraoperatively.
Conclusion
CT-guided marking is a feasible and safe method that can be used to identify and resect tiny pulmonary lesions in pediatric cancer patients. An ICG navigation-guided surgery is useful when combined with CT-guided marking, particularly in hepatoblastoma cases.