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Using a Dedicated Lung-Marker System for Localization of Pulmonary Nodules Before Thoracoscopic Surgery

Bernhard L. Partik1,2, Ann N. Leung1, Michael R. Müller3, Martin Breitenseher2, Franz Eckersberger3, Gerhard Dekan4, Thomas H. Helbich2 and Viktor Metz2

1 Department of Radiology, Stanford University Medical Center, 300 Pasteur Dr., Rm. S-072, Stanford, CA 94305-5105.
2 Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A 1090 Vienna, Austria.
3 Department of Cardio-Thoracic Surgery, University of Vienna, A 1090 Vienna, Austria.
4 Institute of Clinical Pathology, University of Vienna, A 1090 Vienna, Austria.



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  		Fig. 1. —Photograph of commercially available dedicated localization kit for pulmonary nodules used in this study shows introducer needle (a), insertion device (b), and guidewire with helical tip (c).

 


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  		Fig. 2A. —39-year-old woman with history of uterine carcinoma. Axial CT fluoroscopic image (collimation, 10 mm) shows 4-mm pulmonary nodule in right lower lobe (histologically proven fibrous scar).

 


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  		Fig. 2B. —39-year-old woman with history of uterine carcinoma. Axial CT scan shows deployed guidewire tip in nodule (arrowhead).

 


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  		Fig. 3. —74-year-old woman with history of breast carcinoma and 4-mm pulmonary nodule in right lower lobe (histologically proven metastases from breast carcinoma). Axial CT scan (collimation, 3 mm) shows small tentlike pneumothorax (arrowhead) at insertion site of guidewire.

 


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  		Fig. 4. —56-year-old man with no known malignancy and 10-mm pulmonary nodule in left lower lobe (histologically proven hamartoma). Axial CT fluoroscopic image (collimation, 10 mm) shows nodule in subpleural location and shallow angle of introducer needle (arrowhead) relative to pleural surface.

 

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