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INTERVENTIONAL

CT-guided microcoil localization for pulmonary nodules before VATS: a retrospective evaluation of risk factors for pleural marking failure Yanyan Xu 1 & Lingchuan Ma 2 & Hongliang Sun 1 & Zhenguo Huang 1 & Zhenrong Zhang 3 & Fei Xiao 3 & Qianli Ma 3 & Chuandong Li 1 & Xiaomeng Zhang 4 & Sheng Xie 1 Received: 14 December 2019 / Revised: 3 April 2020 / Accepted: 13 May 2020 # European Society of Radiology 2020

Abstract Objectives To summarize the experiences of CT-guided microcoil localization before video-assisted thoracoscopic surgery (VATS) and to investigate the risk factors associated with pleural marking failure. Methods Totally, 249 consecutive patients with 279 pulmonary nodules who underwent CT-guided microcoil localization prior to VATS were enrolled in this study. According to intraoperative observation, all the nodules were divided into two groups. The clinical characteristics and microcoil localization procedure-related variables of the nodules were analyzed by univariate analysis and multivariate logistic regression analysis to screen the independent factors associated with procedure results. Results Among the 279 nodules, 28 failed to observe the proximal end of the microcoil deployed on visceral pleura during VATS. The logistic regression revealed that needle-pleura angle (≤ 30°: OR = 39.022, p = 0.003), pleura-microcoil distance (≤ 10 mm: OR = 87.054, p < 0.001; 10~20 mm: OR = 10.088, p = 0.010), and presence of pleural indentation (OR = 21.623, p < 0.001) were independent risk factors for pleural marking failure. Conclusions CT-guided microcoil localization for pulmonary nodules is a safe and effective procedure. Small needle-pleura angle (≤ 30°), pleura-microcoil distance (≤ 20 mm), and the presence of pleural indentation during the procedure are significant risk factors contributing to microcoil pleura marking failure. Key Points • CT-guided microcoil localization for pulmonary nodules was a safe and effective procedure. • CT-guided microcoil localization for pulmonary nodules yielded low complication rates. • Small needle-pleura angle, short pleura-microcoil distance, and the presence of pleural indentation were contributing to pleura marking failure. Keywords Lung . Tomography . Thoracic surgery

Yanyan Xu and Lingchuan Ma have contributed equally to this work. * Hongliang Sun [email protected] 1

Department of Radiology, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China

2

Department of Radiology, The People’s Hospital of Wenshan Prefecture, Wenshan 663099, China

3

Department of Thoracic Surgery, China-Japan Friendship Hospital, No.2 Yinghua East Street, Chaoyang District, Beijing 100029, China

4

Department of Radiology, The First Hospital of Fangshan District, Beijing 102400, China

Abbreviations ATS CI ERS FEV1.0/FVC GGO IASLC IQR LLL LUL OR PACS Ref.

American Thoracic Society Confidence interval European Respiratory Society Forced expiratory volume at 1 s/forced vital capacity Ground glass opacity The International A