Affiliation:
1. Department of Thoracic Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
2. Institute for Radiology, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
Abstract
Background: The intraoperative detection of solitary pulmonary nodules (SPNs) continues to be a major challenge, especially in minimally invasive video-assisted thoracic surgery (VATS). The location, size, and intraoperative frozen section result of SPNs are decisive regarding the extent of lung resection. This feasibility study investigates the technical applicability of intraoperative contrast-enhanced ultrasonography (Io-CEUS) in minimally invasive thoracic surgery. Methods: In this prospective, monocentric clinical feasibility study, n = 30 patients who underwent Io-CEUS during elective minimally invasive lung resection for SPNs between October 2021 and February 2023. The primary endpoint was the technical feasibility of Io-CEUS during VATS. Secondary endpoints were defined as the detection and characterization of SPNs. Results: In all patients (female, n = 13; mean age, 63 ± 8.6 years) Io-CEUS could be performed without problems during VATS. All SPNs were detected by Io-CEUS (100%). SPNs had a mean size of 2.2 cm (0.5–4.5 cm) and a mean distance to the lung surface of 2.0 cm (0–6.4 cm). B-mode, colour-coded Doppler sonography, and contrast-enhanced ultrasound were used to characterize all tumours intraoperatively. Significant differences were found, especially in vascularization as well as in contrast agent behaviour, depending on the tumour entity. After successful lung resection, a pathologic examination confirmed the presence of lung carcinomas (n = 17), lung metastases (n = 10), and benign lung tumours (n = 3). Conclusions: The technical feasibility of Io-CEUS was confirmed in VATS before resection regarding the detection of suspicious SPNs. In particular, the use of Doppler sonography and contrast agent kinetics revealed intraoperative specific aspects depending on the tumour entity. Further studies on Io-CEUS and the application of an endoscopic probe for VATS will follow.
Reference33 articles.
1. In patients undergoing video-assisted thoracoscopic surgery excision, what is the best way to locate a subcentimetre solitary pulmonary nodule in order to achieve successful excision?;Zaman;Interact. Cardiovasc. Thorac. Surg.,2012
2. NELSON trial: Reduced lung-cancer mortality with volume CT screening;Dawson;Lancet Respir. Med.,2020
3. Taurchini, M., Quarato, C.M.I., Frongillo, E.M., Ferretti, G.M., Cipriani, C., Bizzarri, M., Barbaro, M.P.F., Lacedonia, D., Simeone, A., and Graziano, P. (2021). Intraoperative Lung Ultrasound (ILU) for the Assessment of Pulmonary Nodules. Diagnostics, 11.
4. Ultrasound location of pulmonary nodules in video-assisted thoracoscopic surgery for precise sublobectomy;Hou;Thorac. Cancer,2020
5. Ultrasonographic evaluation of small nodules in the peripheral lung during video-assisted thoracic surgery (VATS);Matsumoto;Eur. J. Cardiothorac. Surg.,2004
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