CT localisation of small pulmonary nodules prior to thorascopic resection: Evaluation of a point marker system

PURPOSE: To evaluated the utility of a 5-mm long point marker system for CT localisation of small pulmonary nodules prior to thorascopic resection. MATERIALS AND METHODS: Percutaneous localisation of 57 pulmonary nodules was performed with computed tomographic (CT) guidance in 52 patients. The size of the nodules ranged from 3mm to 20mm (mean: 9mm, median: 8mm). The mean distance of the outer rim to the pleura ranged from 3mm to 55mm (mean: 19mm, median: 15mm). A stainless steel, 5-mm long point marker with a 30-cm long nylon suture and introducer system (21-gauge) was firmly attached to the funnel at the proximal end of the marker. RESULTS: The point marker system was successfully placed without being dislodged in 56 out of the 57 lesions (98%) and served as a clear guide during thoracoscopy. In 10 out of 52 patients (19%), non-symptomatic pneumothorax cases were observed. In 6 out of 52 patients (10%), haemorrhages into the lung parenchyma were observed. In no case did insertion of the point marker system cause strong pain and require an analgesic agent to be added. No patients produced hemopysis or air emboli. All nodules, including a dislodgment case, were successfully resected and the suture served as a clear guide during thoracoscopy. Pathologic findings of nodules included 37 malignancies and 20 non-malignancies. CONCLUSION: The marker system used for thoracoscopic resection was a safe and useful procedure.