Success and complication rate of CT-guided marking of pulmonary nodules with coil wires for video-assisted thoracoscopic surgery (VATS)

Purpose: To assess the success and complication rate of the CT-guided marking of pulmonary nodules for video-assisted thoracoscopic surgery (VATS). Materials and Methods: Pulmonary nodules (mean diameter 9±5 mm, mean pleural distance 7±5 mm) were marked with a coil wire in 30 patients (20 males, mean age 57.6±15.5 years, 22 patients with a history of malignancy). The intended coil-nodule distance was ≤10 mm. Results: 81% of nodules were not visible by thoracoscopy. The technical success rate of CT-guided marking was 86.7%. The projected nodule-coil distance was achieved in 90% of cases. The procedure had to be changed from thoracoscopy to thoracotomy in 4 patients due to coil wire marking problems: 2 x coil displacement, 1 x coil-nodule distance <10 mm, unfavorable direction of wire. Histology was determined in all patients (70% malignant, 30% benign). Complications requiring therapy were not observed. Conclusions: The CT-guided marking of pulmonary nodules is a precondition for VATS if the nodule does not involve the visceral pleura in the majority of cases. The success rate is high with a low complication rate. (orig.)