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Preoperative Localization of Lung Nodules With Fiducial Markers: Feasibility and Technical Considerations  Amita Sharma, MD, Shaunagh McDermott, MD, Douglas.

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Presentation on theme: "Preoperative Localization of Lung Nodules With Fiducial Markers: Feasibility and Technical Considerations  Amita Sharma, MD, Shaunagh McDermott, MD, Douglas."— Presentation transcript:

1 Preoperative Localization of Lung Nodules With Fiducial Markers: Feasibility and Technical Considerations  Amita Sharma, MD, Shaunagh McDermott, MD, Douglas J. Mathisen, MD, Jo-Anne O. Shepard, MD  The Annals of Thoracic Surgery  Volume 103, Issue 4, Pages (April 2017) DOI: /j.athoracsur Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Photograph of 19G coaxial needle and two 3 mm × 0.8 mm fiducial markers. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Incidental nodule found on imaging for ascending aorta aneurysm in a 76-year-old man. (A) Axial computed tomography (CT) scan demonstrates 19-mm nonsolid nodule in the right upper lobe (arrow). (B) Axial CT scan obtained during fiducial placement procedure shows coaxial needle positioned beyond nodule. (C) Axial CT scan obtained after placement of three fiducial markers. Note how path of coaxial needle is longer than a direct route through adjacent pleura to nodule. A shorter path increases risk of fiducial migration into the pleural cavity. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Pulmonary nodule found on follow-up of thyroid cancer in a 39-year-old woman. (A) Axial computed tomography (CT) scan demonstrates 10-mm part solid nodule in left upper lobe (arrow). (B) Axial CT scan shows two fiducial markers lateral to the nodule. (C) Axial CT scan performed 3 months later shows unchanged fiducial markers lateral to the nodule (arrows). The patient underwent wedge resection 123 days after fiducial placement, and the nodule represented organizing pneumonia. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 (A) Fluoroscopy image of wedge resection for patient in Figure 2 that confirms all fiducial markers have been removed. (B) Gross photograph of lesion demonstrates defect (arrow) created by fiducial marker. Lesion was confirmed to be invasive adenocarcinoma. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

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