TY - JOUR
T1 - Interhospital variability in localization techniques for small pulmonary nodules in children
T2 - A pediatric surgical oncology research collaborative study
AU - Morgan, Katrina M.
AU - Anderson, K. Tinsley
AU - Johnston, Michael E.
AU - Dasgupta, Roshni
AU - Crowley, John J.
AU - Fahy, Aodhnait S.
AU - Lapidus-Krol, Eveline
AU - Baertschiger, Reto M.
AU - Lautz, Timothy B.
AU - Many, Benjamin T.
AU - Marquart, John P.
AU - Gainer, Haley
AU - Lal, Dave R.
AU - Rich, Barrie S.
AU - Glick, Richard D.
AU - MacArthur, Taleen A.
AU - Polites, Stephanie F.
AU - Kastenberg, Zachary J.
AU - Short, Scott S.
AU - Meyers, Rebecka L.
AU - Talbot, Lindsay
AU - Abdelhafeez, Abdelhafeez
AU - Prajapati, Hasmukh
AU - Davidoff, Andrew M.
AU - Rubaclava, Nathan
AU - Newman, Erika
AU - Ehrlich, Peter F.
AU - Rothstein, David H.
AU - Roach, Jonathan P.
AU - Ladd, Patricia
AU - Janek, Kevin C.
AU - Le, Hau D.
AU - Leraas, Harold J.
AU - Tracy, Elisabeth T.
AU - Bisset, Logan
AU - Mora, Maria C.
AU - Warren, Patrick
AU - Aldrink, Jennifer H.
AU - Malek, Marcus M.
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/6
Y1 - 2022/6
N2 - Background: Pulmonary nodules that are deep within lung parenchyma and/or small in size can be challenging to localize for biopsy. This study describes current trends in performance of image-guided localization techniques for pulmonary nodules in pediatric patients. Methods: A retrospective review was performed on patients < 21 years of age undergoing localization of pulmonary nodules at 15 institutions. Localization and resection success, time in interventional radiology (IR), operating room (OR) and total anesthesia time, complications, and technical problems were compared between techniques. Results: 225 patients were included with an average of 1.3 lesions (range 1–5). Median nodule size and depth were 4 mm (range 0–30) and 5.4 mm (0–61), respectively. The most common localization techniques were: wire + methylene blue dye (MBD) (28%), MBD only (25%), wire only (14%), technetium-99 only (11%), coil + MBD (7%) and coil only (5%). Localization technique was associated with institution (p < 0.01); technique and institution were significantly associated with mean IR, OR, and anesthesia time (all p < 0.05). Comparing techniques, there was no difference in successful IR localization (range 92–100%, p = 0.75), successful resection (94–100%, p = 0.98), IR technical problems (p = 0.22), or operative complications (p = 0.16). Conclusions: Many IR localization techniques for small pulmonary nodules in children can be successful, but there is wide variability in application by institution and in procedure time. Level of evidence: Retrospective review, Level 3.
AB - Background: Pulmonary nodules that are deep within lung parenchyma and/or small in size can be challenging to localize for biopsy. This study describes current trends in performance of image-guided localization techniques for pulmonary nodules in pediatric patients. Methods: A retrospective review was performed on patients < 21 years of age undergoing localization of pulmonary nodules at 15 institutions. Localization and resection success, time in interventional radiology (IR), operating room (OR) and total anesthesia time, complications, and technical problems were compared between techniques. Results: 225 patients were included with an average of 1.3 lesions (range 1–5). Median nodule size and depth were 4 mm (range 0–30) and 5.4 mm (0–61), respectively. The most common localization techniques were: wire + methylene blue dye (MBD) (28%), MBD only (25%), wire only (14%), technetium-99 only (11%), coil + MBD (7%) and coil only (5%). Localization technique was associated with institution (p < 0.01); technique and institution were significantly associated with mean IR, OR, and anesthesia time (all p < 0.05). Comparing techniques, there was no difference in successful IR localization (range 92–100%, p = 0.75), successful resection (94–100%, p = 0.98), IR technical problems (p = 0.22), or operative complications (p = 0.16). Conclusions: Many IR localization techniques for small pulmonary nodules in children can be successful, but there is wide variability in application by institution and in procedure time. Level of evidence: Retrospective review, Level 3.
KW - CT-guided localization
KW - Lung metastasis
KW - Lung nodule
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U2 - 10.1016/j.jpedsurg.2022.01.061
DO - 10.1016/j.jpedsurg.2022.01.061
M3 - Article
C2 - 35307194
AN - SCOPUS:85126532359
SN - 0022-3468
VL - 57
SP - 1013
EP - 1017
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 6
ER -