A new preoperative localization of pulmonary nodules guided by mixed reality: a pilot study of an animal model

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Abstract

Background

With the popularity of high-resolution computed tomography (HRCT), more and more pulmonary nodules are being discovered. Video-assisted thoracoscopic surgery (VATS) has become the first choice for surgical treatment of pulmonary nodules. The use of accurate preoperative localization is crucial for successful resection in VATS. At present, there are many kinds of preoperative localization methods, but there are certain disadvantages. This study aimed to evaluate the feasibility and safety of mixed reality (MR)-guided pulmonary nodules localization, which is a new method that can benefit patients to a greater extent.

Methods

By constructing an animal model of pulmonary nodules localization, 28 cases of pulmonary nodules were located by MR-guided localization. We recorded the localization accuracy, localization time, insertion attempts, and incidence of complications related to localization under MR-guidance.

Results

All 28 nodules were successfully located: the deviation of MR-guided localization was 5.71±2.59 mm, localization time was 8.07±1.44 min, and insertion attempts was 1. A pneumothorax and localizer dislodgement occurred in 1 case, respectively.

Conclusions

Since preoperative localization is critical for VATS resection of pulmonary nodules, we investigated a new localization method. As indicated by our study, MR-guided localization of pulmonary nodules is feasible and safe, which is worthy of further research and promotion. We have also registered corresponding clinical trials to further investigate and help to improve our understanding of this technique.

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Most cited references 28

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Mixed Reality with HoloLens

Oren M Tepper, Hayeem Rudy, Aaron Lefkowitz … (2017)

Virtual reality and augmented reality devices have recently been described in the surgical literature. The authors have previously explored various iterations of these devices, and although they show promise, it has become clear that virtual reality and/or augmented reality devices alone do not adequately meet the demands of surgeons. The solution may lie in a hybrid technology known as mixed reality, which merges many virtual reality and augmented realty features. Microsoft's HoloLens, the first commercially available mixed reality device, provides surgeons intraoperative hands-free access to complex data, the real environment, and bidirectional communication. This report describes the use of HoloLens in the operating room to improve decision-making and surgical workflow. The pace of mixed reality-related technological development will undoubtedly be rapid in the coming years, and plastic surgeons are ideally suited to both lead and benefit from this advance.

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Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial.

Richard Finley, John R Mayo, Kyle Grant … (2015)

Growing, small, peripheral, pulmonary nodules in patients at high risk for lung cancer lead to requests for video-assisted thoracoscopic (VATS) resection for pathologic diagnosis. The purpose of this randomized controlled trial was to determine if preoperative localization using percutaneously placed computed tomography (CT)-guided platinum microcoils decreases the need for thoracotomy or VATS anatomic resection (segmentectomy/lobectomy) for diagnosis.

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Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking.

K. Suzuki, K. Nagai, J Yoshida … (1999)

To determine the indications for preoperative localization of a small indeterminate pulmonary nodule. In this retrospective study, univariate and multivariate analyses were performed by the logistic regression procedure. A single National Cancer Center Hospital in Japan. A series of 92 consecutive patients who underwent video-assisted thoracoscopic surgery (VATS) at our institute between 1993 and 1996. The frequency and reasons for conversion to thoracotomy were assessed retrospectively. All preoperative CT scans were reviewed for eight radiologic features by two of the authors. These data were entered into univariate and multivariate analyses to identify the significant risk factors for a failure to detect a pulmonary nodule. Fifty patients (54%) needed conversion to a thoracotomy. The most common reason for the conversion was failure to localize nodules (46%). Univariate and multivariate analyses of 11 variables revealed one significant risk factor in the failure to detect nodules: distance to the nearest pleural surface (p 5 mm in cases of nodules 5 mm in cases of lung nodules of < or = 10 mm in size.

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Author and article information

Journal

Journal ID (nlm-ta): Transl Lung Cancer Res

Journal ID (iso-abbrev): Transl Lung Cancer Res

Journal ID (publisher-id): TLCR

Title: Translational Lung Cancer Research

Publisher: AME Publishing Company

ISSN (Print): 2218-6751

ISSN (Electronic): 2226-4477

Publication date (Electronic): 10 January 2023

Publication date (Print): 31 January 2023

Volume: 12

Issue: 1

Pages: 150-157

Affiliations

[1 ]deptDepartment of Thoracic Surgery , PLA 960th Hospital , Jinan, China;

[2 ]deptDepartment of Thoracic Surgery, Shanghai Changzheng Hospital , Navy Military Medical University , Shanghai, China;

[3 ]deptSchool of Health Science and Engineering , University of Shanghai for Science and Technology , Shanghai, China;

[4 ]deptDepartment of Surgery , Teikyo University School of Medicine , Tokyo, Japan;

[5 ]Department of Pulmonology, Thoracic Oncology and Respiratory Intensive Care, Hôpital Charles Nicolle, CHU de Rouen, Rouen Cedex , France;

[6 ]deptThoracic Surgery Unit , Careggi University Hospital , Florence, Italy;

[7 ]deptDepartment of Thoracic and Cardiovascular Surgery , Osaka Medical and Pharmaceutical University , Osaka, Japan;

[8 ]Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon , Lyon, France

Author notes

Contributions: (I) Conception and design: H Tang, K Huang; (II) Administrative support: Z Xu; (III) Provision of study materials or patients: Z Chen, X Wu; (IV) Collection and assembly of data: N Xin, R Wei, Z Chen; (V) Data analysis and interpretation: N Xin; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

[#]

These authors contributed equally to this work.

Correspondence to: Hua Tang. Department of Thoracic Surgery, Shanghai Changzheng Hospital, Navy Military Medical University, 415 Fengyang Road, Huangpu District, Shanghai 200003, China. Email: tangh_mits@ 123456163.com .

[^]

ORCID: 0000-0002-7348-7919.

Article

Publisher ID: tlcr-12-01-150

DOI: 10.21037/tlcr-22-884

PMC ID: 9903086

PubMed ID: 36762064

SO-VID: 43865d65-c72e-417e-b681-6920648dbc05

License:

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

History

Date received : 26 October 2022

Date accepted : 03 January 2023

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A new preoperative localization of pulmonary nodules guided by mixed reality: a pilot study of an animal model

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Abstract

Background

Methods

Results

Conclusions

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Animal Welfare

Most cited references 28

Mixed Reality with HoloLens

Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial.

Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking.

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Cited by 1

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