Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Morgan, KM; Anderson, KT; Johnston, ME; Dasgupta, R; Crowley, JJ; Fahy, AS; Lapidus-Krol, E; Baertschiger, RM; Lautz, TB; Many, BT; Marquart, JP; Gainer, H; Lal, DR; Rich, BS; Glick, RD; MacArthur, TA; Polites, SF; Kastenberg, ZJ; Short, SS; Meyers, RL; Talbot, L; Abdelhafeez, A; Prajapati, H; Davidoff, AM; Rubaclava, N; Newman, E; Ehrlich, PF; Rothstein, DH; Roach, JP; Ladd, P; Janek, KC; Le, HD; Leraas, HJ; Tracy, ET; Bisset, L; Mora, MC; Warren, P; Aldrink, JH; Malek, MM

Published Date

  • June 2022

Published In

Volume / Issue

  • 57 / 6

Start / End Page

  • 1013 - 1017

PubMed ID

  • 35307194

Electronic International Standard Serial Number (EISSN)

  • 1531-5037

Digital Object Identifier (DOI)

  • 10.1016/j.jpedsurg.2022.01.061


  • eng

Conference Location

  • United States