Small Pulmonary Nodule Localization을 위한 CT Fluoroscopy의 유용성

The Usefulness of CT Fluoroscopy in Small Pulmonary Nodule Localization: for Mammographic Hook Wire Anchoring

Purpose To investigate the operation methods, accuracy and usefulness for CT fluroscopy guided mammographic hook wire localization before thoracoscopic surgery of small pulmonary nodules. Materials and methods From December 2006 and October 2008, 26 patients(33 nodules) who received localization for small pulmonary nodules were included in this study. Mammographic hook wire anchoring was done under fluoroscopic guidance using a 64 slice MDCT manufactured by Philips. After the procedure, video-assisted thoracoscopic surgery(VATS) was carried out. The size of the nodule and the amount of radiation dose were measured. The pathological result of the nodules were compared to determine the accuracy. Results 12 out of 33 nodules proved to be malignant while 20 nodules were confirmed as benign. One lesion revealed an inadequate result most likely due to mammogrphic hook wire dislodging from the lesion. Overall, 32(97%) out of 33 procedures were considered as successful with only one case(3%) considered as a failure. The average size of nodule was 6.5±3.2㎜ and the average CTDIVOL, DLP for each nodule were 43.9±15.1mGy, 266.3±113.7mGyㆍcm respectively. Conclusion Anchoring mammographic hook wires under CT fluoroscopic guidance was effective method in localizing small pulmonary nodules prior to surgery due to the relatively small amount of radiation dose and economical feasibility of the procedure.