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  • Title: Comparison between the application of microcoil and hookwire for localizing pulmonary nodules.
    Author: Hu L, Gao J, Chen C, Zhi X, Liu H, Hong N.
    Journal: Eur Radiol; 2019 Aug; 29(8):4036-4043. PubMed ID: 30631924.
    Abstract:
    OBJECTIVES: To compare the efficacy and safety of localization of small pulmonary nodules with microcoil and hookwire prior to surgical resection. METHODS: A total of 112 patients who underwent preoperative computed tomography (CT)-guided localization of small pulmonary nodules were enrolled in this single-center retrospective non-randomized cohort study between June 2016 and June 2017. Seventy-nine patients who underwent percutaneous localization with microcoils formed the microcoil group; the remaining 33 patients underwent percutaneous localization with hookwires (hookwire group). The primary outcomes were the success and complication rates of the procedure. Student's t test was used for continuous variables, whereas chi-square analysis and logistic regression were used for dichotomous variables. RESULTS: Video-assisted thoracoscopic surgery (VATS) was successfully performed in all cases, without conversion to thoracotomy. The localization success rate was 94.9% (75/79) in the microcoil group and 93.9% (31/33) in the hookwire group (p = 0.836). Hookwire group (p = 0.000) and nodule location of the lower lobe (p = 0.012) were associated with an increased incidence of pneumothorax. Hookwire group (p = 0.027) and decreased nodule diameter (p = 0.024) were associated with an increased incidence of moderate to severe chest pain, as well as an increased incidence of overall complications. CONCLUSIONS: Although the deployment of the microcoil was more complex and required more time than hookwire placement, microcoil localization was associated with fewer complications. KEY POINTS: • CT-guided percutaneous localization using a microcoil and that using a hookwire are equally effective for localizing small pulmonary nodules prior to resection with video-assisted thoracoscopic surgery. • Lung nodule localization using a microcoil was associated with fewer complications than localization using a hookwire.
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