2015 Volume 29 Issue 5 Pages 552-558
The chance of detecting a small peripheral pulmonary nodule has recently increased due to the marked progress in the capability of computer tomography (CT). Although preoperative CT-guided marking has been developed to identify the site of a nodule, there are some problems such as air embolism. We have performed intraoperative marking of a small pulmonary nodule using CT-like images, also called cone-beam CT (CBCT) images, produced using the Hybrid OR System. This system consists of Allura Xper FD20 (Phillips Co., Ltd., Netherlands) and Magnus Table (Maquet Co., Ltd., Germany). Nineteen small nodules in 17 patients were resected using this procedure. None of them were diagnosed preoperatively. There were eight primary lung cancers, nine pulmonary metastases from other malignancies, and two benign regions. All regions could be clearly detected by CBCT. There was no complication related to this procedure. This method can be a very useful technique of intraoperative pulmonary marking which can avoid serious complications such as air embolisms for the patient.
