Yojiro Yutaka1,2, Toshihiko Sato3,4, Jitian Zhang5,2, Koichi Matsushita6, Hiroyuki Aiba7, Yusuke Muranishi1,2, Yasuto Sakaguchi1,2, Teruya Komatsu1,2, Fumitsugu Kojima8, Tatsuo Nakamura1,2, Hiroshi Date2. 1. Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 2. Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 3. Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. tsato@kuhp.kyoto-u.ac.jp. 4. Department of Thoracic Surgery, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. tsato@kuhp.kyoto-u.ac.jp. 5. Clinical Research Center for Medical Equipment Development, Kyoto University Hospital, 54 Shogoin, Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. 6. Hogy Medical Co., Ltd., 2-7-7 Akasaka, Minato-ku, Tokyo, 107-8615, Japan. 7. Asahi Intecc Co., Ltd., 1703 Wakita-cho, Moriyama-ku, Nagoya-shi, Aichi, 463-0024, Japan. 8. Department of Thoracic Surgery, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 101-8560, Japan.
Abstract
BACKGROUND: To facilitate accurate localization of small lung lesions in thoracoscopic surgery, we employed a micro-radiofrequency identification tag designed to be delivered through the 2-mm working channel of a flexible bronchoscope. This report presents the results of preclinical studies of our novel localizing technique in a canine model. METHODS: To evaluate functional placement, three types of tags [Group A, tag alone (n = 18); Group B, tag + resin anchor (n = 15); and Group C, tag + NiTi coil anchor (n = 15)] were bronchoscopically placed in subpleural areas and subsegmental bronchi via our new delivery device; tags were examined radiographically on days 0-7 and day 14. In addition, eight tags, which were placed at a mean depth of 13.3 mm (range 9-15.7 mm) from visceral pleura in bronchi with a mean diameter of 1.46 mm (range 0.9-2.3 mm), were recovered by partial lung resection under video-assisted thoracoscopic surgery using a 13.56-MHz wand-shaped probe with a 30-mm communication range. RESULTS: Peripheral airway placement: Group C had a significantly higher retention rate than the other two groups (retention rate at day 14: Group A, 11.1 %; Group B, 26.7 %; Group C, 100.0 %; P < 0.0001). Central airway placement: Overall retention rate was 73.3 % in Group C, and placement was possible in bronchi of up to 3.3 mm in diameter. Outcomes of partial resection: Tag recovery rate was 100 %, mean time required for tag detection was 10.8 s (range 8-15 s), and mean surgical margin from the delivered tag was 9.13 mm (range 6-13 mm). CONCLUSION: Radiofrequency identification marking enabled accurate localization with depth, which could ensure effective deep resection margins.
BACKGROUND: To facilitate accurate localization of small lung lesions in thoracoscopic surgery, we employed a micro-radiofrequency identification tag designed to be delivered through the 2-mm working channel of a flexible bronchoscope. This report presents the results of preclinical studies of our novel localizing technique in a canine model. METHODS: To evaluate functional placement, three types of tags [Group A, tag alone (n = 18); Group B, tag + resin anchor (n = 15); and Group C, tag + NiTi coil anchor (n = 15)] were bronchoscopically placed in subpleural areas and subsegmental bronchi via our new delivery device; tags were examined radiographically on days 0-7 and day 14. In addition, eight tags, which were placed at a mean depth of 13.3 mm (range 9-15.7 mm) from visceral pleura in bronchi with a mean diameter of 1.46 mm (range 0.9-2.3 mm), were recovered by partial lung resection under video-assisted thoracoscopic surgery using a 13.56-MHz wand-shaped probe with a 30-mm communication range. RESULTS: Peripheral airway placement: Group C had a significantly higher retention rate than the other two groups (retention rate at day 14: Group A, 11.1 %; Group B, 26.7 %; Group C, 100.0 %; P < 0.0001). Central airway placement: Overall retention rate was 73.3 % in Group C, and placement was possible in bronchi of up to 3.3 mm in diameter. Outcomes of partial resection: Tag recovery rate was 100 %, mean time required for tag detection was 10.8 s (range 8-15 s), and mean surgical margin from the delivered tag was 9.13 mm (range 6-13 mm). CONCLUSION: Radiofrequency identification marking enabled accurate localization with depth, which could ensure effective deep resection margins.
Authors: John R Mayo; Joanne C Clifton; Tom I Powell; John C English; Ken G Evans; John Yee; Annette M McWilliams; Stephen C Lam; Richard J Finley Journal: Radiology Date: 2009-02 Impact factor: 11.105
Authors: Ravi J Menezes; Heidi C Roberts; Narinder S Paul; Maureen McGregor; Tae Bong Chung; Demetris Patsios; Gordon Weisbrod; Stephen Herman; Andre Pereira; Alexander McGregor; Zhi Dong; Igor Sitartchouk; Scott Boerner; Ming-Sound Tsao; Shaf Keshavjee; Frances A Shepherd Journal: Lung Cancer Date: 2009-05-07 Impact factor: 5.705