{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:40:23Z","timestamp":1780580423242,"version":"3.54.1"},"reference-count":34,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T00:00:00Z","timestamp":1728518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Multiple techniques exist for the preoperative localization of small, deeply located solid or subsolid pulmonary nodules to guide limited thoracoscopic resection. This study aims to conduct a multi-institutional comparison of three different tomography-guided tracers\u2019 methods. Methods: A retrospective multicenter cross-sectional study was conducted. All patients suitable for CT-guided tracers with microcoil (GROUP1, n = 58), hook wire (GROUP2, n = 86), or bioabsorbable hydrogel plug (GROUP3, n = 33) were scheduled for video-assisted thoracoscopic wedge resection. Outcome variables: successful nodule localization, safety, and the feasibility of the tracers\u2019 placement. A \u03c72 test or Fisher\u2019s test for expected numbers less than five and a Kruskal\u2013Wallis test were used to analyze the categorical and continuous variables, respectively. For the power calculations, we used G*Power version 3.1.9.6. Results: One hundred seventy-seven patients underwent the localization and resection of 177 nodules detected with three different CT-guided tracers. A significant difference was recorded for cancer history (p = 0.030), respiratory function, Charlson comorbidity index (p = 0.018), lesion type (p &lt; 0.0001), distance from pleura surface (p &lt; 0.0001), and time between preoperative CT-guided tracers and surgical procedures (p &lt; 0.0001). Four post-procedural complications were recorded and in GROUP2, four cases of tracer dislocations occurred. Finally, hook wire group was associated with the shortest surgical time (93 min, p = 0.001). Conclusions: All methods were feasible and efficient, resulting in a 100% success rate for the microcoils and the bioabsorbable hydrogel plugs and a 94.2% success rate for the hook wires. Our results highlight the need to choose a technique that is less stressful for the patient and helps the surgeon by extending the approach to deep nodules and resecting over the course of several days from deployment.<\/jats:p>","DOI":"10.3390\/jcm13206041","type":"journal-article","created":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T08:16:42Z","timestamp":1728548202000},"page":"6041","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unlocking the Potential of Computed Tomography-Guided Tracers in Pinpointing Lung Lesions during Surgery: A Collaborative Multi-Institutional Journey"],"prefix":"10.3390","volume":"13","author":[{"given":"Rossella","family":"Potenza","sequence":"first","affiliation":[{"name":"Thoracic Surgery Unit, University of Perugia Medical School, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0399-7374","authenticated-orcid":false,"given":"Marco","family":"Andolfi","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, AOU delle Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1384-7441","authenticated-orcid":false,"given":"Andrea","family":"Dell\u2019Amore","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, 06129 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0965-9595","authenticated-orcid":false,"given":"Marialuisa","family":"Lugaresi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery (DIMEC), University of Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Roca","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, 06129 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8021-9338","authenticated-orcid":false,"given":"Leonardo","family":"Valentini","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Alma Mater Studiorum\u2014IRCSS Ospedaliero-Universitaria S. Orsola di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2473-8511","authenticated-orcid":false,"given":"Chiara","family":"Catelli","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, 06129 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Buia","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic-Radiology Unit, Department of Cardio-Thoracic-Vascular, IRCSS Ospedaliero-Universitaria S. Orsola di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6053-3608","authenticated-orcid":false,"given":"Giampiero","family":"Dolci","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Alma Mater Studiorum\u2014IRCSS Ospedaliero-Universitaria S. Orsola di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Floridi","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences, Universit\u00e0 Politecnica Marche, AOU delle Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Moretti","sequence":"additional","affiliation":[{"name":"Department of Radiology, Santa Maria della Misericordia Hospital, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Colafigli","sequence":"additional","affiliation":[{"name":"Department of Radiology, Santa Maria della Misericordia Hospital, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majed","family":"Refai","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, AOU delle Marche, 60121 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Rea","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences, University of Padua, 06129 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Puma","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, University of Perugia Medical School, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2460-9657","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Daddi","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Alma Mater Studiorum\u2014IRCSS Ospedaliero-Universitaria S. 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