Radionuclide Localization > Background

Background

Subcentimeter pulmonary nodules are detected quite frequently on computed tomography (CT) examinations of the chest performed for various reasons. In patients at high risk for cancer (e.g. smokers) this presents a diagnostic dilemma.


Some of these lesions undoubtedly represent early lung cancers. Unfortunately, subcentimeter pulmonary nodules are difficult to reliably biopsy percutaneously. Their small size makes them a difficult target to hit. In addition, their small size often makes it difficult to obtain an adequate tissue sample.

Thoracoscopic surgical excision of small or ill-defined pulmonary nodules is often limited by inability to directly visualize, palpate, or localize these lesions by instrument. This difficulty is usually due to a combination of their small size, distance from the parietal pleura, and their soft consistency.

Unfortunately, in many cases of attempted thoracoscopic excision this challenge results in removal of a larger than necessary amount of parenchyma to ensure excision of the lesion in question or sometimes conversion to open thoracotomy. Either of these situations may increase the morbidity and mortality of the procedure.


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