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Application of Electromagnetic Navigation System in Pulmonary Nodule Localization

16. maj 2026 opdateret af: Haifeng Wang, Shanghai Pulmonary Hospital, Shanghai, China

Electromagnetic Navigation-Guided Versus CT-Guided Localization of Pulmonary Nodules: A Multicenter, Prospective, Randomized Controlled Trial

This study aims to design and conduct a multicenter, prospective, randomized controlled post-market clinical trial to validate the clinical efficacy of high-precision electromagnetic navigation technology.

Studieoversigt

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

400

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

      • Shanghai, Kina
        • Shanghai Pulmonary Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  1. Age 18-80 years, regardless of gender;
  2. Solitary single nodule, scheduled for lung nodule puncture and localization;
  3. Chest CT (lung window mode) showing a maximum nodule diameter ≤ 2 cm;
  4. Eastern Cooperative Oncology Group (ECOG) performance status score 0-2;
  5. Voluntary participation, with signed informed consent.

Exclusion Criteria:

  1. Not suitable for video-assisted thoracoscopic surgery;
  2. The distance between the center of the lesion and the dome of the diaphragm is < 3 cm;
  3. History of thoracic adhesion due to previous thoracotomy or pleural infection;
  4. Patients judged by the investigator to be unsuitable for preoperative transthoracic or transbronchial localization;
  5. Inability to complete follow-up or poor compliance.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Electromagnetic Navigation Localization Group
Performed by an experienced thoracic surgeon or interventional radiologist under general or local anesthesia, the procedure is guided by an electromagnetic navigation system. The procedural steps include: 1) preoperative import of the patient's CT data into the navigation system for path planning; 2) intraoperative coupling of the positioning sensor with the puncture instrument; 3) under real-time three-dimensional imaging guidance of the electromagnetic navigation system, performing percutaneous puncture to accurately place a positioning guidewire / microcoil / dye near the target pulmonary nodule; 4) postoperative CT scan to confirm the localization. This is a single-session procedure.
Aktiv komparator: CT-Guided Localization Group
Performed by an experienced thoracic surgeon or interventional radiologist under local anesthesia, the procedure is guided using a CT scanner. The steps include: 1) positioning the patient appropriately and performing a CT scan to determine the puncture site and path; 2) employing CT fluoroscopy or intermittent CT scanning for real-time guidance; 3) under CT image guidance, performing a percutaneous puncture to place a localization guidewire / microcoil / dye near the target pulmonary nodule; 4) performing a repeat CT scan post-procedure to confirm the localization position. This is a single-session procedure.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Success rate of intraoperative localization of lung nodules
Tidsramme: Day 0 (Intraoperative)
Thoracoscopic exploration enables accurate identification and localization of markers (e.g., contrast dye, microcoils, etc.), with the distance between the center of the marker or the main imaging area and the center of the target nodule being ≤20 mm, and ultimately successfully guides the resection of the target lesion.
Day 0 (Intraoperative)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Localization Accuracy
Tidsramme: Day 0 (Intraoperative)
The shortest physical distance (unit: mm) between the actual localization marker point (e.g., the center of the dye) and the outer edge of the nodular lesion in the resected specimen.
Day 0 (Intraoperative)
Location Procedure Time
Tidsramme: Day 0 (Intraoperative)

CT-guided group: Time from the start of the initial localization planning CT scan to the completion of marker/needle deployment and withdrawal of instruments from the body surface.

Electromagnetic navigation group: Time from when the bronchoscope passes the vocal cords to the completion of marker deployment and withdrawal of the guiding instrument (unit: min).

Day 0 (Intraoperative)
Conversion Rate
Tidsramme: Day 0 (Intraoperative)
The proportion of subjects in whom conversion from complete thoracoscopy to thoracotomy, or from the planned sublobar resection (wedge/segment) to an extended resection (e.g., lobectomy), was necessitated due to failure to locate the lesion, insufficient surgical margin resulting from excessive localization error, or severe complications related to localization (such as major hemorrhage).
Day 0 (Intraoperative)
Complication Rate
Tidsramme: Day 0 through hospital discharge or Day 7 postoperatively, whichever comes first
Record the incidence of all complications related to the localization procedure. In addition to complications common to percutaneous approaches, such as pneumothorax and intrathoracic hemorrhage, airway-related complications, including airway mucosal injury/bleeding, bronchospasm, and severe hypoxemia, should be systematically documented. Assessment should be performed based on the adverse event grading criteria.
Day 0 through hospital discharge or Day 7 postoperatively, whichever comes first
Radiation Exposure
Tidsramme: Day 0 (Intraoperative)
Dose-length product (DLP) value of radiation received by the patient, as recorded by the CT scanner (unit: mGy·cm).
Day 0 (Intraoperative)
Operative Time
Tidsramme: Day 0 (Intraoperative)
Time from the initiation of the skin incision for thoracoscopy to the completion of wound closure (unit: min).
Day 0 (Intraoperative)
Early Postoperative Pain Score
Tidsramme: Day 0 (immediately after localization); 24 hours postoperatively
Visual Analog Scale (VAS) or Numeric Rating Scale (NRS), scored from 0 to 10 points (with 0 representing no pain and 10 representing the most severe pain).
Day 0 (immediately after localization); 24 hours postoperatively

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Ledende efterforsker: Haifeng Wang, Shanghai Pulmonary Hospital, Shanghai, China

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

1. januar 2027

Studieafslutning (Anslået)

1. april 2027

Datoer for studieregistrering

Først indsendt

5. maj 2026

Først indsendt, der opfyldte QC-kriterier

16. maj 2026

Først opslået (Faktiske)

19. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

19. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

16. maj 2026

Sidst verificeret

1. maj 2026

Mere information

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