Application of Electromagnetic Navigation System in Pulmonary Nodule Localization
Electromagnetic Navigation-Guided Versus CT-Guided Localization of Pulmonary Nodules: A Multicenter, Prospective, Randomized Controlled Trial
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Shenghao Huang
- Telefonnummer: +86 153 5656 1656
- E-Mail: huangshplus5@163.com
Studienorte
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Shanghai, China
- Shanghai Pulmonary Hospital
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Kontakt:
- Haifeng Wang
- Telefonnummer: +8602156561656
- E-Mail: huangshplus5@163.com
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Age 18-80 years, regardless of gender;
- Solitary single nodule, scheduled for lung nodule puncture and localization;
- Chest CT (lung window mode) showing a maximum nodule diameter ≤ 2 cm;
- Eastern Cooperative Oncology Group (ECOG) performance status score 0-2;
- Voluntary participation, with signed informed consent.
Exclusion Criteria:
- Not suitable for video-assisted thoracoscopic surgery;
- The distance between the center of the lesion and the dome of the diaphragm is < 3 cm;
- History of thoracic adhesion due to previous thoracotomy or pleural infection;
- Patients judged by the investigator to be unsuitable for preoperative transthoracic or transbronchial localization;
- Inability to complete follow-up or poor compliance.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
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Experimental: Electromagnetic Navigation Localization Group
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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.
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Aktiver Komparator: CT-Guided Localization Group
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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.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Success rate of intraoperative localization of lung nodules
Zeitfenster: Day 0 (Intraoperative)
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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.
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Day 0 (Intraoperative)
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Localization Accuracy
Zeitfenster: Day 0 (Intraoperative)
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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.
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Day 0 (Intraoperative)
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Location Procedure Time
Zeitfenster: Day 0 (Intraoperative)
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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)
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Conversion Rate
Zeitfenster: Day 0 (Intraoperative)
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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).
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Day 0 (Intraoperative)
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Complication Rate
Zeitfenster: Day 0 through hospital discharge or Day 7 postoperatively, whichever comes first
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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.
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Day 0 through hospital discharge or Day 7 postoperatively, whichever comes first
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Radiation Exposure
Zeitfenster: Day 0 (Intraoperative)
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Dose-length product (DLP) value of radiation received by the patient, as recorded by the CT scanner (unit: mGy·cm).
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Day 0 (Intraoperative)
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Operative Time
Zeitfenster: Day 0 (Intraoperative)
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Time from the initiation of the skin incision for thoracoscopy to the completion of wound closure (unit: min).
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Day 0 (Intraoperative)
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Early Postoperative Pain Score
Zeitfenster: Day 0 (immediately after localization); 24 hours postoperatively
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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).
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Day 0 (immediately after localization); 24 hours postoperatively
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Haifeng Wang, Shanghai Pulmonary Hospital, Shanghai, China
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- IRB-K26-427
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