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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
Studie Overzicht
Toestand
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Shenghao Huang
- Telefoonnummer: +86 153 5656 1656
- E-mail: huangshplus5@163.com
Studie Locaties
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Shanghai, China
- Shanghai Pulmonary Hospital
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Contact:
- Haifeng Wang
- Telefoonnummer: +8602156561656
- E-mail: huangshplus5@163.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: 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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Actieve vergelijker: 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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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Success rate of intraoperative localization of lung nodules
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Localization Accuracy
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Haifeng Wang, Shanghai Pulmonary Hospital, Shanghai, China
Studie record data
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Studie start (Geschat)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
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Eerst ingediend dat voldeed aan de QC-criteria
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Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- IRB-K26-427
Plan Individuele Deelnemersgegevens (IPD)
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