Three-Dimensionally Printed Template for Percutaneous Localization of Multiple Lung Nodules

Background. When multiple target lung nodules exist, the computed tomography (CT)-guided percutaneous localization procedure becomes complicated. In this study, a three-dimensional (3D)-printed template was designed that could guide hook wire localization of multiple lung nodules. The pilot study aimed for preliminary validation of the feasibility of template-guided localization for multiple lesions. Methods. Patients with multiple lung nodules (<2 cm) and who were scheduled for surgical resection were recruited for participation in this study. After securing their preadmission CT images, the study investigators reconstructed a 3D thorax model from which they designed a digital model as a navigational template. A physical template was then printed for guiding the percutaneous localization of lung nodules. The localization accuracy was evaluated on the basis of the deviation between the localizer and the nodule. Results. From April 2018 to November 2018, the study enrolled 16 patients with 34 lung nodules. All nodules were successfully localized under template guidance, with a median procedural time of 10.0-minutes (interquartile range [IQR], 8.5-12.6 minutes) and a median radiation exposure of 235 mGy . cm (IQR, 195-254 mGy . cm). The median deviation from the hook wires and nodule centers was 9.0 mm (IQR, 6.2-11.8 mm). Except for 2 cases of pneumothorax without need for further intervention, no complications occurred. Conclusions. Navigational templates built using 3D printing may serve as an effective approach for facilitating localization of multiple lung nodules. (C) 2019 by The Society of Thoracic Surgeons