2024 World Conference on Lung Cancer (WCLC) - ePosters-EP.07A.06 Usefullness and Appropriate Indication of Intraoperative CT-Guided Marking Using O-Arm Based on Cancellation Rate

EP.07A.06 Usefullness and Appropriate Indication of Intraoperative CT-Guided Marking Using O-Arm Based on Cancellation Rate

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The study assesses the usefulness and indications of intraoperative CT-guided marking using the O-arm system in lung surgeries, focusing on the cancellation rate of markings compared to conventional methods. Traditionally, percutaneous marking methods like dye injection were used, but are now less favored due to risks like air embolization. Recent alternatives include RFID, VAL-MAP, and the Cone Beam CT methods, with the latter using the O-arm being implemented since 2017 at Wakayama Medical University.<br /><br />Between January 2007 and April 2023, 76 out of 3021 respiratory surgeries utilized marking, split into early (2007-2016) and late (2017-2023) groups. The early group employed preoperative dye injection, while the late group used intraoperative O-arm guided marking. Data revealed significant improvements with the O-arm, including fewer CT scans needed, less procedure time, and no marking failures.<br /><br />The study found that in the late group, the cancellation rate of markings was 22%, indicating that in many cases, lesions could be recognized without marking. This suggests O-arm's potential to forego unnecessary markings if lesions are detectable by palpation during the surgery. <br /><br />Advantages of the O-arm method include no preparation required, the ability to mark multiple areas, safety from complications, and the option to terminate the procedure if unnecessary. However, there remains uncertainty in pre-operatively predicting when a lesion can be detected, which can necessitate marking as a precaution against possible conversion to open thoracotomy if lesions are not palpable. <br /><br />In conclusion, the O-arm method is highlighted for its practicality, safety, reliability, and minimal invasiveness, making it a useful tool in determining and adjusting marking procedures during lung surgeries.

Asset Subtitle

Yoshimitsu Hirai

Meta Tag

Speaker Yoshimitsu Hirai

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

intraoperative CT-guided marking

O-arm system

lung surgeries

cancellation rate

percutaneous marking

air embolization

RFID

VAL-MAP

Cone Beam CT

Wakayama Medical University