Quantitative imaging in medicine and surgery · 2026
Percutaneous iodixanol localization of pulmonary ground-glass nodules for synchronous microwave ablation and biopsy: a multicenter, retrospective, matched analysis.
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Wei Zhigang, Yang Xia, Cao Pikun, Wang Gang, Xie Qi, Xue Guoliang, Wang Nan, Zhang Chao, Zhang Wen, Ye Xin
Аннотация
BACKGROUND: Synchronous microwave ablation (MWA) and biopsy are suitable for patients with high-risk pulmonary ground-glass nodules (GGNs) who are unfit for resection. The ablation accuracy is affected by hemorrhage and nodule displacement. We thus aimed to verify whether iodixanol localization could enhance the accuracy of the synchronous MWA and biopsy of GGNs.
METHODS: A total of 211 continuous patients who underwent synchronous MWA and biopsy were enrolled in a multicenter retrospective study from January 1, 2021, to December 31, 2022. Patients undergoing synchronous MWA and biopsy under conventional computed tomography (CT) guidance were placed in the conventional CT guidance for synchronous MWA and biopsy (cSMB) group and those with iodixanol localization were placed in the iodixanol localization for synchronous MWA and biopsy (iSMB) group. The primary outcomes included primary technique efficacy rate (defined as complete ablation based on a CT scan at 3 months), positive biopsy rate, and complications. In addition to an analysis of the overall cohort, data were compared in propensity score matching for GGN characteristics to minimize the impact of confounding factors.
RESULTS: Compared to the cSMB group (n=108), the iSMB group (n=103) had a higher primary technique efficacy rate (100.0% vs. 92.6%; P=0.007) and positive biopsy rate (96.1% vs. 88.0%, P=0.030). In the cSMB group, the rates of pneumothorax and pleural effusion were 49.1% (53/108) and 37.1% (40/108), respectively, while they were 38.8% (40/103) and 21.3% (22/103), respectively, in the iSMB group (P=0.134 and P=0.012, respectively). Analysis of the matched cohort (n=94 per group) confirmed that the iSMB group, as compared to the cSMB group, had a higher primary technique efficacy rate (100.0% vs. 91.5%; P=0.007) and a higher positive biopsy rate (97.9% vs. 89.4%; P=0.017).
CONCLUSIONS: Iodixanol localization during synchronous MWA and biopsy of GGNs is efficient and safe.
METHODS: A total of 211 continuous patients who underwent synchronous MWA and biopsy were enrolled in a multicenter retrospective study from January 1, 2021, to December 31, 2022. Patients undergoing synchronous MWA and biopsy under conventional computed tomography (CT) guidance were placed in the conventional CT guidance for synchronous MWA and biopsy (cSMB) group and those with iodixanol localization were placed in the iodixanol localization for synchronous MWA and biopsy (iSMB) group. The primary outcomes included primary technique efficacy rate (defined as complete ablation based on a CT scan at 3 months), positive biopsy rate, and complications. In addition to an analysis of the overall cohort, data were compared in propensity score matching for GGN characteristics to minimize the impact of confounding factors.
RESULTS: Compared to the cSMB group (n=108), the iSMB group (n=103) had a higher primary technique efficacy rate (100.0% vs. 92.6%; P=0.007) and positive biopsy rate (96.1% vs. 88.0%, P=0.030). In the cSMB group, the rates of pneumothorax and pleural effusion were 49.1% (53/108) and 37.1% (40/108), respectively, while they were 38.8% (40/103) and 21.3% (22/103), respectively, in the iSMB group (P=0.134 and P=0.012, respectively). Analysis of the matched cohort (n=94 per group) confirmed that the iSMB group, as compared to the cSMB group, had a higher primary technique efficacy rate (100.0% vs. 91.5%; P=0.007) and a higher positive biopsy rate (97.9% vs. 89.4%; P=0.017).
CONCLUSIONS: Iodixanol localization during synchronous MWA and biopsy of GGNs is efficient and safe.