Computed tomography guided percutaneous injection of a mixture of lipiodol and methylene blue in rabbit lungs: evaluation of localization ability for video-assisted thoracoscopic surgery

• Published in: Journal of Korean medical science Vol. 29; no. 1; pp. 129 - 136
• Main Authors: Jin, Kwang Nam, Lee, Kyung Won, Kim, Tae Jung, Song, Yong Sub, Kim, Dong Il
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01-01-2014; 대한의학회
• Subjects: Animals; Ethiodized Oil - administration & dosage; Fluoroscopy; Injections, Subcutaneous; Lung - diagnostic imaging; Lung - surgery; Methylene Blue - administration & dosage; Original; Preoperative Care; Rabbits; Solitary Pulmonary Nodule - surgery; Staining and Labeling - methods; Thoracic Surgery, Video-Assisted - methods; Thoracoscopy - methods; Tomography, X-Ray Computed; 의학일반; Methylene Blue; Tomography, X-Ray Computed; Radiology, Interventional; Lung; Ethiodized Oil
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2014.29.1.129

Preoperative localization is necessary prior to video assisted thoracoscopic surgery for the detection of small or deeply located lung nodules. We compared the localization ability of a mixture of lipiodol and methylene blue (MLM) (0.6 mL, 1:5) to methylene blue (0.5 mL) in rabbit lungs. CT-guided percutaneous injections were performed in 21 subjects with MLM and methylene blue. We measured the extent of staining on freshly excised lung and evaluated the subjective localization ability with 4 point scales at 6 and 24 hr after injections. For MLM, radio-opacity was evaluated on the fluoroscopy. We considered score 2 (acceptable) or 3 (excellent) as appropriate for localization. The staining extent of MLM was significantly smaller than methylene blue (0.6 vs 1.0 cm, P<0.001). MLM showed superior staining ability over methylene blue (2.8 vs 2.2, P=0.010). Excellent staining was achieved in 17 subjects (81%) with MLM and 8 (38%) with methylene blue (P=0.011). An acceptable or excellent radio-opacity of MLM was found in 13 subjects (62%). An appropriate localization rate of MLM was 100% with the use of the directly visible ability and radio-opacity of MLM. MLM provides a superior pulmonary localization ability over methylene blue.