{
  "abstract": "Background\n\nPrecise localization is critical for sublobar resection of small pulmonary nodules. We evaluated the safety, technical efficiency, and clinical outcomes of preoperative percutaneous dye-localization using a cone-beam computed tomography (CBCT)-enabled flat-panel detector interventional fluoroscopy system in a hybrid operating room (HOR).Methods\n\nWe retrospectively reviewed 74 consecutive patients (137 lesions) who underwent image-guided localization followed by video-assisted thoracoscopic surgery (VATS) sublobar resection (wedge resection or segmentectomy) between 2022 and 2023 at Chia-Yi Christian Hospital. Procedural workflow, localization success, surgical margins, and perioperative outcomes were systematically analyzed.Results\n\nTechnical localization success was achieved in 100% of lesions (mean nodule diameter: 8.59 ± 4.85 mm). The procedure required a mean of 1.31 ± 0.67 puncture attempts per lesion at a mean depth of 5.22 ± 1.86 cm. Procedure-related pneumothorax occurred in 29.7% (22/74) of patients, with 14.9% (11/74) requiring pigtail catheter drainage; pneumothorax occurrence was significantly associated with multiple puncture attempts (p < 0.001) and lower-lobe lesions (p = 0.001). Lower-lobe location was significantly associated with requiring more puncture attempts (p = 0.028). For malignant lesions, the mean pathological resection margin was 17.16 ± 8.73 mm, with 92.31% achieving a margin-to-tumor ratio (MTR) ≥ 1. The mean postoperative hospital stay was 3.04 ± 1.16 days.Conclusions\n\nSingle-stage image-guided dye-localization and VATS sublobar lung resection in an HOR using a biplane CBCT-enabled platform is safe, feasible, and effective. This streamlined workflow ensures high technical success and adequate surgical margins with manageable complications. Further studies are warranted to evaluate long-term oncological outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Thoracic Surgery, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.",
    "Department of Biomedical Sciences, National Chung Cheng University, Chia-Yi, Taiwan.",
    "Division of Pulmonary Medicine, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.",
    "Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.",
    "Clinical Data Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan.",
    "Institute of Molecular Biology, National Chung Cheng University, Chia-Yi, Taiwan."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yueh-Lin Wu"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Kam-Hong Kam"
    },
    {
      "affs": [
        2
      ],
      "name": "Chi-Yen Liang"
    },
    {
      "affs": [
        2
      ],
      "name": "Yu-Ting Lai"
    },
    {
      "affs": [
        2
      ],
      "name": "Tien-Hsin Jeng"
    },
    {
      "affs": [
        2
      ],
      "name": "Chang-Ching Lee"
    },
    {
      "affs": [
        0
      ],
      "name": "Ya-Fen Wu"
    },
    {
      "affs": [
        3
      ],
      "name": "Yung-Cheng Yang",
      "orcid": "0000-0002-9406-2880"
    },
    {
      "affs": [
        4
      ],
      "name": "Hsin-Yi Yang",
      "orcid": "0000-0002-8571-5202"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Jia-Ming Chang",
      "orcid": "0000-0002-0763-0545"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f2wsawexqw5bx.bib",
  "cited_by": 0,
  "doi": "10.1111/1759-7714.70401",
  "fulltext_url": "https://europepmc.org/articles/PMC13673405",
  "id": "f2wsawexqw5bx",
  "issns": [
    "1759-7706",
    "1759-7714"
  ],
  "landing_url": "https://europepmc.org/article/MED/42885537",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7222721307",
  "pdf_url": "https://europepmc.org/articles/PMC13673405?pdf=render",
  "pmcid": "PMC13673405",
  "pmid": "42885537",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/f2wsawexqw5bx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42885537",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42885537"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Lung Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Nodule Dye-Localization Using Interventional Fluoroscopy for Image-Guided Sublobar Lung Resection.",
  "title_text": "Nodule Dye-Localization Using Interventional Fluoroscopy for Image-Guided Sublobar Lung Resection.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:00Z",
  "url": "https://research.draconitic.com/paper/f2wsawexqw5bx",
  "venue": "Thoracic cancer",
  "versions": []
}