Ex vivo pulmonary nodule detection with miniaturized ultrasound convex probes

• Published in: The Journal of surgical research Vol. 202; no. 1; pp. 49 - 57
• Main Authors: Daddi, Niccolò, MD, PhD, Sagrini, Elisabetta, MD, PhD, Lugaresi, Marialuisa, MD, PhD, Perrone, Ottorino, MD, PhD, Candoli, Piero, MD, Ragusa, Mark, MD, PhD, Puma, Francesco, MD, Mattioli, Sandro, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016
• Subjects: Animals; Endobronchial ultrasound probe; Ex vivo lung perfusion; Finger probe; In vitro simulation; In Vitro Techniques; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - surgery; Lung nodule; Microconvex probe; Sensitivity and Specificity; Surgery; Swine; Thoracic Surgery, Video-Assisted; Ultrasonography, Interventional - instrumentation; Ultrasound; Microconvex probe; In vitro simulation; Finger probe; Ex vivo lung perfusion; Lung nodule; Ultrasound; Endobronchial ultrasound probe
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.12.005

Abstract Background The intraoperative localization of small and deep pulmonary nodules is often difficult during minimally invasive thoracic surgery. We compared the performance of three miniaturized ultrasound (US) convex probes, one of which is currently used for thoracic endoscopic diagnostic procedures, for the detection of lung nodules in an ex vivo lung perfusion model. Methods Three porcine cardiopulmonary blocks were perfused, preserved at 4°C for 6 h and reconditioned. Lungs were randomly seeded with different patterns of echogenicity target nodules (9 water balls, 10 fat, and 11 muscles; total n  = 30). Three micro-convex US probes were assessed in an open setting on the pleural surface: PROBE 1, endobronchial US 5–10 MHz; PROBE 2, laparoscopic 4–13 MHz; PROBE 3, fingertip micro-convex probe 5–10 MHz. US probes were evaluated regarding the number of nodules localized/not localized, the correlation between US and open specimen measurements, and imaging quality. Results For detecting target nodules, the sensitivity was 100% for PROBE 1, 86.6% for PROBE 2, and 78.1% for PROBE 3. A closer correlation between US and open specimen measurements of target diameter ( r  = 0.87; P  = 0.0001) and intrapulmonary depth ( r  = 0.97; P  = 0.0001) was calculated for PROBE 1 than for PROBES 2 and 3. The imaging quality was significantly higher for PROBE 1 than for PROBES 2 and 3 ( P  < 0.04). Conclusions US examination with micro-convex probes to detect pulmonary nodules is feasible in an ex vivo lung perfusion model. PROBE 1 achieved the best performance. Clinical research with the endobronchial US micro-convex probe during minimally invasive thoracic surgery is advisable.