ELECTROMAGNETIC navigation bronchoscopy (ENB)-guided dye marking offers a safer, faster alternative to CT-guided lung puncture for preoperative localization of multiple ipsilateral pulmonary nodules, according to a new retrospective cohort study.
As pulmonary nodule detection continues to rise, optimizing localization techniques is critical for improving surgical precision and patient safety. Researchers evaluated 203 patients who underwent video-assisted thoracoscopic surgery following either ENB-guided dye marking (ENBDM) or traditional CT-guided lung puncture for localizing multiple nodules in the same lung.
The findings demonstrate that ENBDM significantly reduced localization time, averaging 8 minutes versus 22 minutes with CT guidance. Most notably, ENBDM entirely avoided radiation exposure and procedural complications. While 34.6% of patients in the CT group experienced pneumothorax, none occurred in the ENB group. Similarly, hemothorax and pleural reactions were absent in the ENB group but occurred in 14.4% and 7.7% of CT-guided cases, respectively.
Despite these differences in safety and efficiency, both methods delivered comparable localization success rates, 97.4% for ENBDM and 94.9% for CT guidance, suggesting ENBDM does not compromise clinical accuracy.
These results are especially relevant for thoracic surgeons and pulmonologists managing patients with multiple pulmonary nodules, a cohort that increasingly demands precise, minimally invasive interventions. ENBDM’s ability to localize multiple nodules in a single session, without radiation or invasive puncture, positions it as a highly viable tool in modern lung cancer surgery planning.
The study’s authors conclude that ENB-guided dye marking is an effective preoperative strategy, offering similar localization accuracy to CT-guided puncture with markedly lower risk and greater procedural efficiency.
Reference:
Wang R et al. A better option for localization of multiple pulmonary nodules in the ipsilateral lung: electromagnetic navigation bronchoscopy-guided preoperative localization. TLCR. 2025;14(3).
