Feasibility study of a novel wireless localization technique using radiofrequency identification markers for small and deeply located lung lesions

Objectives: To evaluate the safety and efficacy of a novel wireless localization technique that uses radiofrequency identification markers for small and deep lung lesions. Methods: Preliminary use of the device was retrospectively evaluated in 2 Japanese centers. Under general anesthesia, a marker was placed as close as possible to the tumor via computed tomography-guided bronchoscopy in a hybrid operation theater. Surgeons located the marker without lung palpation using a detection probe the tone of which changed to indicate the marker-probe distance. Efficacy was defined as functional marker placement (bronchoscopy time and marker position) and deep margin distance. Results: Twelve markers were placed for 11 lesions (mean size, 6.8±2.7mm) located at a mean depth from the pleura of 11.4±8.4mm (range=0-26.0mm). Of 12 markers, 7 markers (58.3%) were placed within 10mm from the lesion in 25.5±14.4minutes. For the 11 wedge resections, markers were placed at a mean distance of 6.7mm (range, 0-13.0mm) from the lesion and a mean distance of 14.4mm (range, 3.0-42.0mm) from the pleura. All markers were recovered without complications, and all tumors were resected with negative margins. For 5 lesions >10mm deep to the pleura (mean depth, 18.9±5.5mm; range, 11.0-26.0mm), the median depth of the surgical margin was 11.6±2.1mm (range, 9.0-14.0mm). Conclusions: Radiofrequency identification marking was safe and precisely localized small lung lesions, including their depth.