CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg Rep 2022; 11(01): e58-e60
DOI: 10.1055/s-0042-1756299
Case Report: Thoracic

A Simple Method to Improve Intraoperative Localization of Fiducial Markers during Lung Resections

Shengliang He
1   Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona
Staci Beamer
1   Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona
Dawn Jaroszewski
1   Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona
Jonathan D'Cunha
1   Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona
Samine Ravanbakhsh
1   Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, Arizona
› Author Affiliations
Source of Funding Not applicable.


Background Lung cancer screening programs have increased the detection of early-stage lung cancer. High-resolution computed tomography can detect small, low-density pulmonary nodules, or ground-glass opacities. Obtaining a tissue diagnosis can be challenging, often necessitating surgical diagnosis. Preoperative localization and intraoperative fluoroscopy are valuable tools to guide resections for small pulmonary nodules.

Case Description We present three cases using intraoperative fluoroscopy and Faxitron Bioptics that enhanced our certainty of resection of nonpalpable nodules.

Conclusion We support the use of intraoperative fluoroscopy with the unique addition of Faxitron BioVision as safe and reliable methods to enhance the certainty of resection.


D.J. discloses personal fees from Zimmer Biomet.

Informed Consent

Informed consent was obtained for the publication of the study data.

Publication History

Received: 28 October 2021

Accepted: 04 July 2022

Article published online:
30 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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  • References

  • 1 Sancheti MS, Lee R, Ahmed SU. et al. Percutaneous fiducial localization for thoracoscopic wedge resection of small pulmonary nodules. Ann Thorac Surg 2014; 97 (06) 1914-1918 , discussion 1919
  • 2 SEER cancer statistics factsheets: lung and bronchus cancer. Accessed August 16, 2022, at:
  • 3 Olaiya B, Gilliland CA, Force SD, Fernandez FG, Sancheti MS, Small WC. Preoperative computed tomography-guided pulmonary lesion marking in preparation for fluoroscopic wedge resection-rates of success, complications, and pathology outcomes. Curr Probl Diagn Radiol 2019; 48 (01) 27-31
  • 4 Moon SW, Cho DG, Cho KD, Kang CU, Jo MS, Park HJ. Fluoroscopy-assisted thoracoscopic resection for small intrapulmonary lesions after preoperative computed tomography-guided localization using fragmented platinum microcoils. Thorac Cardiovasc Surg 2012; 60 (06) 413-418
  • 5 Finley RJ, Mayo JR, Grant K. et al. Preoperative computed tomography-guided microcoil localization of small peripheral pulmonary nodules: a prospective randomized controlled trial. J Thorac Cardiovasc Surg 2015; 149 (01) 26-31
  • 6 Suzuki K, Nagai K, Yoshida J. et al. Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking. Chest 1999; 115 (02) 563-568
  • 7 Lin CW, Ko HJ, Yang SM. et al. Computed tomography-guided dual localization with microcoil and patent blue vital dye for deep-seated pulmonary nodules in thoracoscopic surgery. J Formos Med Assoc 2019; 118 (06) 979-985
  • 8 Sharma A, McDermott S, Mathisen DJ, Shepard JO. Preoperative localization of lung nodules with fiducial markers: feasibility and technical considerations. Ann Thorac Surg 2017; 103 (04) 1114-1120
  • 9 Ginsberg RJ, Rubinstein LV. Lung Cancer Study Group. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Ann Thorac Surg 1995; 60 (03) 615-622 , discussion 622–623