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The role of virtual-assisted lung mapping in the resection of ground glass nodules

	author = {Masaaki Sato and Taiji Kuwata and Atsushi Kitamura and Kenji Misawa and Kota Imashimizu and Keiji Yamanashi and Masaki Ikeda and Terumoto Koike and Masashi Kobayashi and Shinji Kosaka and Ryuta Fukai and Noritaka Isowa and Kazuhiro Nagayama and Akihiro Aoyama and Hiroshi Date and Jun Nakajima},
	title = {The role of virtual-assisted lung mapping in the resection of ground glass nodules},
	journal = {Journal of Thoracic Disease},
	volume = {10},
	number = {5},
	year = {2018},
	keywords = {},
	abstract = {Background: Virtual-assisted lung mapping (VAL-MAP), a bronchoscopic multi-spot dye-marking technique, was tested for its ability to resect ground glass nodules (GGNs) in sublobar lung resections. 
Methods: All patients were prospectively registered in the multi-institutional lung mapping (MIL-MAP) study using VAL-MAP. The data were retrospectively analyzed, focusing on GGNs. GGN characteristics, pathological findings, operation type, and the surgical contribution of VAL-MAP were evaluated. 
Results: The 370 GGNs in 299 patients included 257 pure and 113 mixed GGNs. There were 146 wedge resections (43.6%), 99 simple segmentectomies (29.6%), and 60 complex segmentectomies (18.0%). The largest number of marks were used in complex segmentectomy (4.05±0.74), followed by simple segmentectomy (3.35±0.97) and wedge resection (2.96±0.80). The overall successful resection rate was 98.6%. Multiple [2–5] GGNs were concurrently targeted by VAL-MAP in 53 patients (17.7%) with 123 GGNs. Two concurrent resections were conducted in 36 patients (12.1%), most commonly wedge resection and segmentectomies (21 patients). Among 190 sub-centimeter GGNs, 24 out of 51 GGNs ≤5 mm in diameter (47.1%) and 113 of 139 GGNs >5 mm in diameter (81.3%) were primary lung cancer (P5 mm in diameter are likely to be lung cancer. VAL-MAP may impact decision-making regarding the indications and type of surgery for suspicious small GGNs.},
	issn = {2077-6624},	url = {}