Bridging Targeting Precision and Oncologic Safety: Localization Accuracy for Margin Adequacy in Cone-Beam…

Cohort studyCancers· Jul 2026

Bridging Targeting Precision and Oncologic Safety: Localization Accuracy for Margin Adequacy in Cone-Beam Computed Tomography-Guided Pulmonary Nodule Resection.

Yu-Hsiang Wang, Hsu-Chih Huang, Chih-Yi Chen … Frank Cheau-Feng Lin

Cardiothoracic ImagingCohort studyClinical practiceQ1IF 4.9

Needle-to-tumor distance of 4.9 mm or more is linked to inadequate resection margins.

Bridging Targeting Precision and Oncologic Safety: Localization Accuracy for Margin Adequacy in Cone-Beam Computed Tomography-Guided Pulmonary Nodule Resection.

Yu-Hsiang Wang … Frank Cheau-Feng Lin

Cancers · Jul 2026

Background

Ground-glass pulmonary nodules are often nonpalpable and not visible during thoracoscopic surgery, making accurate localization important for achieving adequate pathological margins.

Purpose

We evaluated the association between Dmn and pathological margin adequacy after image-guided thoracoscopic pulmonary nodule resection and sought to identify a clinically relevant localization-accuracy threshold.

Methods

We retrospectively reviewed 169 patients in a predefined peripheral-lesion cohort who underwent cone-beam computed tomography-guided pulmonary nodule localization using hook-wire placement or dye marking in a hybrid operating room, followed by thoracoscopic wedge resection.

n = 169 patients

Results

at or beyond this gap, resection margins are usually too narrow

71%

Sensitivity

94.2%

Specificity

More results

Dmn was independently associated with pathological margin inadequacy (odds ratio, 1.617; 95% confidence interval, 1.356-1.928; p < 0.001).

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Conclusion · 1 of 2

In this single-center cohort, a Dmn of approximately 4.9 mm was associated with pathological margin inadequacy after cone-beam computed tomography-guided pulmonary nodule localization and thoracoscopic wedge resection.

Conclusion · 2 of 2

This value may serve as a candidate intraoperative warning threshold for margin reassessment; however, prospective external validation is required before routine clinical implementation.

Bridging Targeting Precision and Oncologic Safety: Localization Accuracy for Margin Adequacy in Cone-Beam Computed Tomography-Guided Pulmonary Nodule Resection.

Bridging Targeting Precision and Oncologic Safety: Localization Accuracy for Margin Adequacy in Cone-Beam Computed Tomography-Guided Pulmonary Nodule Resection.

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