Preoperative computed tomography-guided localization for pulmonary nodules: a systematic review and meta-analysis of soft hook-wire and coil localization

Preoperative computed tomography (CT)-guided analysis of pulmonary nodule (PN) localization is performed to increase the success of resection surgery using video-assisted thoracoscopic surgery (VATS). This meta-analysis compared the relative efficacy and safety of soft hook-wire (SHW) and coil-based strategies for CT-guided PN localization. The databases of PubMed, Wanfang, and Cochrane Library were searched to acquire relevant studies published before September 2024 using the following search query: (((coil) AND ((((localization needle) OR (anchored needle)) OR (Sens-cure needle)) OR (soft hook-wire))) AND (localization)) AND ((lung nodule) OR (pulmonary nodule)). The acquired related outcomes were pooled and analyzed. This meta-analysis included 8 studies, including 440 patients undergoing CT-guided coil localization for 502 PNs and 446 patients undergoing CT-guided SHW localization for 521 PNs. The results indicated that the SHW and coil groups had similar pooled localization success rates (P=0.13), pulmonary hemorrhage rates (P=0.28), limited resection duration (P=0.91), pneumothorax rates (P=0.18), and entire VATS duration (P=0.07). Furthermore, SHW localization analysis was substantially faster than coil localization analysis (P=0.0009). Moreover, there was significant heterogeneity in the endpoints of localization duration (I2=95%) and limited resection duration (I2=76%). In addition, there was no publication bias in any endpoints. This study indicated that both coil- and SHW-based CT-guided PN localization can inform limited resection using VATS with similar safety and success rates. However, compared to coil localization, SHW localization is time saving.