The BLUEPAT clinical trial introduces an innovative approach to improve the accuracy of VATS lung nodule resection. Locating small, subpleural nodules during thoracoscopic surgery often presents significant challenges for surgical teams. Consequently, researchers are evaluating the effectiveness of marking these nodules with a mixture of Patent Blue V and iohexol contrast under CT guidance. This prospective, randomized study aims to optimize routine management and provide a gentler diagnostic path for focal lung diseases. Furthermore, the trial seeks to establish a standardized protocol for precise tissue marking.

The Methodology of CT-Guided Marking

The BLUEPAT trial includes 72 participants requiring histological diagnosis of subpleural nodules. Specialists randomize these patients into two distinct arms in a 1:1 ratio. In the interventional arm, radiologists use CT guidance to inject blue dye and a contrast agent near the nodule. Afterward, the surgical team performs the VATS lung nodule resection. In contrast, the control arm undergoes the standard resection procedure without any preoperative color coding. Researchers monitor safety by recording all related adverse events throughout a 30-day follow-up period. This structured approach ensures a rigorous comparison between the two techniques.

Clinical Benefits for VATS Lung Nodule Resection

Color marking provides a vital visual roadmap that simplifies the identification of non-palpable lesions. Although patent blue dye is already a standard tool in breast cancer staging, its application in pulmonary surgery is relatively novel. Moreover, the inclusion of iohexol allows for radiological confirmation before the patient enters the operating theater. This dual-marking technique likely reduces the risk of missed nodules or unnecessarily large tissue resections. Therefore, this study could establish a safer and more precise protocol for thoracic surgeons across India. Ultimately, the trial may lead to shorter operative times and improved patient outcomes.

FAQs about the BLUEPAT Trial

What are the primary markers used in this study?

The BLUEPAT trial utilizes a combination of Patent Blue V dye for visual identification and iohexol, an iodine contrast agent, for radiological localization under CT control.

How does preoperative marking improve surgical outcomes?

Preoperative marking helps surgeons precisely locate small or deep-seated nodules that are otherwise invisible or difficult to palpate during a minimally invasive VATS procedure, ensuring a more accurate wedge resection.

Are there any common side effects of dye marking?

While the procedure is generally safe, potential complications may include minor pneumothorax or localized pulmonary hemorrhage. However, these events are typically asymptomatic and rarely require emergency medical intervention before the surgery.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or establish a doctor-patient relationship. The information provided is based on clinical trial protocols and current research. Refer to the latest local and national guidelines for clinical practice.

References

Chovanec Z et al. Labelling of subpleural pulmonary nodules with blue dye and contrast agents under CT-guided control and subsequent video-assisted thoracoscopic resection: the BLUEPAT prospective randomised study. Trials. 2026 Apr 28. doi: 10.1186/s13063-026-09748-7. PMID: 42045970.

Chen JR et al. Safety and efficacy of computed tomography-guided dye localization using patent blue V for single lung nodule for video-assisted thoracoscopic surgery: a retrospective study. Ann Transl Med. 2019 Jan;7(2):28.

Chovanec Z et al. Subpleural pulmonary nodule marking with patent blue V dye prior to surgical resection. Front Surg. 2024 May 20;11:1381395.