TY - JOUR
T1 - EUS-guided fiducial placement for image-guided radiation therapy in GI malignancies by using a 22-gauge needle (with videos)
AU - DiMaio, Christopher J.
AU - Nagula, Satish
AU - Goodman, Karyn A.
AU - Ho, Alice Y.
AU - Markowitz, Arnold J.
AU - Schattner, Mark A.
AU - Gerdes, Hans
PY - 2010/6
Y1 - 2010/6
N2 - Background: Image-guided radiation therapy (IGRT) is dependent on the presence of fiducial markers for target localization and tracking. EUS-guided placement of fiducial markers with a 19-gauge needle has been reported. However, the size and stiffness of the 19-gauge needle may compromise the safety and ease of fiducial placement. Objective: The aim of this study was to evaluate the safety and feasibility of EUS-guided placement of thin flexible gold coil fiducials by using a 22-gauge needle. Design: Retrospective study. Setting: Memorial Sloan-Kettering Cancer Center, between December 2008 and November 2009. Patients: A total of 30 patients with GI malignancies of the mediastinum and upper abdomen who were to undergo IGRT. Interventions: EUS evaluation with a curvilinear-array echoendoscope was performed. The target lesion was identified, a 22-gauge needle preloaded with a gold coil fiducial was inserted into the lesion, and the fiducial was deployed under EUS guidance. Main Outcome Measurements: Technical success was defined as the ability to place fiducials in the desired location. Immediate and delayed complications were also noted. Results: A total of 69 fiducials were placed in 12 different sites in the mediastinum and upper abdomen. Technical success was achieved in 29 out of 30 cases (97%). No intraprocedural complications were encountered. One patient developed a fever and abnormal liver function tests 12 hours after fiducial placement. Limitations: Retrospective design, small case series. Conclusions: EUS-guided placement of thin flexible gold coil fiducials by using a 22-gauge needle is both safe and feasible for upper GI malignancies.
AB - Background: Image-guided radiation therapy (IGRT) is dependent on the presence of fiducial markers for target localization and tracking. EUS-guided placement of fiducial markers with a 19-gauge needle has been reported. However, the size and stiffness of the 19-gauge needle may compromise the safety and ease of fiducial placement. Objective: The aim of this study was to evaluate the safety and feasibility of EUS-guided placement of thin flexible gold coil fiducials by using a 22-gauge needle. Design: Retrospective study. Setting: Memorial Sloan-Kettering Cancer Center, between December 2008 and November 2009. Patients: A total of 30 patients with GI malignancies of the mediastinum and upper abdomen who were to undergo IGRT. Interventions: EUS evaluation with a curvilinear-array echoendoscope was performed. The target lesion was identified, a 22-gauge needle preloaded with a gold coil fiducial was inserted into the lesion, and the fiducial was deployed under EUS guidance. Main Outcome Measurements: Technical success was defined as the ability to place fiducials in the desired location. Immediate and delayed complications were also noted. Results: A total of 69 fiducials were placed in 12 different sites in the mediastinum and upper abdomen. Technical success was achieved in 29 out of 30 cases (97%). No intraprocedural complications were encountered. One patient developed a fever and abnormal liver function tests 12 hours after fiducial placement. Limitations: Retrospective design, small case series. Conclusions: EUS-guided placement of thin flexible gold coil fiducials by using a 22-gauge needle is both safe and feasible for upper GI malignancies.
UR - http://www.scopus.com/inward/record.url?scp=77952826584&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2010.01.003
DO - 10.1016/j.gie.2010.01.003
M3 - Article
C2 - 20598247
AN - SCOPUS:77952826584
SN - 0016-5107
VL - 71
SP - 1204
EP - 1210
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
IS - 7
ER -