EUS-guided fiducial placement for image-guided radiation therapy in GI malignancies by using a 22-gauge needle (with videos) Journal Article
| Authors: | Dimaio, C. J.; Nagula, S.; Goodman, K. A.; Ho, A. Y.; Markowitz, A. J.; Schattner, M. A.; Gerdes, H. |
| Article Title: | EUS-guided fiducial placement for image-guided radiation therapy in GI malignancies by using a 22-gauge needle (with videos) |
| Abstract: | 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. © 2010 American Society for Gastrointestinal Endoscopy. |
| Keywords: | adult; clinical article; aged; aged, 80 and over; middle aged; retrospective studies; cancer radiotherapy; follow-up studies; reproducibility of results; retrospective study; digestive system cancer; fever; gastrointestinal neoplasms; feasibility study; feasibility studies; device; patient safety; liver disease; liver function test; equipment design; needle; endoscopic echography; endosonography; needles; video recording; abdominal cancer; complication; mediastinum cancer |
| Journal Title: | Gastrointestinal Endoscopy |
| Volume: | 71 |
| Issue: | 7 |
| ISSN: | 0016-5107 |
| Publisher: | Mosby Elsevier |
| Date Published: | 2010-06-01 |
| Start Page: | 1204 |
| End Page: | 1210 |
| Language: | English |
| DOI: | 10.1016/j.gie.2010.01.003 |
| PUBMED: | 20598247 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: GAENB" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work