Fiducial placement for stereotactic radiation by using EUS: feasibility when using a marker compatible with a standard 22-gauge needle.
Gastrointest Endosc
; 71(3): 630-3, 2010 Mar.
Article
em En
| MEDLINE
| ID: mdl-20189527
ABSTRACT
BACKGROUND:
Stereotactic radiation by using fiducial markers permits higher doses of radiation while reducing the exposure of uninvolved, adjacent structures. EUS has been used to deploy fiducials, although a 19-gauge needle has traditionally been required.OBJECTIVE:
To report a new technique and the feasibility of deploying a fiducial compatible with a 22-gauge needle under EUS guidance.DESIGN:
Single-center, case series.SETTING:
Tertiary care referral center. PATIENTS Thirteen patients with primary or metastatic cancer referred for stereotactic radiation.INTERVENTIONS:
EUS-guided placement of a single fiducial marker that is compatible with a 22-gauge EUS-FNA needle. MAIN OUTCOME MEASUREMENTS Technical success and complications.RESULTS:
Thirteen patients referred for EUS-guided placement of a fiducial marker were identified in the endoscopic database. Targeted lesions measured 27 +/- 13 mm (range 8-50) x 21 +/- 10 mm (range 6-42). All fiducials were successfully deployed, 9 using a transgastric and 4 using a transduodenal approach. There were no EUS-associated complications. Two patients did not proceed to radiation therapy as a result of interval peritoneal metastasis. However, all fiducials were visible on the roentogram. Eleven of 13 patients (85%) required placement of 1 fiducial, whereas 2 patients (15%) required 2 fiducials.LIMITATIONS:
Uncontrolled feasibility study with limited sample size and follow-up.CONCLUSION:
EUS-guided placement of a fiducial using a 22-gauge needle is technically feasible and may permit greater access compared with the 19-gauge needle technique.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Endossonografia
/
Neoplasias Gastrointestinais
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article