BACKGROUND/AIMS: Stereotactic body radiation therapy (SBRT) for gastrointestinal malignancies requires the placement of fiducials to guide treatment delivery. This study aimed to determine the safety and technical feasibility of endoscopic ultrasonography (EUS)-guided fiducial placement for SBRT. METHODS: From November 2010 to August 2012, 32 consecutive patients who were scheduled to receive SBRT for pancreatic and hepatic malignancies were referred for EUS-guided fiducial placement. Primary outcome measurements included technical success, the fiducial migration rate, and procedural complications. RESULTS: All 32 patients had successful fiducial placement under EUS guidance. The mean number of fiducials placed per patient was 2.94±0.24 (range, 2 to 3 seeds). Spontaneous fiducial migration was noted in one patient (3.1%). Of the 32 patients with fiducials placed, 29 patients (90.6%) successfully underwent SBRT. One patient (3.1%) developed mild pancreatitis, requiring a 2-day prolonged hospitalization after fiducial placement. Five patients (15.6%) underwent same-session, EUS-guided fine needle aspiration for histologic confirmation at the time of fiducial placement, without any procedure-related complication. CONCLUSIONS: EUS-guided fiducial placement is a safe and technically feasible technique for preparing patients with both pancreatic and hepatic malignancies for SBRT. The fiducial markers facilitate safe and accurate targeting of the tumor during SBRT.
BACKGROUND/AIMS: Stereotactic body radiation therapy (SBRT) for gastrointestinal malignancies requires the placement of fiducials to guide treatment delivery. This study aimed to determine the safety and technical feasibility of endoscopic ultrasonography (EUS)-guided fiducial placement for SBRT. METHODS: From November 2010 to August 2012, 32 consecutive patients who were scheduled to receive SBRT for pancreatic and hepatic malignancies were referred for EUS-guided fiducial placement. Primary outcome measurements included technical success, the fiducial migration rate, and procedural complications. RESULTS: All 32 patients had successful fiducial placement under EUS guidance. The mean number of fiducials placed per patient was 2.94±0.24 (range, 2 to 3 seeds). Spontaneous fiducial migration was noted in one patient (3.1%). Of the 32 patients with fiducials placed, 29 patients (90.6%) successfully underwent SBRT. One patient (3.1%) developed mild pancreatitis, requiring a 2-day prolonged hospitalization after fiducial placement. Five patients (15.6%) underwent same-session, EUS-guided fine needle aspiration for histologic confirmation at the time of fiducial placement, without any procedure-related complication. CONCLUSIONS: EUS-guided fiducial placement is a safe and technically feasible technique for preparing patients with both pancreatic and hepatic malignancies for SBRT. The fiducial markers facilitate safe and accurate targeting of the tumor during SBRT.
Authors: Nishita Kothary; Sonja Dieterich; John D Louie; Daniel T Chang; Lawrence V Hofmann; Daniel Y Sze Journal: AJR Am J Roentgenol Date: 2009-04 Impact factor: 3.959
Authors: Walter G Park; Brian M Yan; Devin Schellenberg; Jeff Kim; Daniel T Chang; Albert Koong; Cheryl Patalano; Jacques Van Dam Journal: Gastrointest Endosc Date: 2010-03 Impact factor: 9.427
Authors: Mouen A Khashab; Katherine J Kim; Erik J Tryggestad; Aaron T Wild; Teboh Roland; Vikesh K Singh; Anne Marie Lennon; Eun Ji Shin; Mark A Ziegler; Reem Z Sharaiha; Marcia Irene Canto; Joseph M Herman Journal: Gastrointest Endosc Date: 2012-11 Impact factor: 9.427
Authors: Indu Srinivasan; Shou-Jiang Tang; Andreas S Vilmann; John Menachery; Peter Vilmann Journal: World J Gastroenterol Date: 2015-11-28 Impact factor: 5.742
Authors: Shalini Moningi; Amanda J Walker; Ashkan A Malayeri; Lauren M Rosati; Susan L Gearhart; Jonathan E Efron; Elizabeth C Wick; Nilofer S Azad; Elwood P Armour; Yi Le; Joseph M Herman; Eun Ji Shin Journal: Gastrointest Endosc Date: 2015-03 Impact factor: 9.427