title: Percutaneous placement of marking coils before stereotactic radiation therapy of malignant lung lesions.
abstract: OBJECTIVE
  To evaluate a technique for implantation of radiopaque markers in lung nodules as an aid in extracranial stereotactic radiation therapy.
  
  
  METHODS
  An implantation technique was developed for marking intrapulmonary lung lesions by introducing a vascular coil through a coaxial needle in or near the target tumor. The markers were placed percutaneously through 15- or 20-gauge coaxial needles in 41 lesions (25 patients) under computed tomographic fluoroscopic guidance. Two different types of vascular helical coils where used.
  
  
  RESULTS
  All lesions were accessible for puncture and coils could be placed in all lesions. Four types of complications were observed, some as a result of the learning curve in the technique: (i) coil misplacement subcutaneously (5%); (ii) small needle trajectory bleeding in the lung (10%); (iii) pneumothorax, for which one patient (10%) in whom the coil was placed through a 15-gauge coaxial needle needed chest tube drainage and required hospitalization; and (iv) one subcutaneous metastasis probably unrelated to the puncture (2.5%).
  
  
  CONCLUSIONS
  With this technique, lung nodules can be marked with radiopaque implants in a safe and accurate way.
authors.affiliation: Department of Radiology, University Hospital Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. johan.demey@az.vub.ac.be
authors.forename: Johan
authors.initials: J
authors.lastname: de Mey
authors.forename: Jan
authors.initials: J
authors.lastname: Van de Steene
authors.forename: Frederik
authors.initials: F
authors.lastname: Vandenbroucke
authors.forename: Dirk
authors.initials: D
authors.lastname: Verellen
authors.forename: Laurence
authors.initials: L
authors.lastname: Trappeniers
authors.forename: Marc
authors.initials: M
authors.lastname: Meysman
authors.forename: Hendrik
authors.initials: H
authors.lastname: Everaert
authors.forename: Marc
authors.initials: M
authors.lastname: Noppen
authors.forename: Guy
authors.initials: G
authors.lastname: Storme
authors.forename: Axel
authors.initials: A
authors.lastname: Bossuyt
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D011880:Radiotherapy Planning, Computer-Assisted; D014057:Tomography, X-Ray Computed