Percutaneous placement of marking coils before stereotactic radiation therapy of malignant lung lesions.
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.
de Mey
Johan
J
Department of Radiology, University Hospital Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium. johan.demey@az.vub.ac.be
Van de Steene
Jan
J
Vandenbroucke
Frederik
F
Verellen
Dirk
D
Trappeniers
Laurence
L
Meysman
Marc
M
Everaert
Hendrik
H
Noppen
Marc
M
Storme
Guy
G
Bossuyt
Axel
A
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