Histopathologic consideration of fiducial gold markers inserted for real-time tumor-tracking radiotherapy against lung cancer.
OBJECTIVE
Internal fiducial gold markers, safely inserted with bronchoscopy, have been used in real-time tumor-tracking radiotherapy for lung cancer. We investigated the histopathologic findings at several points after the insertion of the gold markers.


METHODS
Sixteen gold markers were inserted for preoperative marking in 7 patients who subsequently underwent partial resection of tumors by video-assisted thoracoscopic surgery within 7 days.


RESULTS
Fibrotic changes and hyperplasia of type 2 pneumocytes around the markers were seen 5 or 7 days after insertion, and fibrin exudation without fibrosis was detected 1 or 2 days after insertion.


CONCLUSIONS
Because fibroblastic changes start approximately 5 days after gold marker insertion, real-time tumor-tracking radiotherapy should be started >5 days after gold marker insertion.
Imura
Mikado
M
First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Yamazaki
Koichi
K
Kubota
Kanako C
KC
Itoh
Tomoo
T
Onimaru
Rikiya
R
Cho
Yasushi
Y
Hida
Yasuhiro
Y
Kaga
Kichizo
K
Onodera
Yuya
Y
Ogura
Shigeaki
S
Dosaka-Akita
Hirotoshi
H
Shirato
Hiroki
H
Nishimura
Masaharu
M
D000328:Adult; D000368:Aged; D005260:Female; D005355:Fibrosis; D005548:Foreign-Body Migration / Q000473:pathology; D005549:Foreign-Body Reaction / Q000473:pathology*; D006046:Gold; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011878:Radiotherapy / Q000379:methods; D020775:Thoracic Surgery, Video-Assisted; D013997:Time Factors
D006046:Gold