title: CT-guided fiducial placement for cyberknife stereotactic radiosurgery: an initial experience.
abstract: CyberKnife frameless image-guided radiosurgery has become a widely used system for parenchymal extracranial lesions. Gold fiducials are required for the planning and aiming of CyberKnife therapy. We report our initial experience and describe the technique of positioning tumor markers, under CT guidance. We conducted a retrospective review of 105 patients who were referred for CyberKnife stereotactic radiosurgery at Iatropolis CyberKnife Center in Athens. All patients underwent percutaneous fiducial placement via CT guidance. At the desired location, the 18-G needle was advanced into or near the tumor. Data collected included number and locations of fiducials placed and complications experienced to date. One hundred five patients underwent fiducial placement under CT guidance and a total number of 319 gold seeds were implanted. We experienced one episode of pneumothorax that required drainage, one mild pneumothorax, and three episodes of perifocal pulmonary hemorrhage. In conclusion, fiducial implantation under CT guidance appears to be a safe and efficient procedure, as long as it is performed by an experienced interventional radiologist.
authors.affiliation: Sotiria General Hospital of Chest Diseases, Mesogeion Ave 152, 11527 Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Sotiropoulou
authors.forename: Iotarene
authors.initials: I
authors.lastname: Stathochristopoulou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Stathopoulos
authors.forename: Kosmas
authors.initials: K
authors.lastname: Verigos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Salvaras
authors.forename: Loukas
authors.initials: L
authors.lastname: Thanos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000601:surgery*; D015641:Radiography, Interventional; D016634:Radiosurgery / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome