title: Percutaneous fiducial marker placement under CT fluoroscopic guidance for stereotactic body radiotherapy of the lung: an initial experience.
abstract: The aim of this study is to describe our initial experience with the VISICOIL, which is the first percutaneous fiducial marker approved for stereotactic body radiotherapy in Japan, and to evaluate its technical and clinical efficacy, and safety. Eight patients underwent this procedure under CT fluoroscopic guidance. One patient had two tumors, so the total number of procedures was nine. We evaluated the technical and clinical success rates of the procedure and the frequencies of complications. Technical success was defined as when the fiducial marker could be placed at the target site, and clinical success was defined as when stereotactic body radiotherapy could be performed without the marker dropping out of position. The technical success rate was 78% (7/9). In one of the two failed cases, we aimed to place the marker inside the tumor, but misplaced it beside the tumor. In the other failed case, we successfully placed the marker beside the tumor as planned; however, the marker migrated to near the pleura after the patient stopped holding their breath. None of the markers dropped out of place, so the clinical success rate was 100% (9/9). The complication rates were as follows: pneumothorax: 56% (5/9), pneumothorax necessitating chest tube placement: 44% (4/9), focal intrapulmonary hemorrhaging: 67% (6/9), hemoptysis: 11% (1/9), mild hemothorax 11% (1/9), air embolism 0% (0/9), and death 0% (0/9). In conclusion, this new percutaneous fiducial marker appears to be useful for stereotactic body radiotherapy due to its good stability.
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Ohta
authors.forename: Masashi
authors.initials: M
authors.lastname: Shimohira
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Iwata
authors.forename: Takuya
authors.initials: T
authors.lastname: Hashizume
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ogino
authors.forename: Akifumi
authors.initials: A
authors.lastname: Miyakawa
authors.forename: Taro
authors.initials: T
authors.lastname: Murai
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D057918:Fiducial Markers; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011856:Radiographic Image Enhancement / Q000295:instrumentation* / Q000379:methods; D016634:Radiosurgery / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome
keywords: CT fluoroscopic guidance; SBRT; percutaneous; fiducial marker