title: The effect of metallic tracheal stents on radiation dose in the airway and surrounding tissues.
abstract: BACKGROUND
  Metallic airway stents are often used in the management of central airway malignancies. The presence of a metallic foreign body may affect radiation dose in tissue. We studied the effect of a metallic airway stent on radiation dose delivery in a phantom and an in vivo porcine model.
  
  
  METHODS
  A metallic tracheal stent was fitted onto a support in a water phantom. Point dosimeters were positioned in the phantom around the support and the stent. Irradiation was then performed on a linear accelerator with and without the stent. Metallic tracheal stents were deployed in the trachea of three pigs. Dosimeters were implanted in the tissues near (Group 1) and away (Group 2) from the stent. The pigs were then irradiated, and the dose perturbation factor was calculated by comparing the actual dose detected by the dosimeters versus the planned dose.
  
  
  RESULTS
  The difference in the dose detected by the dosimeters and the planned dose ranged from 1.8% to 6.1% for the phantom with the stent and 0%-5.3% for the phantom without the stent. These values were largely within the manufacturer's specified error of 5%. No significant difference was observed in the dose perturbation factor for Group 1 and Group 2 dosimeters (0.836 ± 0.058 versus 0.877 ± 0.088, P = 0.220) in all the three pigs.
  
  
  CONCLUSIONS
  Metallic airway stents do not significantly affect radiation dose in the airway and surrounding tissues in a phantom and porcine model. Radiation treatment planning systems can account for the presence of the stent. External beam radiation can be delivered without concern for significant dose perturbation.
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Radiation Oncology, Albert Einstein College of Medicine, New York, New York; Division of Radiation Oncology, Continuum Cancers Center of New York, New York, New York.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Evans
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Thoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York; Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, New York.
authors.forename: David Y
authors.initials: DY
authors.lastname: Lee
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Radiation Oncology, Albert Einstein College of Medicine, New York, New York; Division of Radiation Oncology, Continuum Cancers Center of New York, New York, New York.
authors.forename: Anudh K
authors.initials: AK
authors.lastname: Jain
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Thoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York; Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, New York.
authors.forename: Syed S
authors.initials: SS
authors.lastname: Razi
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Thoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York; Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, New York.
authors.forename: Koji
authors.initials: K
authors.lastname: Park
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Thoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York; Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, New York.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Schwartz
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Radiation Oncology, Albert Einstein College of Medicine, New York, New York; Division of Radiation Oncology, Continuum Cancers Center of New York, New York, New York.
authors.forename: Frieda
authors.initials: F
authors.lastname: Trichter
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Radiation Oncology, Albert Einstein College of Medicine, New York, New York; Division of Radiation Oncology, Continuum Cancers Center of New York, New York, New York.
authors.forename: Jason
authors.initials: J
authors.lastname: Ostenson
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Thoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York; Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, New York. Electronic address: josasson@chpnet.org.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Sasson
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Department of Thoracic Surgery, Columbia University College of Physicians and Surgeons, New York, New York; Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, New York.
authors.forename: Faiz Y
authors.initials: FY
authors.lastname: Bhora
mesh_terms: D000497:Alloys; D000818:Animals; D004307:Dose-Response Relationship, Radiation; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D015607:Stents; D013552:Swine; D014134:Tracheal Neoplasms / Q000532:radiotherapy*
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Airway malignancy; Airway obstruction; Bronchial malignancy; Radiation; Stents