Fiducial placement for stereotactic radiation by using EUS: feasibility when using a marker compatible with a standard 22-gauge needle
Fiducial placement for stereotactic radiation by using EUS: feasibility when using a marker compatible with a standard 22-gauge needle
复制标题
DOI：
10.1016/j.gie.2009.11.023
复制
发表时间：
2010-03-01
影响因子：
7.7
通讯作者：
Azar, Riad R.
中科院分区：
文献类型：
--
作者：
Ammar, Tarek;Cote, Gregory A.;Azar, Riad R.
背景资料：通过使用基准标记的立体定向放射允许更高的放射闭合，同时减少未涉及的相邻结构的暴露。EUS已被用于部署基准点，尽管传统上需要19号针。目的：报告一种新技术和在EUS引导下部署与22号针兼容的基准点的可行性。设计：单中心，病例系列。设置：三级护理转诊中心。患者：13名原发性或转移性癌症患者转诊进行立体定向放射治疗。干预措施：EUS引导放置一个单一的基准标记，这是兼容的22号EUS-FNA needle.Main Outcome Measurements：Technical success and complications.Results：在内镜数据库中确定了13例EUS引导放置基准标记的患者。靶向病变测量时间为27 +/- 13分钟（范围8-50）x 21 +/- 10分钟（范围6-42）。所有基准点均成功展开，9例采用经胃入路，4例采用经十二指肠入路。无EUS相关并发症。两个病人没有进行放射治疗的结果，间隔腹膜转移。然而，所有基准点在X线片上都是可见的。13名患者中有11名（85%）需要放置1个基准点，而2名患者（15%）需要放置2个基准点。局限性：不受控制的可行性研究，有限的样本量和follow-up.Conclusion：EUS引导放置的基准使用22号针在技术上是可行的，并可能允许更大的访问相比，19号针技术。（Gastrointest Endosc 2010;71：630-33.）
Background: Stereotactic radiation by using fiducial markers permits higher closes of radiation while reducing the exposure of uninvolved, adjacent structures. EUS has been used to deploy fiducials, although a 19-gauge needle has traditionally been required.Objective: To report a new technique and the feasibility of deploying a fiducial compatible with a 22-gauge needle under EUS guidance.Design: Single-center, case series.Setting: Tertiary care referral center.Patients: Thirteen patients with primary or metastatic cancer referred for stereotactic radiation.Interventions: EUS-guided placement of a single fiducial marker that is compatible with a 22-gauge EUS-FNA needle.Main Outcome Measurements: Technical success and complications.Results: Thirteen patients referred for EUS-guided placement of a fiducial marker were identified in the endoscopic database. Targeted lesions measured 27 +/- 13 min (range 8-50) x 21 +/- 10 min (range 6-42). All fiducials were successfully deployed, 9 using a transgastric and 4 using a transduodenal approach. There were no EUS-associated complications. Two patients did riot proceed to radiation therapy as a result of interval peritoneal metastasis. However, all fiducials were visible on the roentogram. Eleven of 13 patients (85%) required placement of 1 fiducial, whereas 2 patients (15%) required 2 fiducials. Limitations: Uncontrolled feasibility study with limited sample size and follow-up.Conclusion: EUS-guided placement of a fiducial using a 22-gauge needle is technically feasible and may permit greater access compared with the 19-gauge needle technique. (Gastrointest Endosc 2010;71:630-33.)