Intravascular Placement of Metallic Coils as Lung Tumor Markers for CyberKnife Stereotactic Radiation Therapy.
10.3348/kjr.2015.16.3.626
- Author:
Kutlay KARAMAN
1
;
A Murat DOKDOK
;
Oktay KARADENIZ
;
Cemile CEYLAN
;
Kayihan ENGIN
Author Information
1. Department of Radiology, Anadolu Medical Center, Kocaeli 41400, Turkey. kutlaykaraman@yahoo.com
- Publication Type:Original Article
- Keywords:
Fiducial marker;
Lung neoplasm;
CyberKnife
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Female;
*Fiducial Markers;
Humans;
Lung/surgery;
Lung Neoplasms/*surgery;
Male;
Middle Aged;
Platinum;
Pneumonectomy;
*Pulmonary Artery;
Radiosurgery/*methods;
Retrospective Studies
- From:Korean Journal of Radiology
2015;16(3):626-631
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To present our experience with placing endovascular coils in pulmonary arteries used as a fiducial marker for CyberKnife therapy and to describe the technical details and complications of the procedure. MATERIALS AND METHODS: Between June 2005 and September 2013, 163 patients with primary or secondary lung malignancies, referred for fiducial placement for stereotactic radiosurgery, were retrospectively reviewed. Fourteen patients (9 men, 5 women; mean age, 70 years) with a history of pneumonectomy (n = 3), lobectomy (n = 3) or with severe cardiopulmonary co-morbidity (n = 8) underwent coil (fiducial marker) placement. Pushable or detachable platinum micro coils (n = 49) 2-3 mm in size were inserted through coaxial microcatheters into a small distal pulmonary artery in the vicinity of the tumor under biplane angiography/fluoroscopy guidance. RESULTS: Forty nine coils with a median number of 3 coils per tumor were placed with a mean tumor-coil distance of 2.7 cm. Forty three (87.7%) of 49 coils were successfully used as fiducial markers. Two coils could not be used due to a larger tumor-coil distance (> 50 mm). Four coils were in an acceptable position but their non-coiling shape precluded tumor tracking for CyberKnife treatment. No major complications needing further medication other than nominal therapy, hospitalization more than one night or permanent adverse sequale were observed. CONCLUSION: Endovascular placement of coil as a fiducial marker is safe and feasible during CyberKnife therapy, and might be an option for the patients in which percutaneous transthoracic fiducial placement might be risky.
