Convex Probe EBUS-guided Fiducial Placement for Malignant Central Lung Lesions
| Autor: | Adnan Majid, Jorge Guerrero, Michael S. Kent, Richard I. Whyte, Fayez Kheir, Sebastian Fernandez-Bussy, Daniel Alape, Atul Palkar, Sidhu P. Gangadharan, Erik Folch, Joseph A. Aronovitz |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Lung Neoplasms Percutaneous Radiosurgery Endosonography 03 medical and health sciences 0302 clinical medicine Bronchoscopy Fiducial Markers Interquartile range Cyberknife Carcinoma Non-Small-Cell Lung Thoracic Oncology Carcinoma medicine Humans Neoplasm Metastasis Endoscopic Ultrasound-Guided Fine Needle Aspiration Lung Parenchymal Tissue Aged Retrospective Studies Ultrasonography Aged 80 and over medicine.diagnostic_test business.industry Mediastinum Retrospective cohort study Middle Aged medicine.disease 030228 respiratory system 030220 oncology & carcinogenesis Feasibility Studies Female Lymph Nodes Radiology Tomography X-Ray Computed Fiducial marker business |
| Zdroj: | Journal of Bronchology & Interventional Pulmonology. 25:283-289 |
| ISSN: | 1944-6586 |
| Popis: | Background Stereotactic body radiotherapy (SBRT) had become a therapeutic modality in patients with primary tumors, locally recurrent as well as oligometastasis involving the lung. Some modalities of SBRT require fiducial marker (FM) for dynamic tumor tracking. Previous studies have focused on evaluating bronchoscopic-guided FM placement for peripheral lung nodules. We describe the safety and feasibility of placing FM using real-time convex probe endobronchial ultrasound (CP-EBUS) for SBRT in patients with centrally located hilar/mediastinal masses or lymph nodes. Methods This is a retrospective review of patients who were referred to Beth Israel Deaconess Medical Center's multidisciplinary thoracic oncology program for FM placement to pursue SBRT. Results Thirty-seven patients who underwent real-time CP-EBUS were included. Patients had a median age of 71 years [interquartile range (IQR), 59.5 to 80.5]. The median size of the lesion was 2.2 cm (IQR, 1.4 to 3.3 cm). The median distance from the central airway was 2.4 cm (IQR, 0 to 3.4 cm). A total of 51 FMs (median of 1 per patient) were deployed in 37 patients. At the time of SBRT planning, 46 (90.2%) were confirmed radiologically in 32 patients. Patients with unsuccessful fiducial deployment (n=5) underwent a second procedure using the same technique. Of those, 3 patients had a successful fiducial placement via bronchoscopy, 1 patient required FM placement by percutaneous computed tomography-guided approach and 1 patient required FM placement through EUS by gastroenterology. Conclusion CP-EBUS-guided FM placement for patients with malignant lymph nodes and central parenchymal lung lesions appears to be safe and feasible. |
| Databáze: | OpenAIRE |
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