Electromagnetic navigational bronchoscopy-guided fiducial markers for lung stereotactic body radiation therapy: Analysis of safety, feasibility, and interfraction stability

Nima Nabavizadeh, Junan Zhang, David A. Elliott, James Tanyi, Charles Thomas, Martin Fuss, Mark Deffebach

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Embolization coils as fiducial markers for pulmonary stereotactic body radiation therapy (SBRT) are perceived to be the optimal marker type, given their ability to conform and anchor within the small airways. The aim of our study was to assess retention, placement, migration, feasibility, and safety of electromagnetic navigational bronchoscopy (ENB)-guided embolization coil markers throughout courses of SBRT. Methods: Thirty-one patients with 34 nodules underwent ENB-guided fiducial placement of several 4mm fibered platinum embolization coils before SBRT. Patient and nodule positioning was confirmed with daily pretreatment cone-beam computed tomography (CBCT). Fiducial positional characteristics were analyzed utilizing radiation treatment-planning software comparing the simulation CT with daily CBCTs. Results: Of 105 fiducials placed, 103 were identifiable on simulation CT (retention rate: 98.1%). Incidence of asymptomatic pneumothoraces was 6%. One patient experienced hemoptysis requiring hospitalization. Eighty-six percent of fiducials were placed within 1 cm of the nodule, with 52% of fiducials placed directly on the nodule surface. Throughout a 5-fraction SBRT course, fiducial displacement was

Original languageEnglish (US)
Pages (from-to)123-130
Number of pages8
JournalJournal of Bronchology and Interventional Pulmonology
Volume21
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Fiducial Markers
Electromagnetic Phenomena
Bronchoscopy
Radiotherapy
Safety
Lung
Patient Positioning
Cone-Beam Computed Tomography
Hemoptysis
Pneumothorax
Platinum
Hospitalization
Software
Radiation
Incidence

Keywords

  • Fiducials
  • Lung SBRT
  • Navigational bronchoscopy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

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title = "Electromagnetic navigational bronchoscopy-guided fiducial markers for lung stereotactic body radiation therapy: Analysis of safety, feasibility, and interfraction stability",
abstract = "Background: Embolization coils as fiducial markers for pulmonary stereotactic body radiation therapy (SBRT) are perceived to be the optimal marker type, given their ability to conform and anchor within the small airways. The aim of our study was to assess retention, placement, migration, feasibility, and safety of electromagnetic navigational bronchoscopy (ENB)-guided embolization coil markers throughout courses of SBRT. Methods: Thirty-one patients with 34 nodules underwent ENB-guided fiducial placement of several 4mm fibered platinum embolization coils before SBRT. Patient and nodule positioning was confirmed with daily pretreatment cone-beam computed tomography (CBCT). Fiducial positional characteristics were analyzed utilizing radiation treatment-planning software comparing the simulation CT with daily CBCTs. Results: Of 105 fiducials placed, 103 were identifiable on simulation CT (retention rate: 98.1{\%}). Incidence of asymptomatic pneumothoraces was 6{\%}. One patient experienced hemoptysis requiring hospitalization. Eighty-six percent of fiducials were placed within 1 cm of the nodule, with 52{\%} of fiducials placed directly on the nodule surface. Throughout a 5-fraction SBRT course, fiducial displacement was",
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AU - Nabavizadeh, Nima

AU - Zhang, Junan

AU - Elliott, David A.

AU - Tanyi, James

AU - Thomas, Charles

AU - Fuss, Martin

AU - Deffebach, Mark

PY - 2014

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N2 - Background: Embolization coils as fiducial markers for pulmonary stereotactic body radiation therapy (SBRT) are perceived to be the optimal marker type, given their ability to conform and anchor within the small airways. The aim of our study was to assess retention, placement, migration, feasibility, and safety of electromagnetic navigational bronchoscopy (ENB)-guided embolization coil markers throughout courses of SBRT. Methods: Thirty-one patients with 34 nodules underwent ENB-guided fiducial placement of several 4mm fibered platinum embolization coils before SBRT. Patient and nodule positioning was confirmed with daily pretreatment cone-beam computed tomography (CBCT). Fiducial positional characteristics were analyzed utilizing radiation treatment-planning software comparing the simulation CT with daily CBCTs. Results: Of 105 fiducials placed, 103 were identifiable on simulation CT (retention rate: 98.1%). Incidence of asymptomatic pneumothoraces was 6%. One patient experienced hemoptysis requiring hospitalization. Eighty-six percent of fiducials were placed within 1 cm of the nodule, with 52% of fiducials placed directly on the nodule surface. Throughout a 5-fraction SBRT course, fiducial displacement was

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