Endobronchial coil spring fiducial markers for CyberKnife® stereotactic body radiation therapy

Abstract

We assessed for the first time the safety and efficacy of bronchoscopically inserted cs‐FM for CyberKnife® SBRT delivery. We show that this technique is safe and resulted in a very high PPL tracking rate enabling optimal SBRT delivery. See Cover Image See related https://onlinelibrary.wiley.com/doi/full/10.1111/resp.14040

Risks and Benefits of Fiducial Marker Placement in Tumor Lesions for Robotic Radiosurgery: Technical Outcomes of 357 Implantations

“…Smaller case series have examined endobronchial and endovascular FM placement as alternatives to percutaneous FM placement [ 25 , 29 , 30 ]. Mongeon et al [ 25 ] compared endovascular FM placement with percutaneous placement and reported no complications associated with endovascular marker insertion.…”

“…However, endovascular marker placement is challenging and was recommended for patients ineligible for percutaneous FM implantation. Casutt et al [ 29 ] reported one complication (bronchospasm) among 55 EBUS-guided FM implantation procedures and concluded that the low rate of concurrent transbronchial biopsies may have contributed to the absence of pneumothorax. Majid et al [ 30 ] also inserted FM via EBUS and reported a complication rate of 5.4%.…”

“…Bhagat et al [ 23 ] reported a migration rate of 19.0%. Casutt et al [ 29 ] reported a migration rate of 8.0% for EBUS-guided implantations, concluding that the likelihood of migration increased when FM were implanted in a previously irradiated area. Previous irradiation was also a definite cause of FM migration in cervical cancers in our study.…”

Springs that don't spring out: Fiducials for stereotactic radiotherapy

“…In a recent publication in Respirology , Casutt et al . have utilized fluoroscopy with or without radial endobronchial ultrasound (R‐EBUS) to localize the peripheral pulmonary lesion 7 . With this technique, the tumour can be localized with R‐EBUS but then requires removal of the ultrasound probe in order to insert the fiducial marker.…”

“…They have utilized 0.018 in. fibred platinum coils that have been designed for endovascular embolization 7 . The coils have atraumatic tips and form a conical shape when deployed with the apex of the cone being deployed first.…”