Fiducial Marker Placement Using Endobronchial Ultrasound and Navigational Bronchoscopy for Stereotactic Radiosurgery: An Alternative Strategy

Harley, Daniel P.; Krimsky, William; Sarkar, Saiyad; Highfield, David; Aygun, Cengiz; Gurses, Burak

doi:10.1016/j.athoracsur.2009.09.048

Cited by 90 publications

(68 citation statements)

References 17 publications

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“…Radiotracers such as 18 F-FDG will be used undoubtedly to identify and to define lung tumor targets being treated by stereotactic body radiation therapy. Future research directions in the investigator group question whether FDG-PET data contributes to target delineation under other treatment conditions, such as Vero SBRT dynamic tracking [16].…”

Section: Discussionmentioning

confidence: 99%

“…Markers were positioned either by a CT-guided interventional radiology approach [17] or an electromagnetic navigation bronchoscopy approach [18]. To provide intrafraction and interfraction motion tracking, at least one marker was implanted as close as safely possible to the SBRT target center.…”

Section: Vero Sbrt Planning Process and Treatmentmentioning

confidence: 99%

“…Because intracellular hexokinase traps 18 F-FDG as a sugar lookalike, PET has assisted in the spotting of and in the contouring of cancer targets for radiation treatment through image fusion, overlay, or side-by-side viewing [1][2][3][4]. As highly precise radiation delivery platforms become more mainstream, there has been a need for accurate anatomic and metabolic exactness of cancer targets [5].…”

Section: Introductionmentioning

confidence: 99%

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2-[18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Definition of Lung Targets in Vero Stereotactic Body Radiation Therapy Workflow

Kunos¹,

Shanahan²

2015

J Nucl Med Radiat Ther

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This retrospective study explored 2-[ 18 F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) as an aid in target delineation among a first-group of five patients with single or multiple moving lung tumors planned for Vero stereotactic body radiation therapy (SBRT). Computed tomography (CT)-based free-breathing, end-inspiration, and end-expiration lung target volumes generated a single internal target volume (ITV).ITVs were compared to a thresholded 40% maximum standard uptake value FDG-PET target volume (CTVpet), a contour assumed to be a surrogate for lung target motion during quiet breathing. Planning target volumes (PTV) and relevant lung planning constraints determined clinical execution of Vero SBRT. A mean 28% PTV expansion by adding in a CTVpet contour to the CT-based ITV converted two (40%) of five cases from SBRT fractionation (40 Gy in four every other day fractions) to conventional fractionation (30 Gy in ten daily fractions).In all five cases, CTVpet contours captured target motion not enclosed by the CT-based ITV. Vero SBRT radiation plans achieved effective normal tissue sparing without compromise of PTV target coverage. A single instance of less than 30-day posttherapy grade 2 fatigue occurred; no pulmonary toxicity has been observed in the 3-month follow-up period. Thresholded CTVpet contours impacted target delineation and clinical delivery of Vero SBRT treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Vero Sbrt Planning Process and Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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2-[18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Definition of Lung Targets in Vero Stereotactic Body Radiation Therapy Workflow

Kunos¹,

Shanahan²

2015

J Nucl Med Radiat Ther

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“…[ 2,6,8 ] When the tumor position cannot be correlated with internal reference points such as the skeleton, tumor localization can be enhanced by alignment to radiographic markers implanted in or near the tumor. [9][10][11] Such markers can improve treatment through optimized planning, tumor positioning accuracy, and tumor tracking resulting in more precise dose delivery and enable treatment of cancers, which are presently not eligible for radiotherapy. [ 12,13 ] Tissue markers currently used in the clinic are metal-based solid implants with large physical dimensions, which require complicated insertion procedures and therefore the risk of complications.…”

Section: Introductionmentioning

confidence: 99%

Injectable Colloidal Gold for Use in Intrafractional 2D Image‐Guided Radiation Therapy

Jølck

Rydhög

Christensen

et al. 2015

Adv Healthcare Materials

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In the western world, approximately 50% of all cancer patients receive radiotherapy alone or in combination with surgery or chemotherapy. Image-guided radiotherapy (IGRT) has in recent years been introduced to enhance precision of the delivery of radiation dose to tumor tissue. Fiducial markers are often inserted inside the tumor to improve IGRT precision and to enable monitoring of the tumor position during radiation therapy. In the present article, a liquid fi ducial tissue marker is presented, which can be injected into tumor tissue using thin and fl exible needles. The liquid fi ducial has high radioopacity, which allows for marker-based image guidance in 2D and 3D X-ray imaging during radiation therapy. This is achieved by surface-engineering gold nanoparticles to be highly compatible with a carbohydrate-based gelation matrix. The new fi ducial marker is investigated in mice where they are highly biocompatible and stable after implantation. To investigate the clinical potential, a study is conducted in a canine cancer patient with spontaneous developed solid tumor in which the marker is successfully injected and used to align and image-guide radiation treatment of the canine patient. It is concluded that the new fi ducial marker has highly interesting properties that warrant investigations in cancer patients.

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“…It is reasonably accurate and less likely to cause pneumothoraces than CTFNAs. NB also allows for the placement of fiducial markers for Stereotactic Radiosurgery in patients with lung cancer who are otherwise not candidates for lung resection (6).…”

mentioning

confidence: 99%

Management of the pulmonary nodule—shifting paradigms and an opportunity for change

Krimsky

Harley

2016

J. Thorac. Dis.

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Fiducial Marker Placement Using Endobronchial Ultrasound and Navigational Bronchoscopy for Stereotactic Radiosurgery: An Alternative Strategy

Cited by 90 publications

References 17 publications

2-[18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Definition of Lung Targets in Vero Stereotactic Body Radiation Therapy Workflow

2-[18F]Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography Definition of Lung Targets in Vero Stereotactic Body Radiation Therapy Workflow

Injectable Colloidal Gold for Use in Intrafractional 2D Image‐Guided Radiation Therapy

Management of the pulmonary nodule—shifting paradigms and an opportunity for change

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