Performance of a new preloaded fiducial needle to guide radiation therapy of upper gastrointestinal cancers

“…On this account, various types of destructive energy sources, radio-opaque markers (fiducials), anti-tumor agents and radioactive particles (seeds) can be administered [ 75 ]. ‘Fiducials’ are markers that can be placed using an ultrasound-guided procedure or around the tumor tissue and help to better administer radiotherapy in a more targeted manner [ 76 , 77 ]. Where patients are unfit for surgery, liver lesions can be treated via percutaneous tumor ablation using radio frequency waves or ethanol.…”

Section: The Most Important Diagnostic and Therapeutic Interventional...mentioning

confidence: 99%

Diagnostic and Therapeutic Indications for Endoscopic Ultrasound (EUS) in Patients with Pancreatic and Biliary Disease—Novel Interventional Procedures

Prager

Sebesta

2022

Current Oncology

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There is growing evidence supporting the substantial, essential and indispensable role of endoscopic ultrasound (EUS) as a key diagnostic armamentarium for upper GI oncologic surgery. Well described in countless publications, EUS holds that position in gastroenterological expert centers all over Europe. Despite its undisputable contributions to oncologic upper GI surgery, the availability of this technique at the expert level shows up in an irregular spread pattern. Endoscopic ultrasound’s primary use during the first few years after its creation was the detection of pancreatic cancer. From then on, EUS developed in different directions, becoming a diagnostic tool that increasingly better defines its status as a method of minimally invasive therapeutic applications and a useful addition to surgical options. As a result, several surgical interventions could even be replaced by ultrasound-targeted interventions. This process took place in just a few years and was made possible by technical development that sensibly combined high-resolution ultrasound with therapeutic endoscopy. The present article will serve to cover the most prevalent uses with supporting data considering the growing list of suggested indications for EUS while also examining cutting-edge initiatives that might soon become the standard of clinical practice. Endoscopic centers with high expertise are needed to train future experts in the growing field of EUS interventions.

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“…[95] Fiducial placement using EUS has a high success rate and helps to plan stereotactic radiotherapy. [9697]…”

Section: Ablative Techniquesmentioning

confidence: 99%

Therapeutic EUS: New tools, new devices, new applications

2019

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Linear echoendoscopes with large instrument channels enable EUS-guided interventions in organs and anatomical spaces in proximity to the gastrointestinal tract. Novel devices and tools designed for EUS-guided transluminal interventions allow various new applications and improve the efficacy and safety of these procedures. New-generation biopsy needles provide higher histology rates and require less passes. Specially designed stents and stent insertion devices enable intra- and extra-hepatic bile and pancreatic duct stenting as well as gallbladder drainage. Currently, EUS-guided biliary drainage in obstructive jaundice due to malignant distal bile duct obstruction is feasible and safe when ERCP has failed. It might replace ERCP as first choice intervention in future. EUS-guided transmural stenting is regarded as the preferred intervention in the management of symptomatic peripancreatic fluid collections. Creating a new anastomosis between different organs such as gastrojejunostomy has also become possible with lumen-apposing stents. EUS-guided creation of a gastrogastrostomy is a promising novel technique to access the excluded stomach to facilitate conventional ERCP in patients with Roux-en-Y gastric bypass anatomy. The role of EUS in tumor ablation and targeted angiotherapy is also constantly expanding. In this review, we report on the newest developments of therapeutic EUS within the past 4 years.

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Performance of a new preloaded fiducial needle to guide radiation therapy of upper gastrointestinal cancers

Cited by 12 publications

References 13 publications

EUS-guided fiducial placement for intramural GI neoplasia: a facilitated technique

EUS-guided fiducial placement for intramural GI neoplasia: a facilitated technique

Diagnostic and Therapeutic Indications for Endoscopic Ultrasound (EUS) in Patients with Pancreatic and Biliary Disease—Novel Interventional Procedures

Therapeutic EUS: New tools, new devices, new applications

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