Korean Journal of Radiology

  • 제16권3호
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  • Pages.626-631
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  • 2015
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Intravascular Placement of Metallic Coils as Lung Tumor Markers for CyberKnife Stereotactic Radiation Therapy

  • Karaman, Kutlay (Department of Radiology, Anadolu Medical Center) ;
  • Dokdok, A. Murat (Department of Radiology, Anadolu Medical Center) ;
  • Karadeniz, Oktay (Department of Radiology, Anadolu Medical Center) ;
  • Ceylan, Cemile (Department of Radiation Oncology, Anadolu Medical Center) ;
  • Engin, Kayihan (Department of Radiation Oncology, Anadolu Medical Center)
  • 투고 : 2014.01.08
  • 심사 : 2015.02.04
  • 발행 : 2015.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: To present our experience with placing endovascular coils in pulmonary arteries used as a fiducial marker for CyberKnife therapy and to describe the technical details and complications of the procedure. Materials and Methods: Between June 2005 and September 2013, 163 patients with primary or secondary lung malignancies, referred for fiducial placement for stereotactic radiosurgery, were retrospectively reviewed. Fourteen patients (9 men, 5 women; mean age, 70 years) with a history of pneumonectomy (n = 3), lobectomy (n = 3) or with severe cardiopulmonary co-morbidity (n = 8) underwent coil (fiducial marker) placement. Pushable or detachable platinum micro coils (n = 49) 2-3 mm in size were inserted through coaxial microcatheters into a small distal pulmonary artery in the vicinity of the tumor under biplane angiography/fluoroscopy guidance. Results: Forty nine coils with a median number of 3 coils per tumor were placed with a mean tumor-coil distance of 2.7 cm. Forty three (87.7%) of 49 coils were successfully used as fiducial markers. Two coils could not be used due to a larger tumor-coil distance (> 50 mm). Four coils were in an acceptable position but their non-coiling shape precluded tumor tracking for CyberKnife treatment. No major complications needing further medication other than nominal therapy, hospitalization more than one night or permanent adverse sequale were observed. Conclusion: Endovascular placement of coil as a fiducial marker is safe and feasible during CyberKnife therapy, and might be an option for the patients in which percutaneous transthoracic fiducial placement might be risky.

키워드

참고문헌

  1. Adler JR Jr, Chang SD, Murphy MJ, Doty J, Geis P, Hancock SL. The Cyberknife: a frameless robotic system for radiosurgery. Stereotact Funct Neurosurg 1997;69(1-4 Pt 2):124-128 https://doi.org/10.1159/000099863
  2. Chang SD, Murphy M, Geis P, Martin DP, Hancock SL, Doty JR, et al. Clinical experience with image-guided robotic radiosurgery (the Cyberknife) in the treatment of brain and spinal cord tumors. Neurol Med Chir (Tokyo) 1998;38:780-783 https://doi.org/10.2176/nmc.38.780
  3. Uematsu M, Shioda A, Tahara K, Fukui T, Yamamoto F, Tsumatori G, et al. Focal, high dose, and fractionated modified stereotactic radiation therapy for lung carcinoma patients: a preliminary experience. Cancer 1998;82:1062-1070 https://doi.org/10.1002/(SICI)1097-0142(19980315)82:6<1062::AID-CNCR8>3.0.CO;2-G
  4. Whyte RI, Crownover R, Murphy MJ, Martin DP, Rice TW, DeCamp MM Jr, et al. Stereotactic radiosurgery for lung tumors: preliminary report of a phase I trial. Ann Thorac Surg 2003;75:1097-1101 https://doi.org/10.1016/S0003-4975(02)04681-7
  5. Wulf J, Haedinger U, Oppitz U, Thiele W, Mueller G, Flentje M. Stereotactic radiotherapy for primary lung cancer and pulmonary metastases: a noninvasive treatment approach in medically inoperable patients. Int J Radiat Oncol Biol Phys 2004;60:186-196 https://doi.org/10.1016/j.ijrobp.2004.02.060
  6. Timmerman RD, Kavanagh BD, Cho LC, Papiez L, Xing L. Stereotactic body radiation therapy in multiple organ sites. J Clin Oncol 2007;25:947-952 https://doi.org/10.1200/JCO.2006.09.7469
  7. Prevost JB, Nuyttens JJ, Hoogeman MS, Poll JJ, van Dijk LC, Pattynama PM. Endovascular coils as lung tumour markers in real-time tumour tracking stereotactic radiotherapy: preliminary results. Eur Radiol 2008;18:1569-1576 https://doi.org/10.1007/s00330-008-0933-x
  8. Bhagat N, Fidelman N, Durack JC, Collins J, Gordon RL, LaBerge JM, et al. Complications associated with the percutaneous insertion of fiducial markers in the thorax. Cardiovasc Intervent Radiol 2010;33:1186-1191 https://doi.org/10.1007/s00270-010-9949-0
  9. Ginsberg RJ, Rubinstein LV. Randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Lung Cancer Study Group. Ann Thorac Surg 1995;60:615-622; discussion 622-623 https://doi.org/10.1016/0003-4975(95)00537-U
  10. Imura M, Yamazaki K, Shirato H, Onimaru R, Fujino M, Shimizu S, et al. Insertion and fixation of fiducial markers for setup and tracking of lung tumors in radiotherapy. Int J Radiat Oncol Biol Phys 2005;63:1442-1447 https://doi.org/10.1016/j.ijrobp.2005.04.024
  11. Shirato H, Harada T, Harabayashi T, Hida K, Endo H, Kitamura K, et al. Feasibility of insertion/implantation of 2.0-mm-diameter gold internal fiducial markers for precise setup and real-time tumor tracking in radiotherapy. Int J Radiat Oncol Biol Phys 2003;56:240-247 https://doi.org/10.1016/S0360-3016(03)00076-2
  12. Schroeder C, Hejal R, Linden PA. Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery. J Thorac Cardiovasc Surg 2010;140:1137-1142 https://doi.org/10.1016/j.jtcvs.2010.07.085
  13. Hong JC, Yu Y, Rao AK, Dieterich S, Maxim PG, Le QT, et al. High retention and safety of percutaneously implanted endovascular embolization coils as fiducial markers for image-guided stereotactic ablative radiotherapy of pulmonary tumors. Int J Radiat Oncol Biol Phys 2011;81:85-90 https://doi.org/10.1016/j.ijrobp.2010.04.037
  14. Mager JJ, Overtoom TT, Blauw H, Lammers JW, Westermann CJ. Embolotherapy of pulmonary arteriovenous malformations: long-term results in 112 patients. J Vasc Interv Radiol 2004;15:451-456 https://doi.org/10.1097/01.RVI.0000126811.05229.B6
  15. Pump KK. Distribution of bronchial arteries in the human lung. Chest 1972;62:447-451 https://doi.org/10.1378/chest.62.4.447

피인용 문헌

  1. The Role of Interventional Oncology in the Management of Lung Cancer vol.40, pp.2, 2015, https://doi.org/10.1007/s00270-016-1495-y
  2. Peripheral tumour targeting using open-source virtual bronchoscopy with electromagnetic tracking: a multi-user pre-clinical study vol.28, pp.6, 2019, https://doi.org/10.1080/13645706.2018.1544911
  3. Real-time liver tracking algorithm based on LSTM and SVR networks for use in surface-guided radiation therapy vol.16, pp.1, 2015, https://doi.org/10.1186/s13014-020-01729-7