Safety and Efficacy of Percutaneous Fiducial Marker Implantation for Image-guided Radiation Therapy; Initial experience in Ramathibodi Hospital
Abstract
Purpose: To evaluate the safety and technical success rate of percutaneous fiducial marker implantation in preparation for image-guided radiation therapy.
Materials and Methods: From January 2009 to September 2009, we retrospectively reviewed 21 percutaneous fiducial marker implantations by interventional radiologist in 20 patients. Of the 21 implantations, 3 were in the lung, 9 were in the prostate gland. 8 were in the liver and one was in the pancreas. Procedure-related major and minor complications were documented. Technical success was defined as implantation enabling adequate treatment planning and computed tomographic simulation.
Results: The major and minor complication rates were 4.8% and 19.1%, respectively. Pneumothorax after lung implantation was the most common complication. Pneumothoraces were seen in 2 of the 3 lung implantations (66.6%): a chest tube was required in one of three the lung transplantations. Of the 21 implantations, 17 were successful (80.9%): in 1 implantation at the lung the fiducial markers migrated. However, it not required additional procedures or more implantation.
Conclusions: Percutaneous implantation of fiducial marker at the liver, pancreas and prostate gland is a safe and effective procedure with risks that are similar to those of conventional percutaneous organ biopsy. However, lung implantation is high risk to the pneumothorax that may require chest tube.
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