Jae Hyun Kim MD, Presenter: Nothing to Disclose

Seong Sook Hong MD, Abstract Co-Author: Nothing to Disclose

Jung Hoon Kim MD, Abstract Co-Author: Nothing to Disclose

A Ram Chang, Abstract Co-Author: Nothing to Disclose

Sung Tae Park MD, Abstract Co-Author: Nothing to Disclose

Yun-Woo Chang, Abstract Co-Author: Nothing to Disclose

To evaluate the safety and technical success rate of Ultrasound-guided fiducial marker implantation in preparation for Cyberknife radiation therapy.

From Jun. 2008 to Mar. 2010, we retrospectively reviewed 250, percutaneous ultrsound-guided fiducial marker implantations on 69 patients. Among the 250 implantations, 99 were implanted in liver, 86 were in metastatic lymph node, 31 were in prostate, and 34 were in pancreas. During and after the implantation, major and minor procedure-related complications were documented. We defined technical success as enabling adequate treatment planning and computed tomographic simulation by implantation.

The major and minor complication rates were 1.4% and 21.7%. Abdominal pain was the most common complication in 9 patients (13%). But, four patients had no requiring specific treatments during the follow-up period. Two patients presented mild fever (2.8%). One patient who had implantation in the liver suffered severe abdominal pain, biloma, and pleural effusion (1.4%). One patient had a mild transient bullae change at puncture skin site and another one patient had woozing at insertion site. Among 9 patients who were inserted in the prostate, one patient presented transient hematuria less than 24hrs lasting and the other one patient presented the transient voiding difficulty. Nelaton voiding was required only one time. Of the 250 implantations, 242 were successful (96.8%), migration of fiducial markers in 5 implantations (2.0%) and failure of discrimination of fiducial markers in 3 implantations (1.2%) were noted. Among them, 6 patients required additional procedures (8.7%).

Symptomatic complication following ultrasound guided-percutaneous implantation of fiducial marker was relatively low. But, careful consideration for relatively higher rate of migration and discrimination failure should be needed.

Ultrsound-guided fiducial marker implantation for cyberknife radiation therapy shows relatively low complication rate and it is a safe technique.

Kim, J, Hong, S, Kim, J, Chang, A, Park, S, Chang, Y, Safety and Efficacy of Ultrasound-guided Fiducial Marker Implantation for Cyberknife Radiation Therapy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9009212.html