Olga Rachel Brook MD, Presenter: Nothing to Disclose

Mishal Mendiratta-Lala MD, Abstract Co-Author: Nothing to Disclose

Sofia Gourtsoyianni MD, Abstract Co-Author: Nothing to Disclose

Robert G. Sheiman MD, Abstract Co-Author: Nothing to Disclose

Bettina Siewert MD, Abstract Co-Author: Nothing to Disclose

To evaluate complications associated with percutaneous CT and ultrasound guided fiducial seed placement in deep tissues of abdomen and pelvis for Stereotactic Radiotherapy.

This is a retrospective study of all consecutive patients that underwent CT or US guided placement of fiducial seeds in abdomen or pelvis in our institution from 10/2005 to 04/2010. The study was approved by the hospital IRB with a waiver of informed consent. Complications were assessed through review of patient's radiology reports and medical records and graded accordingly to the Society of Interventional Radiology guidelines.

216 patients underwent percutaneous placement of fiducial seeds in liver (n=101), kidney (n=38), pancreas (n=14), retroperitoneum (n=11), adrenal (n=9), and others lesions (n=43). All procedures were performed by a trainee (resident or fellow) under guidance and supervision of experienced attending radiologists. Seeds were placed with aid of CT in 175 cases (81%), ultrasound in 36 cases (16.7%) and both in 5 cases (2.3%). Prior to fiducial seed placement biopsy of the lesion was performed in 61 cases (28.2%). On average 3.3 seeds were placed (range 1-9, median 3). In the most cases (89%) a single lesion was targeted. 216 (95.8%) cases were devoid of procedural complications. 6 of 216 patients had major complications (2.8%) which required hospital admission: pneumothorax with chest tube drainage (n=2), bleeding (n=3) and a case of sepsis. 3 minor complications (1.4%) consisted of small hematoma, that did not require intervention or admission. The procedure was successful in 215 cases (99.5%). Seed migration occurred in 8 cases (3.7%), necessitating repeat of the procedure in one case only (0.5%).

Percutaneous fiducial seed placement for Stereotactic Radiotherapy in abdomen and pelvis is a highly successful and safe procedure with a small rate of complications.

Fiducial placement for Stereotactic Radiotherapy is successful and safe procedure with small rate of major complications, which appears less than reported rate of percutaneous biopsies complications.

Brook, O, Mendiratta-Lala, M, Gourtsoyianni, S, Sheiman, R, Siewert, B, Complications Associated with Percutaneous Fiducial Seed Placement in Abdomen and Pelvis for Stereotactic Radiotherapy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012598.html