Role and technique of endoscopic ultrasound placement of fiducial markers in gastrointestinal malignancies

Techniques in Gastrointestinal Endoscopy Pub Date : 2017-10-01 DOI:10.1016/j.tgie.2017.10.009

Antonio R. Cheesman MD, Christopher J. DiMaio MD

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引用次数: 4

Abstract

Stereotactic body radiation therapy may be used in the neoadjuvant, adjuvant, or palliative treatment of multiple cancers. Fiducials serve as radiographic reference points for real-time dynamic tracking and accurate radiation delivery. Endoscopic ultrasound with real-time Doppler imaging is a safe minimally invasive approach for fiducial implantation in lesions both within and adjacent to the gastrointestinal lumen. The decision to incorporate image-guided radiotherapy and specifics regarding fiducials and their use in a patient’s treatment plan depends on the multidisciplinary collaboration between gastroenterologists, radiation oncologists, medical oncologists, and surgical oncologists. This article will review the indications, controversies in timing, and use of endoscopic ultrasound-guided fiducial placement, the various types of fiducial markers, delivery systems, and deployment techniques available. Also covered will be associated technical and clinical success rates, in addition to previously reported complications.

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内镜超声放置基准标记物在胃肠道恶性肿瘤中的作用和技术

立体定向全身放射治疗可用于多种癌症的新辅助、辅助或姑息性治疗。基准点作为实时动态跟踪和精确辐射传递的放射学参考点。超声内镜下实时多普勒成像是一种安全的微创方法，可用于胃肠道管腔内及邻近病变的基底植入。将影像引导放射治疗纳入患者治疗计划的决定和关于基准及其应用的细节取决于胃肠病学家、放射肿瘤学家、内科肿瘤学家和外科肿瘤学家之间的多学科合作。本文将回顾内窥镜超声引导下基准放置的适应症、时间争议和使用、各种类型的基准标记物、输送系统和可用的部署技术。除了先前报道的并发症外，还将涉及相关的技术和临床成功率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Gastrointestinal Endoscopy GASTROENTEROLOGY & HEPATOLOGY-

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期刊介绍： The purpose of each issue of Techniques in Gastrointestinal Endoscopy is to provide a comprehensive, current overview of a clinical condition or surgical procedure in gastrointestinal endoscopy, combining the effectiveness of an atlas with the timeliness of a journal. Each issue places a vigorous emphasis on diagnosis, rationale for and against a procedure, actual technique, management, and prevention of complications. The journal features abundant illustrations, line drawings and color artwork to guide readers through even the most complicated procedure.