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Percutaneous Placement of Marking Coils before Stereotactic Radiation Therapy of Malignant Lung Lesions

2005; Elsevier BV; Volume: 16; Issue: 1 Linguagem: Inglês

10.1097/01.rvi.0000142599.48497.6b

1535-7732

Johan De Mey, Jan Van de Steene, Frederik Vandenbroucke, Dirk Verellen, Laurence Trappeniers, Marc Meysman, Hendrik Everaert, Marc Noppen, Guy Storme, Axel Bossuyt,

Medical Imaging Techniques and Applications

To evaluate a technique for implantation of radiopaque markers in lung nodules as an aid in extracranial stereotactic radiation therapy.An implantation technique was developed for marking intrapulmonary lung lesions by introducing a vascular coil through a coaxial needle in or near the target tumor. The markers were placed percutaneously through 15- or 20-gauge coaxial needles in 41 lesions (25 patients) under computed tomographic fluoroscopic guidance. Two different types of vascular helical coils where used.All lesions were accessible for puncture and coils could be placed in all lesions. Four types of complications were observed, some as a result of the learning curve in the technique: (i) coil misplacement subcutaneously (5%); (ii) small needle trajectory bleeding in the lung (10%); (iii) pneumothorax, for which one patient (10%) in whom the coil was placed through a 15-gauge coaxial needle needed chest tube drainage and required hospitalization; and (iv) one subcutaneous metastasis probably unrelated to the puncture (2.5%).With this technique, lung nodules can be marked with radiopaque implants in a safe and accurate way.