Limits...
Technical advances in endoscopic ultrasound-guided fiducial placement for the treatment of pancreatic cancer.

Chavalitdhamrong D, DiMaio CJ, Siersema PD, Wagh MS - Endosc Int Open (2015)

Bottom Line: Because of the challenge of delivering an accurate and optimal radiation dose, image-guided radiation therapy can be used to improve targeting.Fiducial markers can be placed in the tumor and used for localization in patients undergoing image-guided radiation therapy.We herein review the technique, efficacy, and safety profile of EUS-guided fiducial placement.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, University of Florida, Gainesville, Florida, United States.

ABSTRACT
Radiation therapy has an important role in the treatment of locally advanced or metastatic pancreatic cancer and can be used alone or in conjunction with surgery and/or systemic chemotherapy. Because of the challenge of delivering an accurate and optimal radiation dose, image-guided radiation therapy can be used to improve targeting. Fiducial markers can be placed in the tumor and used for localization in patients undergoing image-guided radiation therapy. The safety and feasibility of endoscopic ultrasound (EUS)-guided placement of fiducials has been assessed and reported for the management of pancreatic cancer. We herein review the technique, efficacy, and safety profile of EUS-guided fiducial placement. In addition, we highlight recent advances and technological upgrades in EUS-guided fiducial delivery systems for pancreatic cancer most relevant to practicing gastroenterologists and interventional endoscopists.

No MeSH data available.


Related in: MedlinePlus

 Endosonographic image of needle with fiducial.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4554510&req=5

FI197-5:  Endosonographic image of needle with fiducial.

Mentions: The primary drawback of EUS-guided fiducial placement is the lack of dedicated accessories designed specifically for fiducial placement. Multi-fiducial delivery systems are therefore a welcome upgrade in this field. More flexible fiducial delivery systems that are unlikely to bend or kink during deployment with the echoendoscope in the long position, or in an angulated and torqued configuration, are desirable to allow fiducial placement in the pancreatic head and uncinate. Enhanced visualization of the needle and fiducial during EUS is necessary to allow fiducial placement solely under endosonographic guidance without the use of fluoroscopy, thus minimizing radiation exposure (Fig. 5). Increasing the awareness of this application of EUS among oncologists, radiation oncologists, surgeons, gastroenterologists, and interventional endoscopists is vital as this technology can become an essential part of the multidisciplinary approach to pancreatic cancer treatment.


Technical advances in endoscopic ultrasound-guided fiducial placement for the treatment of pancreatic cancer.

Chavalitdhamrong D, DiMaio CJ, Siersema PD, Wagh MS - Endosc Int Open (2015)

 Endosonographic image of needle with fiducial.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554510&req=5

FI197-5:  Endosonographic image of needle with fiducial.
Mentions: The primary drawback of EUS-guided fiducial placement is the lack of dedicated accessories designed specifically for fiducial placement. Multi-fiducial delivery systems are therefore a welcome upgrade in this field. More flexible fiducial delivery systems that are unlikely to bend or kink during deployment with the echoendoscope in the long position, or in an angulated and torqued configuration, are desirable to allow fiducial placement in the pancreatic head and uncinate. Enhanced visualization of the needle and fiducial during EUS is necessary to allow fiducial placement solely under endosonographic guidance without the use of fluoroscopy, thus minimizing radiation exposure (Fig. 5). Increasing the awareness of this application of EUS among oncologists, radiation oncologists, surgeons, gastroenterologists, and interventional endoscopists is vital as this technology can become an essential part of the multidisciplinary approach to pancreatic cancer treatment.

Bottom Line: Because of the challenge of delivering an accurate and optimal radiation dose, image-guided radiation therapy can be used to improve targeting.Fiducial markers can be placed in the tumor and used for localization in patients undergoing image-guided radiation therapy.We herein review the technique, efficacy, and safety profile of EUS-guided fiducial placement.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, University of Florida, Gainesville, Florida, United States.

ABSTRACT
Radiation therapy has an important role in the treatment of locally advanced or metastatic pancreatic cancer and can be used alone or in conjunction with surgery and/or systemic chemotherapy. Because of the challenge of delivering an accurate and optimal radiation dose, image-guided radiation therapy can be used to improve targeting. Fiducial markers can be placed in the tumor and used for localization in patients undergoing image-guided radiation therapy. The safety and feasibility of endoscopic ultrasound (EUS)-guided placement of fiducials has been assessed and reported for the management of pancreatic cancer. We herein review the technique, efficacy, and safety profile of EUS-guided fiducial placement. In addition, we highlight recent advances and technological upgrades in EUS-guided fiducial delivery systems for pancreatic cancer most relevant to practicing gastroenterologists and interventional endoscopists.

No MeSH data available.


Related in: MedlinePlus