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Comparison of fiducials implanted during image-guided radiation therapy in pancreatic cancer

A study in this month's issue of Gastrointestinal Endoscopy compares traditional with coiled fiducials implanted during EUS for pancreatic cancer patients receiving stereotactic body radiation therapy.

News image

EUS-guided fiducial placement facilitates image-guided radiation therapy (IGRT).

Dr Mouen Khashab and colleagues from Maryland, USA compared 2 types of commercially available fiducials for technical success, complications, visibility, and migration.

The team performed a retrospective, single-center, comparative study.

The researchers compared traditional fiducials, and Visicoil fiducials.

Fiducials were placed using linear 19-gauge or 22-gauge needles.

Mean migration was not significantly different between the 2 types of fiducials
Gastrointestinal Endoscopy

A subjective visualization scoring system was used to assess visibility on CT.

Fiducial migration was calculated as a change in interfiducial distance.

The team's main outcome measurements included technical success, complications, visibility, and migration of 2 types of fiducials.

The research team found that 39 patients with locally advanced pancreatic cancer underwent EUS-guided placement of 103 fiducials.

The mean number of fiducials placed per patient was 2.7 for the 19-gauge needle, and 2.6 for the 22-gauge needle.

The researchers encountered intra- or postprocedural complications.

The median visibility score for traditional fiducials was significantly better than that for Visicoil fiducials, both when scores of 0 were and were not included.

The team observed that mean migration was not significantly different between the 2 types of fiducials.

Dr Khashab's team concludes, "Visibility was significantly better for traditional fiducials compared with Visicoil fiducials."

"The degree of fiducial migration was not significantly different for traditional fiducials and Visicoil fiducials."

"There was no significant difference in the mean number of fiducials placed, indicating a similar degree of technical difficulty for traditional fiducial and Visicoil fiducial deployment."

Gastrointest Endoscopy 2012: 76(5): 962-971
21 November 2012

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