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ORIGINAL ARTICLE
Year : 2015  |  Volume : 35  |  Issue : 3  |  Page : 92-96

Sonographic-guided percutaneous fiducial marker implantation of hepatic malignancies for Cyberknife radiation therapy: Evaluation of safety and technical efficacy


1 Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
2 Department of Radiation Oncology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
3 Department of Internal Medicine, Division of Rheumatology, Immunology and Allergy, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
4 Department of Internal Medicine, Division of Cardiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China

Correspondence Address:
Chang-Hsien Liu
Department of Radiology, Tri-Service General Hospital, No. 325, Sec. 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
Republic of China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1011-4564.158663

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Background: CyberKnife radiation therapy has a widely used system in the treatment of extracranial lesions. Implanting gold fiducial markers around a tumor is an important procedure for the planning and aiming of CyberKnife radiation therapy. Thus, the purpose of this study was to evaluate the feasibility, safety, and efficacy of percutaneous fiducial marker implantation of hepatic malignancies under sonographic guidance for CyberKnife radiation therapy. Materials and Methods: From April 2009 to November 2011, we retrospectively reviewed 30 percutaneous fiducial marker implantations in 30 patients with hepatic tumors. All patients underwent percutaneous fiducial marker implantation under sonographic guidance. The feasibility, safety, and efficacy of this technique were analyzed on immediate follow-up unenhanced computed tomography (CT) and 1-week follow-up contrast-enhanced CT. The efficacy of this technique was defined as implantation enabling adequate treatment planning and CT simulation. Results: All 30 patients (100%) had successful fiducial marker implantation under sonographic guidance. The mean number of fiducial markers implanted per patient was 4.30 (range: 4-6 seeds). There was one minor complication (3.33%, 1/30). All 30 patients successfully underwent CyberKnife radiation therapy after fiducial marker implantation. Conclusion: Sonographic-guided percutaneous fiducial marker implantation of hepatic malignancies is a feasible, safe, and effective technique for preparing patients before CyberKnife radiation therapy.


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