EUS-guided fiducial placement before targeted radiation therapy for prostate cancer

Julie Yang, May Abdel-Wahab, Afonso Ribeiro

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Image-guided radiation therapy allows the delivery of precisely aimed radiation beams to tumors while minimizing radiation to adjacent normal tissue. This is particularly important in the prostate, a moving target whose positioning depends on the dynamics of its neighboring bladder and rectum. Targeted radiation therapy can be achieved by using implantable radiographic markers, or fiducials, which serve as reference points to accurately delineate tumors. Objective: To determine the feasibility and safety of placing fiducials in the prostate under linear array EUS guidance to facilitate targeted radiation therapy. Design: Retrospective analysis of a prospective database. Setting: University of Miami Hospital and Clinics, a tertiary cancer referral center. Patients: Localized prostate cancer patients scheduled to undergo intensity-modulated radiation therapy. Interventions: A total of 16 patients underwent EUS-guided fiducial placement to delineate the prostate before planned radiation therapy. Results: Fiducial placement was successful in all patients (100%). A total of 71 gold markers were deployed in a 4-quadrant manner outlining the prostate. Seven of 16 patients had an additional fiducial placed to ensure adequate prostate delineation. Patients tolerated the procedure well with minimal discomfort. No complications developed from the procedure. Limitations: Single-center experience, small sample size. Conclusions: EUS-guided placement of fiducials to facilitate image-guided radiation therapy for prostate cancer is a feasible alternative to transperineal or transrectal US approaches, thereby adding to the expanding list of indications for linear EUS. This procedure can be safely performed by endosonographers familiar with perirectal anatomy and transrectal FNA technique.

Original languageEnglish (US)
Pages (from-to)579-583
Number of pages5
JournalGastrointestinal Endoscopy
Volume70
Issue number3
DOIs
StatePublished - Sep 2009
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Radiotherapy
Prostate
Image-Guided Radiotherapy
Radiation
Neoplasms
Rectum
Tertiary Care Centers
Gold
Sample Size
Anatomy
Urinary Bladder
Databases
Safety

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging

Cite this

EUS-guided fiducial placement before targeted radiation therapy for prostate cancer. / Yang, Julie; Abdel-Wahab, May; Ribeiro, Afonso.

In: Gastrointestinal Endoscopy, Vol. 70, No. 3, 09.2009, p. 579-583.

Research output: Contribution to journalArticle

Yang, Julie ; Abdel-Wahab, May ; Ribeiro, Afonso. / EUS-guided fiducial placement before targeted radiation therapy for prostate cancer. In: Gastrointestinal Endoscopy. 2009 ; Vol. 70, No. 3. pp. 579-583.
@article{19366889b31549ca8ceebd16b0a6d933,
title = "EUS-guided fiducial placement before targeted radiation therapy for prostate cancer",
abstract = "Background: Image-guided radiation therapy allows the delivery of precisely aimed radiation beams to tumors while minimizing radiation to adjacent normal tissue. This is particularly important in the prostate, a moving target whose positioning depends on the dynamics of its neighboring bladder and rectum. Targeted radiation therapy can be achieved by using implantable radiographic markers, or fiducials, which serve as reference points to accurately delineate tumors. Objective: To determine the feasibility and safety of placing fiducials in the prostate under linear array EUS guidance to facilitate targeted radiation therapy. Design: Retrospective analysis of a prospective database. Setting: University of Miami Hospital and Clinics, a tertiary cancer referral center. Patients: Localized prostate cancer patients scheduled to undergo intensity-modulated radiation therapy. Interventions: A total of 16 patients underwent EUS-guided fiducial placement to delineate the prostate before planned radiation therapy. Results: Fiducial placement was successful in all patients (100{\%}). A total of 71 gold markers were deployed in a 4-quadrant manner outlining the prostate. Seven of 16 patients had an additional fiducial placed to ensure adequate prostate delineation. Patients tolerated the procedure well with minimal discomfort. No complications developed from the procedure. Limitations: Single-center experience, small sample size. Conclusions: EUS-guided placement of fiducials to facilitate image-guided radiation therapy for prostate cancer is a feasible alternative to transperineal or transrectal US approaches, thereby adding to the expanding list of indications for linear EUS. This procedure can be safely performed by endosonographers familiar with perirectal anatomy and transrectal FNA technique.",
author = "Julie Yang and May Abdel-Wahab and Afonso Ribeiro",
year = "2009",
month = "9",
doi = "10.1016/j.gie.2009.03.001",
language = "English (US)",
volume = "70",
pages = "579--583",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - EUS-guided fiducial placement before targeted radiation therapy for prostate cancer

AU - Yang, Julie

AU - Abdel-Wahab, May

AU - Ribeiro, Afonso

PY - 2009/9

Y1 - 2009/9

N2 - Background: Image-guided radiation therapy allows the delivery of precisely aimed radiation beams to tumors while minimizing radiation to adjacent normal tissue. This is particularly important in the prostate, a moving target whose positioning depends on the dynamics of its neighboring bladder and rectum. Targeted radiation therapy can be achieved by using implantable radiographic markers, or fiducials, which serve as reference points to accurately delineate tumors. Objective: To determine the feasibility and safety of placing fiducials in the prostate under linear array EUS guidance to facilitate targeted radiation therapy. Design: Retrospective analysis of a prospective database. Setting: University of Miami Hospital and Clinics, a tertiary cancer referral center. Patients: Localized prostate cancer patients scheduled to undergo intensity-modulated radiation therapy. Interventions: A total of 16 patients underwent EUS-guided fiducial placement to delineate the prostate before planned radiation therapy. Results: Fiducial placement was successful in all patients (100%). A total of 71 gold markers were deployed in a 4-quadrant manner outlining the prostate. Seven of 16 patients had an additional fiducial placed to ensure adequate prostate delineation. Patients tolerated the procedure well with minimal discomfort. No complications developed from the procedure. Limitations: Single-center experience, small sample size. Conclusions: EUS-guided placement of fiducials to facilitate image-guided radiation therapy for prostate cancer is a feasible alternative to transperineal or transrectal US approaches, thereby adding to the expanding list of indications for linear EUS. This procedure can be safely performed by endosonographers familiar with perirectal anatomy and transrectal FNA technique.

AB - Background: Image-guided radiation therapy allows the delivery of precisely aimed radiation beams to tumors while minimizing radiation to adjacent normal tissue. This is particularly important in the prostate, a moving target whose positioning depends on the dynamics of its neighboring bladder and rectum. Targeted radiation therapy can be achieved by using implantable radiographic markers, or fiducials, which serve as reference points to accurately delineate tumors. Objective: To determine the feasibility and safety of placing fiducials in the prostate under linear array EUS guidance to facilitate targeted radiation therapy. Design: Retrospective analysis of a prospective database. Setting: University of Miami Hospital and Clinics, a tertiary cancer referral center. Patients: Localized prostate cancer patients scheduled to undergo intensity-modulated radiation therapy. Interventions: A total of 16 patients underwent EUS-guided fiducial placement to delineate the prostate before planned radiation therapy. Results: Fiducial placement was successful in all patients (100%). A total of 71 gold markers were deployed in a 4-quadrant manner outlining the prostate. Seven of 16 patients had an additional fiducial placed to ensure adequate prostate delineation. Patients tolerated the procedure well with minimal discomfort. No complications developed from the procedure. Limitations: Single-center experience, small sample size. Conclusions: EUS-guided placement of fiducials to facilitate image-guided radiation therapy for prostate cancer is a feasible alternative to transperineal or transrectal US approaches, thereby adding to the expanding list of indications for linear EUS. This procedure can be safely performed by endosonographers familiar with perirectal anatomy and transrectal FNA technique.

UR - http://www.scopus.com/inward/record.url?scp=68949146885&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=68949146885&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2009.03.001

DO - 10.1016/j.gie.2009.03.001

M3 - Article

C2 - 19560140

AN - SCOPUS:68949146885

VL - 70

SP - 579

EP - 583

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 3

ER -