Endosc Int Open 2015; 03(04): E373-E377
DOI: 10.1055/s-0034-1392274
Review
© Georg Thieme Verlag KG Stuttgart · New York

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

Disaya Chavalitdhamrong
1   Division of Gastroenterology, University of Florida, Gainesville, Florida, United States
,
Christopher J. DiMaio
2   Division of Gastroenterology, Mount Sinai School of Medicine, New York, New York, United States
,
Peter D. Siersema
3   Department of Gastroenterology, University Medical Center Utrecht, The Netherlands
,
Mihir S. Wagh
1   Division of Gastroenterology, University of Florida, Gainesville, Florida, United States
› Author Affiliations
Further Information

Publication History

submitted: 20 December 2014

accepted after revision: 26 February 2015

Publication Date:
21 July 2015 (online)

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.

 
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