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Endoscopy 2019; 51(05): 463-467
DOI: 10.1055/a-0800-0033
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Performance of a new preloaded fiducial needle to guide radiation therapy of upper gastrointestinal cancers

Vinh-An Phan
1   Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia
2   Discipline of Medicine, University of Adelaide, Adelaide, Australia
,
Raymond Dalfsen
3   Department of Radiation oncology, Royal Adelaide Hospital, Adelaide, Australia
,
Hien Le
3   Department of Radiation oncology, Royal Adelaide Hospital, Adelaide, Australia
,
Nam Q. Nguyen
1   Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, Australia
2   Discipline of Medicine, University of Adelaide, Adelaide, Australia
› Author Affiliations
Further Information

Publication History

submitted 19 February 2018

accepted after revision 18 September 2018

Publication Date:
21 December 2018 (online)

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Abstract

Background Insertion of fiducials to outline the targeted lesion allows image-guided radiotherapy, and is best achieved by endoscopic ultrasound (EUS). This study is a performance comparison of the new EUS-guided preloaded fiducial needle against Visicoil fiducials.

Methods Technical success, visibility score, procedural time, costs, and complications for patients who underwent EUS-guided fiducial placement in upper gastrointestinal malignancies were prospectively collected.

Results 60 patients with upper gastrointestinal cancers had fiducials (14 Visicoil; 46 preloaded fiducials) inserted for image-guided radiotherapy. Technical success was 100 %, with a shorter mean (standard deviation) insertion time of 0.94 minutes (0.28 minutes) vs. 5.5 minutes (1.9 minutes; P < 0.001) and higher visibility score on fluoroscopy of 2 vs. 1.18 (P < 0.001) in the preloaded group. Neither group had major complications related to fiducial insertion. The cost of consumables per patient was lower in the preloaded group at US$480 (US$124) vs. US$643 (US$123; P < 0.001).

Conclusion Fiducial insertion for image-guided radiotherapy using the new preloaded needle is associated with 100 % technical success, shorter insertion time, and higher visibility, and is more cost-effective than the Visicoil system.

 

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