RT Journal Article
SR Electronic
T1 Assessment of radial EBUS-GS for disposition of fiducial gold marker in peripheral lung nodule before stereotaxic radiation therapy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P690
VO 44
IS Suppl 58
A1 Bérengère Obstoy
A1 Samy Lachkar
A1 Mathieu Salaun
A1 Suzanna Bota
A1 Luc Thiberville
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P690.abstract
AB INTRODUCTION : Radial EBUS using guide sheath (GS) is a minimally invasive technique that allows the sampling of peripheral lung nodule.AIM : To assess the use of EBUS-GS for gold fiducial marker disposition.METHODS : 28 patients underwent radial-EBUS with fiducial placement in a peripheral lung nodule at the Rouen University Hospital between May 2008 and December 2013. EBUS procedure was performed using a 4.0mm bronchoscope and a 17S Olympus® probe. After sampling (biopsy and brush) a 5 mm / 0.8 mm fiducial gold marker (Best Medical International, USA) was inserted into the distal tip of the bronchial brush and glued with lidocaine gel, for fiducial placement through the GS .RESULTS : 23 patients had a chronic respiratory insufficiency that forcluded lung surgical resection and conventional radiation therapy. Mean nodule diameter was 16mm [min-max= 6-32mm], with 24 nodules ≤ 20mm. There were 24 pulmonary cancers (8 adenocarcinoma, 10 squamous cancer cell, 6 other) and 4 metastases. The histology was known before the procedure in only 8 / 28 cases. 26 procedures were performed under local anesthesia. No adverse event was noted. Nodules were visualized using EBUS in 27/28. The marker was expulsed during cough immediately after the procedure in two cases, and remained stable in the nodules in the other cases. The markers were visible on x-ray 3 months after the procedure in 84% of the cases.CONCLUSION : Fiducial placement into peripheral nodule before stereotaxic radiation therapy is a safe and efficient technique using radial EBUS under local anesthesia.