Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery

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Presentation transcript:

Coil spring fiducial markers placed safely using navigation bronchoscopy in inoperable patients allows accurate delivery of CyberKnife stereotactic radiosurgery Carsten Schroeder, MD, PhD, Rana Hejal, MD, Philip A. Linden, MD The Journal of Thoracic and Cardiovascular Surgery Volume 140, Issue 5, Pages 1137-1142 (November 2010) DOI: 10.1016/j.jtcvs.2010.07.085 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Navigation of electromagnetic navigation bronchoscopy (ENB) sensor probe using multiplanar computed tomography (CT) images and “tip-view” orientation. Locator tip was 0.4 cm from center of targeted tumor location. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1137-1142DOI: (10.1016/j.jtcvs.2010.07.085) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Flattened platinum coil spring fiducial marker loaded in tip of microbiology specimen brush. Box insert: Deployed coil spring fiducial marker. B, Magnified diamond-shaped deployed coiled spring fiducial marker with thrombogenic filament attachments. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1137-1142DOI: (10.1016/j.jtcvs.2010.07.085) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Radiopaque fiducial markers identified in and around right lung legion on A, postelectromagnetic navigation bronchoscopy (ENB) chest radiograph, and B and C, corresponding computed tomography (CT) scan. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1137-1142DOI: (10.1016/j.jtcvs.2010.07.085) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Bar graph depicting remaining and dislodged fiducial markers after electromagnetic navigation bronchoscopy (ENB). Coiled fiducial markers (2 of 217) showed highly significant lower dislodgment rate compared with linear fiducial markers compared with previous studies by Anantham and colleagues10 and Harley and colleagues.11P values calculated using Fisher’s exact test. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 1137-1142DOI: (10.1016/j.jtcvs.2010.07.085) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions