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Abstract: Poster Presentations |

TRANSBRONCHIAL FLUOROSCOPIC-GUIDED GOLD FIDUCIAL PLACEMENT VIA FLEXIBLE FIBEROPTIC BRONCHOSCOPY TO FACILITATE STEREOTACTIC RADIOTHERAPY FOR TREATMENT OF LUNG CANCER FREE TO VIEW

Elizabeth A. Ziner, DO*; Frank W. Walsh, MD; Frank J. Kaszuba, MD; Craig W. Stevens, MD; Thomas J. Dilling, MD
Author and Funding Information

University of South Florida, Tampa, FL


Chest


Chest. 2009;136(4_MeetingAbstracts):86S. doi:10.1378/chest.136.4_MeetingAbstracts.86S
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Abstract

PURPOSE:  We examined the complications of transbronchial fluoroscopic-guided fiducial placement via flexible fiberoptic bronchoscopy in 40 patients with primary lung cancer or metastatic cancer to the lungs to facilitate delivery of stereotactic radiation therapy.

METHODS:  We retrospectively examined complications in 40 patients that were considered non-surgical candidates who underwent transbroncial fluoroscopic-guided fiducial placement via flexible fiberoptic bronchoscopy between 5/2006 and 8/2008.

RESULTS:  A total of 161 gold fiducial markers were successfully deployed in 40 patients. One patient developed hypoxemia following placement of the first fiducial as a result of upper airway obstruction from sleep apnea and conscious sedation. Hypoxemia resolved with reversal of conscious sedation and jaw thrust maneuver. A small right apical pneumothorax was noted in another patient following placement of 3 fiducials. Review of chest radiographs prior to fiducial placement revealed the presence of a persistent right apical pneumothorax. Following fiducial placement the appearance of the pneumothorax was smaller. In this instance we do not feel the pneumothorax was a result of fiducial placement. All other patients tolerated the procedure well without any complications.

CONCLUSION:  Transbronchial fluoroscopic-guided placement of gold fiducials via flexible fiberoptic bronchoscopy to facilitate delivery of stereotactic radiotherapy can be done safely with few complications.

CLINICAL IMPLICATIONS:  This method may be a safer alternative to CT-guided placement of fiducials, which has a relatively high rate of pneumothorax. This might also represent a cost effective alternative to electromagnetic navigation bronchoscopy (ENB) for fiducial placement.

DISCLOSURE:  Elizabeth Ziner, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM


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