Purpose: To evaluate the safety and technical success rate of Ultrsound-guided fiducial marker implantation in preparation for cyberknife radiation therapy.
Materials & Methods: During 7 months,we retrospectively reviewed 164 percutaneous ultrsound-guided fiducial marker implantations in 41 patients. Of the 164 implantations, 67 implants were in the liver, 59 were in the metastatic lymph node, 20 were in the prostate, and 18 were in the pancreas. Procedure-related major and minor complications were documented. Technical success was defined as implantation enabling adequate treatment planning and computed tomographic simulation.
Results: The major and minor complication rates were 2.4% and 21.9%. Abdominal pain was the most common complication in 4 patients (7.6%). But, three patients had no requiring specific treatments during the follow-up period. Two patients presented mild fever (4.9%). One patient who was inserted in the liver suffered severe abdominal pain, biloma, and pleural effusion (2.4%). One patient had a mild bullae at puncture skin site. Among 5 patients who were inserted in the prostate, one patient presented transient hematuria less than 24hr lasing and other one patient presented the transient voiding difficulty. Nelaton voiding was required only one time. Of the 164 implantations, 157 were successful (95.7%); migration of fiducial markers in 4 implantations and failure of discrimination of fiducial markers in 3 implantatiions were noted. Among them, 6 patients required additional procedures (14.6%).
Conclusions: Symptomatic complication following ultrasound guided-percutaneous implantation of fiducial marker is a relatively low, But, careful consideration for relatively higher rate of migration and discrimination failure should be needed.