Endovascular coils as lung tumour markers in real-time tumour tracking stereotactic radiotherapy: preliminary results

To evaluate the use of endovascular coils as markers for respiratory motion correction during high-dose stereotactic radiotherapy with the CyberKnife, an image-guided linear accelerator mounted on a robotic arm. Endovascular platinum embolisation coils were used to mark intrapulmonary lesions. The c...

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Bibliographic Details
Published in:European radiology 2008-08, Vol.18 (8), p.1569-1576
Main Authors: Prévost, Jean-Briac G., Nuyttens, Joost J., Hoogeman, Mischa S., Pöll, Johan J., van Dijk, Lukas C., Pattynama, Peter M. T.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiography - instrumentation
Angiography - methods
Carcinoma, Non-Small-Cell Lung - diagnostic imaging
Carcinoma, Non-Small-Cell Lung - radiotherapy
Computer Systems
Diagnostic Radiology
Embolization, Therapeutic - instrumentation
Female
Humans
Image Enhancement - instrumentation
Image Enhancement - methods
Imaging
Internal Medicine
Interventional
Interventional Radiology
Lung Neoplasms - diagnostic imaging
Lung Neoplasms - radiotherapy
Male
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Pilot Projects
Radiography, Interventional - instrumentation
Radiography, Interventional - methods
Radiology
Radiosurgery - instrumentation
Radiosurgery - methods
Treatment Outcome
Ultrasound
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Summary:To evaluate the use of endovascular coils as markers for respiratory motion correction during high-dose stereotactic radiotherapy with the CyberKnife, an image-guided linear accelerator mounted on a robotic arm. Endovascular platinum embolisation coils were used to mark intrapulmonary lesions. The coils were placed in subsegmental pulmonary artery branches in close proximity to the target tumour. This procedure was attempted in 25 patients who were considered unsuitable candidates for standard transthoracic percutaneous insertion. Vascular coils (n = 87) were succesfully inserted in 23 of 25 patients. Only minor complications were observed: haemoptysis during the procedure (one patient), development of pleural pain and fever on the day of procedure (one patient), and development of small infiltrative changes distal to the vascular coil (five patients). Fifty-seven coils (66% of total inserted number) could be used as tumour markers for delivery of biologically highly effective radiation doses with automated tracking during CyberKnife radiotherapy. Endovascular markers are safe and allow high-dose radiotherapy of lung tumours with CyberKnife, also in patients who are unsuitable candidates for standard transthoracic percutaneous marker insertion.
ISSN:0938-7994
1432-1084
DOI:10.1007/s00330-008-0933-x