Endoscopic ultrasound-guided fiducial placement in pancreatic tumors: safety and technical feasibility

Tabernero, Susana; Prados, Susana; Rubio, María del Carmen; Morena, Felipe de la; López, M.; Sánchez, E.

doi:10.17235/reed.2019.5873/2018

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…The authors concluded that EUS-guided fiducial marker placement should be adopted more broadly due to its feasibility and excellent safety profile [ 86 ]. The most recent single-center retrospective study by Tabernero et al investigated the use of EUS-guided fiducial marker placement in 47 patients with biopsy-proven advanced PDAC [ 87 ]. The technical success rate of the procedure was noted to be 100% [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

“…The most recent single-center retrospective study by Tabernero et al investigated the use of EUS-guided fiducial marker placement in 47 patients with biopsy-proven advanced PDAC [ 87 ]. The technical success rate of the procedure was noted to be 100% [ 87 ]. However, two (4.2%) patients developed adverse events including mild pancreatitis and duodenal abscess [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

“…The technical success rate of the procedure was noted to be 100% [ 87 ]. However, two (4.2%) patients developed adverse events including mild pancreatitis and duodenal abscess [ 87 ]. These findings aligned with previous studies that have demonstrated EUS-guided fiducial marker placement to be a highly safe and feasible procedure in the hands of experienced therapeutic endoscopists who are well-trained in EUS.…”

Section: Discussionmentioning

confidence: 99%

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Role of Therapeutic Endoscopic Ultrasound in Management of Pancreatic Cancer: An Endoscopic Oncologist Perspective

Dahiya,

Chandan,

Ali

et al. 2023

Cancers

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Pancreatic cancer is a highly lethal disease with an aggressive clinical course. Patients with pancreatic cancer are usually asymptomatic until significant progression of their disease. Additionally, there are no effective screening guidelines for pancreatic cancer in the general population. This leads to a delay in diagnosis and treatment, resulting in poor clinical outcomes and low survival rates. Endoscopic Ultrasound (EUS) is an indispensable tool for the diagnosis and staging of pancreatic cancer. In the modern era, with exponential advancements in technology and device innovation, EUS is also being increasingly used in a variety of therapeutic interventions. In the context of pancreatic cancer where therapies are limited due to the advanced stage of the disease at diagnosis, EUS-guided interventions offer new and innovative options. Moreover, due to their minimally invasive nature and ability to provide real-time images for tumor localization and therapy, they are associated with fewer complication rates compared to conventional open and laparoscopic approaches. In this article, we detail the most current and important therapeutic applications of EUS for pancreatic cancer, namely EUS-guided Fine Needle Injections, EUS-guided Radiotherapy, and EUS-guided Ablations. Furthermore, we also discuss the feasibility and safety profile of each intervention in patients with pancreatic cancer to provide gastrointestinal medical oncologists, radiation and surgical oncologists, and therapeutic endoscopists with valuable information to facilitate patient discussions and aid in the complex decision-making process.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Role of Therapeutic Endoscopic Ultrasound in Management of Pancreatic Cancer: An Endoscopic Oncologist Perspective

Dahiya,

Chandan,

Ali

et al. 2023

Cancers

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“…Recent studies have revealed that fiducials with diameters ≤ 0.75 mm that could be loaded into 22-gauge EUS-FNA needles are preferred; the back-loading technique is preferred over the front-loading technique; and preloading fiducial marker needles may reduce the procedure time and eliminate the risk of needle stick injury to operator. 11,15,[17][18][19][20][21][22][23][24][25][26]…”

Section: Technical Difficulties Of Eus-guided Fiducial Placementmentioning

confidence: 99%

“…Fiducial markers are broadly divided into solid and liquid types, and the solid type is subdivided into three different materials: gold, platinum, and carbon ( Table 1 ). Among these, solid gold markers have the most data available from previous studies ( Table 2 ) [ 2 , 11 , 15 , 17 - 26 ].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Ultrasound–Guided Fiducial Placement for Stereotactic Body Radiation Therapy in Pancreatic Malignancy

Kim

Shin

2021

Clin Endosc

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Stereotactic body radiation therapy (SBRT) is an important treatment option for pancreatic cancer, which is known to be one of the malignancies with the worst prognosis. However, the high radiation doses delivered during SBRT may cause damage to adjacent radiosensitive organs. To minimize such damage, fiducial markers are used for localization during SBRT for pancreatic cancer. The development of endoscopic ultrasound (EUS) has enabled fiducial markers to be inserted into the pancreas using an EUS fine-needle aspiration (FNA) needle, unlike in the past when percutaneous placement was generally performed. For successful EUS-guided fiducial marker placement, it is necessary for the fiducial markers to be loaded within the EUS-FNA needles to have a low probability of complications and a low migration risk, and to be stably observed in SBRT imaging. A systematic review has shown that the technical success rate of EUS-guided fiducial marker placement is 96.27%, whereas the fiducial marker migration and adverse event rates are 4.33% and 4.85%, respectively. Nonetheless, standardized techniques for fiducial marker placement and the characteristics of optimal fiducial markers have not yet been established. This review will introduce the characteristics (e.g., materials and shapes) of fiducial markers used in fiducial marker placement for pancreatic cancer and will discuss conventional techniques along with their success rates, difficulties, and adverse events.

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A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer

et al. 2020

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Endoscopic ultrasound-guided fiducial placement in pancreatic tumors: safety and technical feasibility

Cited by 4 publications

References 15 publications

Role of Therapeutic Endoscopic Ultrasound in Management of Pancreatic Cancer: An Endoscopic Oncologist Perspective

Role of Therapeutic Endoscopic Ultrasound in Management of Pancreatic Cancer: An Endoscopic Oncologist Perspective

Endoscopic Ultrasound–Guided Fiducial Placement for Stereotactic Body Radiation Therapy in Pancreatic Malignancy

A prospective observational study of the clinical and pathological impact of stereotactic body radiotherapy (SBRT) as a neoadjuvant strategy of chemoradiation in pancreatic cancer

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