Malignancy: Practical Feasibility and Safety

Background/Aims: Stereotactic body radiation therapy (SBRT) for gastrointestinal malignancies requires the place-ment of fiducials to guide treatment delivery. This study aimed to determine the safety and technical feasibility of endoscopic ultrasonography (EUS)-guided fiducial placement for SBRT. Methods: From November 2010 to August 2012, 32 consecutive patients who were scheduled to receive SBRT for pancreatic and hepatic malignancies were referred for EUS-guided fiducial placement. Primary outcome mea-surements included technical success, the fiducial migration rate, and procedural complications. Results: All 32 patients had successful fiducial placement under EUS guidance. The mean number of fiducials placed per patient was 2.94±0.24 (range, 2 to 3 seeds). Spontaneous fiducial migration was noted in one patient (3.1%). Of the 32 patients with fiducial