Premium
Evaluation of a new endoscopic ultrasound‐guided multi‐fiducial delivery system: A prospective non‐survival study in a live porcine model
Author(s) -
Draganov Peter V.,
Chavalitdhamrong Disaya,
Wagh Mihir S.
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12046
Subject(s) - fiducial marker , medicine , radiology , fluoroscopy , nuclear medicine
Background Endoscopic ultrasound ( EUS ) is an excellent tool for implanting fiducials for gastrointestinal malignancies, but a dedicated delivery system for EUS ‐guided fiducial placement is not available. The aim of the present study was to evaluate the performance characteristics of a new dedicated EUS ‐guided multi‐fiducial delivery system. Methods This was a prospective live porcine study using prototype 22‐ G EUS needles preloaded with four fiducials. Primary outcomes were technical success and accuracy of fiducial placement. Secondary outcomes were ease of passage of delivery system, ease of deployment, EUS visualization of the needle, visual appearance of fiducials on EUS , fluoroscopy and computed tomography ( CT ) scans, time taken for fiducial placement and adverse events. Outcomes were scored on a predetermined 5‐point L ikert scale (1 = best, 5 = worst). Results Fiducial deployment was successful in 43 out of 45 needles (95.6%). All 172 fiducials (43 needles, four fiducials each)were successfully deployed on target. Fiducial placement accuracy score was 1.30 ± 0.64. All needles passed with ease (score 1.0 ± 0.0). Ease of fiducial deployment score was 1.85 ± 1.02. Mean scores for EUS visualization of the needle and fiducial were 1.02 ± 0.15 and 2.10 ± 0.91, respectively. Fluoroscopic and CT visualization of fiducials was excellent. Time for placement of four fiducials was <1 min (0.86 ± 0.50 min). No adverse events were seen. Conclusion The new EUS ‐guided multi‐fiducial delivery system provided quick, easy, and accurate fiducial deployment without adverse events.