Khanmohammadi Shaghayegh, Golzarian Jafar, Akhlaghpoor Shahram
Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Cardiovasc Intervent Radiol. 2023 Oct;46(10):1409-1413. doi: 10.1007/s00270-023-03539-2. Epub 2023 Aug 28.
To Evaluate the safety and technical success of transgluteal CT-guided fiducial marker implantation into the prostate as an alternative method to transperineal and transrectal approaches.
We retrospectively identified all patients who had undergone CT-guided transgluteal fiducial marker insertion between 2020 and 2022. Four patients with confirmed prostate cancer were identified. One radiologist performed all procedures via a bilateral transgluteal approach under the guidance of real-time CT-fluoroscopy. Twenty cm long pre-waxed 18G guiding needles, preloaded with smooth gold fiducial markers, were used to implant markers. Technical success was defined as the successful placement of the fiducial markers into the planned positions.
The mean age of patients was 70 years. The mean procedure time was 19.25 (SD: 6.75) min, and the mean total dose length product (DLP) was 801.75 (SD: 291.17) mGycm, which is compatible with the 12 mSv estimated effective dose. All procedures were technically successful (100%). All patients tolerated the procedure and did not require any analgesia for pain, and there were no requests to stop or pause the procedure. Only one patient reported hematuria one day after the procedure, which required no treatment.
Transgluteal CT-guided fiducial marker implantation into the prostate is an alternative method to transperineal and transrectal approaches. In this technique, the risk of septic complications is minor, and general anesthesia is not required. Thus, transgluteal CT-guided marker insertion is a feasible and well-tolerated method for image-guided radiation therapy (IGRT) in patients with prostate cancer.
评估经臀CT引导下将基准标记物植入前列腺的安全性和技术成功率，作为经会阴和经直肠方法的替代方法。
我们回顾性地确定了2020年至2022年间所有接受CT引导下经臀基准标记物插入术的患者。确定了4例确诊前列腺癌的患者。一名放射科医生在实时CT透视引导下通过双侧经臀入路进行了所有手术。使用预先装有光滑金基准标记物的20厘米长的预蜡18G引导针植入标记物。技术成功定义为将基准标记物成功放置到计划位置。
患者的平均年龄为70岁。平均手术时间为19.25（标准差：6.75）分钟，平均总剂量长度乘积（DLP）为801.75（标准差：291.17）mGycm，与估计有效剂量12 mSv相符。所有手术在技术上均成功（100%）。所有患者均耐受手术，无需任何止痛措施，也无人要求停止或暂停手术。只有一名患者在术后一天报告有血尿，无需治疗。
经臀CT引导下将基准标记物植入前列腺是经会阴和经直肠方法的替代方法。在该技术中，感染并发症风险较小，无需全身麻醉。因此，经臀CT引导下插入标记物是前列腺癌患者图像引导放射治疗（IGRT）的一种可行且耐受性良好的方法。
