eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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SCImago Journal & Country Rank

4/2020
vol. 12
 
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abstract:
Original paper

Iodine-125 seed implantation treatment of lung metastases < 2.5 cm using 5-ml syringe as a guide

Jie Li
1
,
Lijuan Zhang
2
,
Zongqiong Sun
3
,
Yuxi Ge
3
,
Jialiang Zhou
4
,
Qigen Xie
1

1.
Department of Intervention, Affiliated Hospital of Jiangnan University (Wuxi Fourth People’s Hospital), China
2.
Department of Radiology, Wuxi People’s Hospital, Nanjing Medical University, China
3.
Department of Radiology, Affiliated Hospital of Jiangnan University (Wuxi Fourth People’s Hospital), China
4.
Department of Radiation Oncology, Affiliated Hospital of Jiangnan University (Wuxi Fourth People’s Hospital), China
J Contemp Brachytherapy 2020; 12, 4: 335–342
Online publish date: 2020/08/21
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Purpose
Small lung metastases change their location with respiration, making difficult to localize, therefore, increasing the number of punctures. Accurate puncture can reduce trauma to lung tissue and accelerate patient’s recovery. The aim of the study was to present our experience with the technique of using local anesthesia 5-ml syringe as a guide for computerized tomography-guided iodine-125 seed implantation (CT-ISI).

Material and methods
This was a retrospective study, including patients with small metastatic tumors in the lung, treated with CT-ISI between December 2013 and March 2018 at the Affiliated Hospital of the University. The patients were divided according to whether a 5-ml syringe was used as a guide during CT-ISI or not. The final follow-up was on March 31st, 2018. Implantation success and complications were examined.

Results
Nineteen patients were included. A total of 840 seeds were used, with 44.2 ±33.6 (range, 10-160) seeds per patient. The mean D90 for CT-ISI was 134.5 ±7.5 Gy. Treatment intervention for eleven patients was performed using a 5-ml syringe as a guide during CT-ISI. There were no differences in total dose and number of implanted seeds between the two groups, but the number of punctures per lesion was lower in the syringe group than in the no-syringe group (1.9 ±0.5 vs. 2.9 ±0.6, p < 0.001), suggesting a higher puncture accuracy. The total number of SMTIL was 50 (median, 2; range, 1-10), and the median size was 1.9 cm (range, 0.8-2.4 cm). All SMTIL were well-controlled at 6-months follow-up (response rate [RR] = 100%). One patient in the no-syringe group experienced grade 2 chest tightness, chest pain, intraoperative needle tract bleeding, and post-operative blood in sputum.

Conclusions
Puncture with a 5-ml syringe as a guide during CT-ISI seems to be a more accurate option for patients with small (< 2.5 cm) lung metastasis.

keywords:

neoplasm metastasis, lung neoplasms, computed tomography, iodine-125, brachytherapy, anesthesia

 
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