32553 Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), percutaneous, intra-thoracic, single or multiple

Name of the Procedure:

Placement of Interstitial Device(s) for Radiation Therapy Guidance (e.g., Fiducial Markers, Dosimeter), Percutaneous, Intra-Thoracic, Single or Multiple

Summary

This procedure involves the percutaneous (through the skin) placement of small devices, such as fiducial markers or dosimeters, into the thoracic (chest) area. These devices help guide radiation therapy by precisely marking the location of tumors and monitoring radiation doses.

Purpose

The procedure aims to enhance the accuracy of radiation therapy for treating thoracic cancers, such as lung cancer. By placing these markers or dosimeters, healthcare providers can better target tumors, maximize the effectiveness of radiation treatment, and minimize damage to surrounding healthy tissues.

Indications

• Diagnosed with thoracic cancers (e.g., lung cancer)
• Patients scheduled for radiation therapy
• Need for precise tumor localization and radiation dose monitoring

Preparation

• Patients may be required to fast for a few hours before the procedure.
• Certain medications may need to be adjusted or temporarily halted.
• Pre-procedure imaging tests (e.g., CT scan) may be performed to plan the placement of devices.

Procedure Description

1. The patient is positioned on a procedure table.
2. Local anesthesia or sedation may be administered to minimize discomfort.
3. Using imaging guidance (such as CT or ultrasound), the healthcare provider inserts a needle through the chest wall to the target area.
4. The fiducial marker(s) or dosimeter(s) are carefully placed through the needle into or near the tumor.
5. The needle is withdrawn, and the placement is confirmed via imaging.

Duration

The procedure typically takes 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital's interventional radiology or imaging department.

Personnel

• Interventional radiologist or thoracic surgeon
• Nursing staff
• Radiologic technologist
• Anesthesiologist or nurse anesthetist (if sedation is used)

Risks and Complications

• Minor bleeding or infection at the insertion site
• Pneumothorax (collapsed lung)
• Discomfort or pain at the insertion site
• Rarely, migration of the marker(s)

Benefits

• Improved targeting of radiation therapy
• Better monitoring of radiation doses
• Increased effectiveness of treatment with reduced side effects
• Benefits are typically realized immediately upon start of radiation therapy

Recovery

• Patients may need to be observed for a short period post-procedure.
• Mild pain or discomfort can be managed with over-the-counter pain relievers.
• Patients can usually resume normal activities within a day.
• Follow-up imaging may be scheduled to ensure device positions.

Alternatives

• External surface markers or imaging techniques (less precise)
• Surgical placement of markers (more invasive)
• Watchful waiting with imaging without markers
• Pros and cons vary; precision and minimal invasiveness are primary benefits of the described procedure.

Patient Experience

• Patients might feel pressure or mild pain during needle insertion.
• Sedation, if used, will make the procedure more comfortable.
• Post-procedure discomfort is usually minimal.
• Pain management includes local anesthetics, sedation, and over-the-counter analgesics.

This description provides an overview of the placement of interstitial devices for radiation therapy guidance, incorporating detailed information about the procedural aspects, from preparation to recovery.