Name of the Procedure:

Placement of Interstitial Device(s) for Radiation Therapy/Surgery Guidance
Common Name(s): Placement of fiducial markers, dosimeter placement
Technical Term: Interstitial device implantation for radiation therapy or surgery guidance

Summary

This procedure involves inserting small devices, such as fiducial markers or dosimeters, into the body to help guide radiation therapy or surgical interventions. These devices assist in precisely targeting the treatment area to improve outcomes.

Purpose

The procedure is primarily used to aid in the precise delivery of radiation therapy or to guide surgical interventions by marking specific areas within the body. It helps ensure that the treatment targets the correct spot, thereby increasing effectiveness and reducing harm to surrounding healthy tissues.

Indications

• Tumors or abnormal tissues in areas other than the abdomen, pelvis, prostate, retroperitoneum, or thorax.
• Patients requiring precise radiation therapy or surgical guidance.
• Conditions where accurate localization of treatment areas is critical for the success of the therapy.

Preparation

• Patients may need to fast for a few hours before the procedure.
• Medications, especially blood thinners, may need to be adjusted per the doctor's advice.
• Pre-procedure imaging tests, such as CT or MRI scans, may be required to identify the exact location for device placement.

Procedure Description

1. The patient will be positioned to access the target area.
2. Local anesthesia or sedation may be administered to minimize discomfort.
3. Using imaging guidance (e.g., CT, ultrasound), the healthcare provider will insert a needle into the target area.
4. The interstitial device, such as a fiducial marker or dosimeter, is placed through the needle.
5. The position of the device is confirmed using imaging, ensuring it is accurately placed.
6. The needle is removed, and the site is dressed.

Duration

The procedure typically takes 30 minutes to an hour, depending on the complexity and number of devices placed.

Setting

The procedure is usually performed in a hospital, outpatient clinic, or a specialized medical center equipped with imaging technology.

Personnel

• Specialist (e.g., Radiologist, Oncologist, or Surgeon)
• Nurses or medical assistants
• Anesthesiologist or trained personnel for sedation, if required

Risks and Complications

• Common risks: Minor bleeding, infection, discomfort at the insertion site.
• Rare risks: Incorrect placement of device, allergic reaction to anesthesia, damage to surrounding tissues or organs.
• Complications are managed through antibiotics for infections or minor surgical interventions for misplaced devices.

Benefits

• Improved accuracy in targeting treatment areas, which can enhance the effectiveness of radiation therapy or surgical outcomes.
• Reduced risk of damage to surrounding healthy tissues.
• Benefits are generally immediate, as the devices help guide treatments accurately from their implantation.

Recovery

• Post-procedure instructions may include care for the insertion site and pain management.
• Most patients can resume normal activities within a day but should avoid strenuous activities for a short period.
• Follow-up appointments may be necessary to monitor the device and treatment progress.

Alternatives

• External marking techniques using imaging for guidance.
• Advanced imaging technologies like MRI or PET scans without fiducial markers.
• Each alternative has its pros and cons concerning accuracy, invasiveness, and practicality.

Patient Experience

During the procedure, patients might feel minimal discomfort due to local anesthesia or sedation. Post-procedure, there may be slight soreness or bruising at the insertion site. Pain can be managed with over-the-counter medications, and the overall experience is generally well-tolerated.