Convex Endobronchial Ultrasound-Guided Fiducial Placement for Malignant Central Lung Lesions: A Case Series

Abstract

Background: Stereotactic radiotherapy is a useful therapeutic modality in patients with lung cancer and patients with pulmonary metastases who cannot tolerate, are not candidates for, or do not want surgery. Successful use of radial endobronchial ultrasound (EBUS) and navigation bronchoscopy to guide the placement of the fiducials required for stereotactic radiotherapy in peripheral lung lesions has been previously reported. We present the first series of patients in which convex-probe EBUS was used to deliver fiducials to hilar and mediastinal lymph nodes as well as central thoracic lesions.

Methods: Retrospective case series of 5 patients in which convex-probe EBUS was used to place fiducials in central lesions.

Results: Fiducial markers were successfully placed in all 5 patients and were durable. There were no procedure-related complications.

Conclusion: Convex-probe EBUS is a useful tool in the placement of fiducial markers in patients with malignant lymphadenopathy and central parenchymal lung lesions.