fiducial markers

overview

Fiducial markers are bits of metal that are often placed around a pancreatic tumor before radiation therapy. The markers show up on images (such as X-rays) to better pinpoint a tumor. Because organs in the body shift around when we move, fiducial markers permanently mark the tumor and help make sure radiation is aimed precisely. That way, radiation can be as exact as possible, affecting just the cancerous cells and not harming healthy tissue. Using imaging to help guide radiation is called image-guided radiation therapy (IGRT).

what to expect

Typically, 3 to 6 fiducial markers are placed around a tumor during an outpatient procedure called endoscopic ultrasound (EUS). A thin, flexible tube (endoscope) is inserted through the mouth, down the esophagus, past the stomach and into the pancreas. A thin needle is inserted through the tube into the pancreatic tumor to place the fiducial markers. The endoscope contains a tiny camera, which transmits pictures to a monitor so a doctor can see inside as the markers are placed.

The markers are the size of a grain of rice and can sometimes be placed by a thin needle inserted through the skin. In this case, a doctor uses a CT (computed tomography) scan to help guide the needle and markers to the right spots.

You must wait a week or so after having markers placed before beginning radiation therapy.

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