Background (extract): The aim of this video (Video 1, available online at www.VideoGIE.org) is to describe the technique for placement of EUS-guided fiducial markers in the treatment of locally advanced PC.
Conclusion (extract): The application of SBRT to locally advanced or metastatic PC usually requires the use of fiducial markers to track the precise location of the tumor in real time. This advancement in radiation therapy technique can contribute to tumor downstaging and improve the chances of secondary resection; furthermore, it can enhance local control for unresectable disease and facilitate palliation of obstructive symptoms. In clinical practice, the decision to use EUS-guided fiducial placement requires a multidisciplinary approach involving gastroenterologists, oncologists, surgeons, and radiation oncologists.
Comment: The video in the below link shows Gold Anchor implanted in a pancreatic cancer patient with a 22G EUS-FNA needle. Please note that the back-loading technique shown in the video is now possible with the Gold Anchor Introducer device, see more information here.