Image-guided placement of fiducial markers is in some ways an extension of percutaneous procedures such as needle biopsy of lung pathology, which are native to most interventional radiology practices. To that extent, learning the procedure is not difficult for those who are familiar with the basic principles of image-guided lung nodule biopsy. However, there are significant modifications in the procedure that are necessary in order to ensure appropriate placement and distribution of the fiducial markers. Proper positioning of fiducial markers in specific geometric configurations is essential for accurate targeting of the nodule. This chapter focuses on the principles of CT-guided percutaneous placement of fiducial markers. For the most part, this procedure is performed on a consultative basis by interventional radiologists, physicians who specialize in minimally invasive image-guided therapy. Special considerations for patient selection, pre-procedural preparation, techniques, and post-procedural care are explained.
ASJC Scopus subject areas