CT-assisted transbronchial brachytherapy for small peripheral lung cancer

Transbronchial brachytherapy for small peripheral lung cancer was developed with the use of the CT-guided bronchoscopy technique. Under CT guidance, an applicator carrying a dummy source was introduced into a lesion and stabilized. A radioactive source was then delivered through the applicator using a high dose rate remote afterloading system. For multiple radiation fractions, a marker was placed immediately under the pleura in a peripheral bronchus penetrating the lesion using the CT-guided barium marking technique. During brachytherapy, an applicator with a dummy source was inserted under fluoroscopic guidance up to the marker. A radioactive source was subsequently delivered. CT-assisted transbronchial brachytherapy allows radiation to be delivered from inside a lesion. This minimizes radiation damage to noncancerous tissue and offers distinct advantages over conventional radiation techniques.