Fiducial marker placement via convex probe EBUS

The efficacy of low-dose computed tomography screening is likely to increase the number of early-stage lung cancers identified. The aging population, as well as increase in number of patients with multiple comorbidities, suggests that nonsurgical techniques such as stereotactic body radiotherapy will be vital in treating such malignancies. Convex probe endobronchial ultrasound facilitates the identification of mediastinal and hilar lymph nodes, in addition to central lung tumors. Using a simple modification of the transbronchial needle aspiration technique, we describe a method for placing fiducial markers into isolated central tumors that ensures appropriate localization for definitive radiotherapy.