CyberKnife® (Accuray Incorporated, Sunnyvale, CA) Frameless Image-Guided Radiosurgery [1, 2] with the Synchrony® Motion Tracking Module (Accuray Incorporated) [3, 4] is now available for the treatment of thoracic malignancies. Gold fiducial markers are required for the treatment planning and tracking of the tumor during each treatment. Fiducials have traditionally been placed percutaneously under CT-guidance. This chapter describes our center's experience placing fiducials using flexible bronchoscopy with a transbronchial aspiration needle (TBNA).
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