Introduction: Radiotherapy for the primary treatment of bladder cancer is becoming increasingly common. Several studies have shown that fiducial marking of the site of the primary tumour can assist with radiotherapy planning and reduce dosimetry to surrounding benign bladder tissue. Lipiodol, which is Iodinated contrast agent can be injected cystoscopically and serve as a fiducial marker to demarcate the primary bladder tagets for radiotherapy.
Few studies have looked at the ideal technique and dose of lipiodol injection. Furthermore those study is typically advise 5 mL of concentrated lipiodol injected in 1mL aliquats through a rigid cystoscope with a williams cystoscopic needle, which tends to lead to excessive urothelial migration of the lipiodol.
We described a novel technique of 100uL injections of 1:3 dilute lipiodol performed via flexible cystoscopy under local anaesthesia.
Methods: After obtaining patient consent, we video-recorded a case of cystoscopic injection of Lipiodol in a patient selected for image guided radiotherapy treatment (IGRT).
Using iMovie editing software we prepared a video describing this technique.
Results: This technique for injection has been successfully implemented at our single centre and has allowed effective delivery of targeted radiotherapy treatment using Lipiodol as a fiducial marker.
Conclusions: This is a simple, reproducible, and easily performed office procedure with durable results and minimal lipiodol migration.