PMC10086341_01
Thoracic computerized tomography (CT) scans for adenoid cystic carcinoma (ACC) in central airway. (A-G) Thoracic CT scans before placing the stent with 125I seeds. (H-N) Thoracic CT scans 35 months after removing the stent with 125I seeds.
fonc-13-837394-g001.jpg
PMC10086341_01_fonc-13-837394-g001.jpg
f1
Thoracic computerized tomography (CT) scanning showed soft tissue nodules at the bifurcation of the right main bronchus ( Figures 1A-G ). The number and distribution of seeds were planed using treatment planning system (TPS) (Beijing Feitianzhaoye Co., Ltd.) ( Figure 3 ) before placement based on the thoracic CT scanning ( Figures 1A-G ). At the most recent follow-up on September 9, 2021, the patient was alive without symptoms, and her central airway looked like normal without stenosis or tumors ( Figures 1H-N ,  2G-I ;  Supplementary File 2 ).
Bronchoscopy pictures in central airway. (A) Adenoid cystic carcinoma (ACC) in lower trachea. (B) ACC in left main bronchus. (C) ACC in right main bronchus. (D) Stent carrying 125I seeds in lower trachea. (E) Stent carrying 125I seeds in left main bronchus. (F) Stent carrying 125I seeds in right main bronchus. (G) lower trachea 35 months after removing the stent. (H) Left main bronchus 35 months after removing the stent. (I) Right main bronchus 35 months after removing the stent.
fonc-13-837394-g002.jpg
PMC10086341_01_fonc-13-837394-g002.jpg
f2
On July 12, 2018, bronchoscopy showed swelling and congestion of mucosa in lower trachea, widened and rough carina, and stenosis in lower trachea and both left and right main bronchi (stenosis in lumen >=50%) ( Figures 2A-C ). On July 24, 2018, under the guidance from bronchoscope, a Y-shaped and stainless-steel stent loaded with 40 radioactive 125I seeds (0.60 mCi) was placed in her lower trachea using bronchoscope ( Figures 2D-F ;  Supplementary File 1 ). At the most recent follow-up on September 9, 2021, the patient was alive without symptoms, and her central airway looked like normal without stenosis or tumors ( Figures 1H-N ,  2G-I ;  Supplementary File 2 ).
The number and distribution of seeds in plan before placement. (A-G) The seeds distribution and isodose distribution in thoracic computerized tomography (CT) scans. (H) Planning target volume (PTV) in three-dimension (3D). (I, J)
125I seeds distribution in 3D. (K) Isodose cloud of 120Gy in 3D. Red seeds: 125I seeds. Red curve: target area in planning. Green curve: Isodose curve of 120Gy.
fonc-13-837394-g003.jpg
PMC10086341_01_fonc-13-837394-g003.jpg
f3
The number and distribution of seeds were planed using treatment planning system (TPS) (Beijing Feitianzhaoye Co., Ltd.) ( Figure 3 ) before placement based on the thoracic CT scanning ( Figures 1A-G ).