A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

McNair, Helen; Hansen, Vibeke; Parker, Christopher; Evans, Philip; Norman, A.; Miles, Elizabeth; Harris, Emma; Delacroix, Louise; Smith, Elizabeth; Keane, Richard D.; Khoo, Vincent; Thompson, Alan; Dearnaley, David P.

doi:10.1016/j.ijrobp.2007.09.002

Cited by 67 publications

(80 citation statements)

References 55 publications

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“…[6][7][8][9][10][11] Before in-room imaging was widely available, Crook et al 6 demonstrated significant prostate gland motion based on FM positions relative to bony landmarks on repeat CT scans in a study of 55 patients. They found the average prostate displacement in the posterior and inferior directions to be 6 mm and that 30% had displacements .10 mm posteriorly, which standard treatment planning margins would not have encompassed.…”

Section: Fiducial Markers For Prostate Image-guided Radiotherapy Feasmentioning

confidence: 99%

Fiducial marker guided prostate radiotherapy: a review

O’Neill¹,

Jain²,

Hounsell³

et al. 2016

The British Journal of Radiology

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Image-guided radiotherapy (IGRT) is an essential tool in the accurate delivery of modern radiotherapy techniques. Prostate radiotherapy positioned using skin marks or bony anatomy may be adequate for delivering a relatively homogeneous whole-pelvic radiotherapy dose, but these surrogates are not reliable when using reduced margins, dose escalation or hypofractionated stereotactic radiotherapy. Fiducial markers (FMs) for prostate IGRT have been in use since the 1990s. They require surgical implantation and provide a surrogate for the position of the prostate gland. A variety of FMs are available and they can be used in a number of ways. This review aimed to establish the evidence for using prostate FMs in terms of feasibility, implantation procedures, types of FMs used, FM migration, imaging modalities used and the clinical impact of FMs. A search strategy was defined and a literature search was carried out in Medline. Inclusion and exclusion criteria were applied, which resulted in 50 articles being included in this review. The evidence demonstrates that FMs provide a more accurate surrogate for the position of the prostate than either external skin marks or bony anatomy. A combination of FM alignment and soft-tissue analysis is currently the most effective and widely available approach to ensuring accuracy in prostate IGRT. FM implantation is safe and well tolerated. FM migration is possible but minimal. Standardization of all techniques and procedures in relation to the use of prostate FMs is required. Finally, a clinical trial investigating a non-surgical alternative to prostate FMs is introduced.

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Section: Fiducial Markers For Prostate Image-guided Radiotherapy Feasmentioning

confidence: 99%

Fiducial marker guided prostate radiotherapy: a review

O’Neill¹,

Jain²,

Hounsell³

et al. 2016

The British Journal of Radiology

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“…For example, the ability to visualise a patient's soft tissue anatomy on a CBCT scan is an improvement on the EPI system, which relies on bony anatomy or radiopaque markers implanted inside the patient. However, the extent to which this is an improvement in radiotherapy treatments for prostate cancer has been debated due to other inaccuracies in the planning process (Moore et al, 2006;McNair et al, 2008). Kaldor (1981) argued that questions of effectiveness or efficiency are difficult to test for with military technologies, which rely on 'real--world' experimentation.…”

Section: Not Necessarily An Improvementmentioning

confidence: 99%

Conceptualising Decadent Technology: A Case Study of Path Dependence in Radiotherapy

Wood

2015

Science as Culture

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“…McNair et al [14] compared setup error correction methods by using the bony anatomy and gold markers implanted in the prostate. Corrections made by means of the gold markers resulted in a more accurate setup than did those made based on the bony anatomy.…”

Section: Introductionmentioning

confidence: 99%

Impact of pitch angle setup error and setup error correction on dose distribution in volumetric modulated arc therapy for prostate cancer

Takemura

Togawa

Yokoi

et al. 2016

Radiol Phys Technol

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In volumetric modulated arc therapy (VMAT) for prostate cancer, a positional and rotational error correction is performed according to the position and angle of the prostate. The correction often involves body leaning, and there is concern regarding variation in the dose distribution. Our purpose in this study was to evaluate the impact of body pitch rotation on the dose distribution regarding VMAT. Treatment plans were obtained retrospectively from eight patients with prostate cancer. The body in the computed tomography images for the original VMAT plan was shifted to create VMAT plans with virtual pitch angle errors of ±1.5 and ±3 degrees. Dose distributions for the tilted plans were recalculated with use of the same beam arrangement as that used for the original VMAT plan. The mean value of the maximum dose differences in the dose distributions between the original VMAT plan and the tilted plans was 2.98 ± 0.96%. The value of the homogeneity index for the planning target volume (PTV) had an increasing trend according to the pitch angle error, and the values of the D 95 for the PTV and D 2ml , V 50 , V 60 and V 70 for the rectum had decreasing trends (p<0.05). However, there was no correlation between differences in these indexes and the maximum dose difference. The pitch angle error caused by body leaning had little effect on the dose distribution, in contrast, the pitch angle correction reduced the effects of organ displacement and improved these indexes. Thus, the pitch angle setup error in VMAT for prostate cancer should be corrected. Keywordsvolumetric modulated arc therapy, prostate cancer, setup error, dose distribution, pitch angle 4

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A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

Cited by 67 publications

References 55 publications

Fiducial marker guided prostate radiotherapy: a review

Fiducial marker guided prostate radiotherapy: a review

Conceptualising Decadent Technology: A Case Study of Path Dependence in Radiotherapy

Impact of pitch angle setup error and setup error correction on dose distribution in volumetric modulated arc therapy for prostate cancer

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