A Prospective Randomized Controlled Trial to Compare the Use of Conventional Dark-Ink Tattoo and Ultraviolet-Ink Tattoo for Patients Undergoing Breast Radiation Therapy

Lim, L.H.; Pang, Eric Pei Ping; Sultana, Rehena; Kusumawidjaja, Grace; Wong, Ru Xin; Yeo, Reuben J.; Ho, Bryan Shihan; Ng, W.L.; Lim, Faye; Chua, Eu Tiong; Sim, A.; Wong, Fuh Yong

doi:10.1016/j.prro.2021.08.001

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…Much more confident.” In a prospective, randomized control trial of 34 breast cancer patients receiving RT, Lim et al. showed that all patients with UV ink tattoos were satisfied with tattoo appearance and did not feel cautious about clothing choices versus 82.4% and 88.2%, respectively, of patients with VITs at 6 weeks post-RT ( 10 ). Furthermore, of 12 radiation therapists responding to staff satisfaction surveys, 9 commented that IITs preserve body image perception.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: the PREFER trial

Hardy-Abeloos,

Gorovets,

Lewis

et al. 2024

Front. Oncol.

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IntroductionInvisible ink tattoos (IITs) avoid cosmetic permanence of visible ink tattoos (VITs) while serving as more reliable landmarks for radiation setup than tattooless setups. This trial evaluated patient-reported preference and feasibility of IIT implementation.Methods and materialsIn an IRB-approved, single institution, prospective trial, patients receiving proton therapy underwent IIT-based treatment setup. A survey tool assessed patient preference on tattoos using a Likert scale. Matched patients treated using our institutional standard tattooless setup were identified; treatment times and image guidance requirements were evaluated between tattooless and IIT-based alignment approaches. Distribution differences were estimated using Wilcoxon rank-sum tests or Chi-square tests.ResultsOf 94 eligible patients enrolled, median age was 58 years, and 58.5% were female. Most common treatment sites were breast (18.1%), lung (17.0%) and pelvic (14.9%). Patients preferred to receive IITs versus VITs (79.8% pre-treatment and 75.5% post-treatment, respectively). Patients were willing to travel farther from home to avoid VITs versus IITs (p<0.01). Females were willing to travel (45.5% vs. 23.1%; p=0.04) and pay additional money to avoid VITs (34.5% vs. 5.1%; p<0.01). Per-fraction average +treatment time and time from on table/in room to first beam were shorter with IIT-based vs. tattooless setup (12.3min vs. 14.1min; p=0.04 and 24.1min vs. 26.2min; p=0.02, respectively).DiscussionIn the largest prospective trial on IIT-based radiotherapy setup to date, we found that patients prefer IITs to VITs. Additionally, IIT-based alignment is an effective and efficient strategy in comparison with tattooless setup. Standard incorporation of IITs for patient setup should be strongly considered.

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Section: Discussionmentioning

confidence: 99%

Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: the PREFER trial

Hardy-Abeloos,

Gorovets,

Lewis

et al. 2024

Front. Oncol.

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“…Several studies have compared fluorescent ink tattoos with conventional dark ink. Lim et al conducted a prospective randomized trial to compare the reproducibility and body imaging of UV ink tattoos with those of dark ink tattoos in patients with breast cancer [ 10 ]. The authors reported no significant differences in the setup accuracy and body imaging between UV ink tattoos and dark ink tattoos.…”

Section: Discussionmentioning

confidence: 99%

An Invisible Skin Marker for External Beam Radiation Therapy: Utilization of Ultraviolet Fluorescent Marker Pens

Katano¹,

Nozawa²,

Imae³

et al. 2023

Cureus

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Radiation therapy plays an important role in cancer treatment along with surgery and systemic therapy. The total dose of radiation therapy is divided into small doses, and the treatment is typically delivered once a day. The total treatment period can need several weeks or more, and it is necessary to deliver the radiation dose to the target volume within the patient precisely each time. Therefore, the reproducibility of patient positioning is essential for the precision of the dose delivery. Although radiological technologies such as image-guided radiation therapy have also recently been widely used for positioning patients, skin marking is still widely used in many facilities. Skin marking is an inexpensive and universal positioning technique in patients undergoing radiation therapy; however, it is considered a major source of psychological stress. We propose the use of fluorescent ink pens, which are invisible in standard room lighting, as skin markers for radiotherapy. The primary technique of fluorescence emission is widely employed in molecular biological experiments and for assessing cleaning protocols for infection control. This technique may reduce the stress induced by skin markings during radiotherapy.

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“…11 , 12 We found that the use of Tegaderm TM dressing did not result in an increase in set-up time, or additional imaging procedures (CBCT or CT simulation) and cost substantially less compared with permanent ink tattoos. Several other studies have investigated alternative methods to tattooing procedures including semi-permanent marks, 12 UV ink tattoos, 11 embedded couch values 14 and surface guided radiotherapy (SGRT). 15 -16 Each of these offered alternatives that have proven to be as reliable as permanent tattoos, but resulted in a greater cost, increased set-up time on the treatment unit, difficulty finding UV ink tattoos or substantial training time and changes to departmental procedures.…”

Section: Discussionmentioning

confidence: 99%

Eliminating tattoos for short course palliative radiation therapy: Set-up error, satisfaction and cost

Javor

Cashell

Rosewall

et al. 2022

Journal of Medical Imaging and Radiation Sciences

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A Prospective Randomized Controlled Trial to Compare the Use of Conventional Dark-Ink Tattoo and Ultraviolet-Ink Tattoo for Patients Undergoing Breast Radiation Therapy

Cited by 10 publications

References 11 publications

Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: the PREFER trial

Prospective evaluation of patient-reported outcomes of invisible ink tattoos for the delivery of external beam radiation therapy: the PREFER trial

An Invisible Skin Marker for External Beam Radiation Therapy: Utilization of Ultraviolet Fluorescent Marker Pens

Eliminating tattoos for short course palliative radiation therapy: Set-up error, satisfaction and cost

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