Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy

Schiffner, Daniel C.; Gottschalk, Alexander; Lometti, M.; Aubin, Michèle; Pouliot, Jean; Speight, Joycelyn L.; Hsu, I-Chow; Shinohara, Katsuto; Roach, Mack

doi:10.1016/j.ijrobp.2006.09.042

Cited by 102 publications

(89 citation statements)

References 35 publications

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“…Image-guided respiratory-gated radiation therapy has been a major advancement in minimizing inter-and intra-fractional target variations. To minimize and correct for setup uncertainties and inter-fractional motion of extracranial tumors, various immobilization and localization techniques have been clinically implemented, including transabdominal ultrasonography (Lattanzi et al 1999;Chandra et al 2003;Langen et al 2003), megavoltage imaging (Schiffner et al 2007;Serago et al 2006), kilovoltage imaging (Jaffray et al 1999;Kupelian et al 2008), use of an in-room computed tomography (CT)-linear accelerator system (Court et al 2003;Wong et al 2005), cone-beam CT (Jaffray et al 1999;Kupelian et al 2008), and placement of internal fiducials (Kupelian et al 2008;Chen et al 2007;Chung et al 2004). Pancreatic tumor targets usually exhibit inter-fractional motion relative to the bony anatomy because of daily variation in stomach and duodenal filling and respiratory patterns.…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiotherapy for Pancreatic Adenocarcinoma: Set-Up Error Correction Using Internal Markers and It’s Association with the Patient’s Body Mass Index

Lin¹,

Chen²,

Baine³

2012

Modern Practices in Radiation Therapy

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Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiotherapy for Pancreatic Adenocarcinoma: Set-Up Error Correction Using Internal Markers and It’s Association with the Patient’s Body Mass Index

Lin¹,

Chen²,

Baine³

2012

Modern Practices in Radiation Therapy

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“…Inter‐ and intrafractional target motion has been observed in radiation oncology treatment therapy of various disease sites 1 , 4 . The motion can be attributed to physiological internal organ movements, patient setup uncertainties, and patient breathing.…”

Section: Introductionmentioning

confidence: 99%

“…Various techniques of IGRT have been explored including transabdominal ultrasound, 8 , 9 implanted fiducial markers with in‐room MV or kV X‐rays, 4 , 8 optical surface tracking systems, (10) implanted electromagnetic markers, 9 , 11 and in‐room CT‐based systems such as kVCT on rail, kilovoltage or megavoltage cone‐beam CT (CBCT) and helical MVCT. Many of these IGRT methods rely on comparing daily X‐ray images taken at the time of treatment to images created at the time of treatment planning.…”

Section: Introductionmentioning

confidence: 99%

“…Many of these IGRT methods rely on comparing daily X‐ray images taken at the time of treatment to images created at the time of treatment planning. The target geometric deviation is then determined by aligning the soft tissue structures, bony anatomy, (11) implanted fiducial markers, 4 , 7 or other landmarks to the corresponding ones on the original images. When X‐ray‐based imaging is used for IGRT, it is typically at the discretion of the oncologist or radiation therapist to align the daily images with the original treatment planning images, sometimes with the help of computer‐assisted registration software (10) .…”

Section: Introductionmentioning

confidence: 99%

“…Fiducial markers have been used in radiotherapy to assist with the registration process 4 , 7 , 8 , 12 . Normally, fiducial markers are placed inside or adjacent to the target volumes prior to the radiotherapy simulation and serve as surrogates to the target volumes.…”

Section: Introductionmentioning

confidence: 99%

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Determination of optimal fiducial marker across image‐guided radiation therapy (IGRT) modalities: visibility and artifact analysis of gold, carbon, and polymer fiducial markers

Handsfield¹,

Yue²,

Zhou³

et al. 2012

J Applied Clin Med Phys

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The purpose of this study was to evaluate the visibility and artifact created by gold, carbon, and polymer fiducial markers in a simple phantom across computed tomography (CT), kilovoltage (kV), and megavoltage (MV) linear accelerator imaging and MV tomotherapy imaging. Three types of fiducial markers (gold, carbon, and polymer) were investigated for their visibility and artifacts in images acquired with various modalities and with different imaging parameters (kV, mAs, slice thickness). The imaging modalities include kV CT, 2D linac‐based kilovoltage and megavoltage X‐ray imaging systems, kV cone‐beam CT, and normal and fine tomotherapy imaging. The images were acquired on a phantom constructed using Superflab bolus in which markers of each type were inserted into the center layer. The visibility and artifacts produced by each marker were assessed qualitatively and quantitatively. All tested markers could be identified clearly on the acquired CT and linac‐based kV images; gold markers demonstrated the highest contrast. On the CT images, gold markers produced a significant artifact, while no artifacts were observed with polymer markers. Only gold markers were visible when using linac‐based MV and tomotherapy imaging. For linac‐based kV images, the contrast increased with kV and mAs values for all the markers, with the gold being the most pronounced. On CT images, the contrast increased with kV for the gold markers, while decreasing for the polymer and carbon marker. With the bolus phantom used, we found that when kV imaging‐based treatment verification equipment is available, polymer and carbon markers may be the preferred choice for target localization and patient treatment positioning verification due to less image artifacts. If MV imaging will be the sole modality for positioning verification, it may be necessary to use gold markers despite the artifacts they create on the simulation CT images.PACS number: 87

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A 3D conformal radiation therapy class solution for dose escalated prostate irradiation

et al. 2008

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Prostate cancer is a dose responsive neoplasm i.e. the higher the dose of radiation administered, the more likely it is to attain local tumour control. However, high doses without careful conformal treatment planning leads to increased complication rates. This study aims to determine the ideal dosimetric and clinically relevant 3D conformal radiation therapy (3D‐CRT) plan for 78 Gy dose escalated prostate treatment. A pilot study was performed on two patients using computed tomography (CT) images previously acquired to plan their treatment. The planning target volume in one patient encompasses the prostate only (PO) while the other had the prostate and seminal vesicles (PSV) contoured. Three senior radiation therapists and a radiation oncologist evaluated 10 optimised plans and recommended the top three techniques for further investigation. The top three techniques, 5‐field (0, 90, 120, 240, 270 gantry angles), 6‐field (30, 90, 120, 240, 270, 330 gantry angles) and 8‐field (30, 60, 100, 135, 225, 260, 295, 330 gantry angles) were further applied to previously acquired CT images of another three patients, each contoured according to a standardised protocol. The median dose volume histograms (DVH) of the organs at risk (OAR) from five patients were compared to determine the best plan. The 6‐field technique is the best option for dose escalated prostate irradiation. The 8‐field technique produced the highest rectal dose while the 5 and 6‐field techniques showed little variation (P = 0.239). The 6‐field technique produced a plan with significantly less dose to the femoral head and neck compared to the 5‐field technique (P = 0.001).

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Daily electronic portal imaging of implanted gold seed fiducials in patients undergoing radiotherapy after radical prostatectomy

Cited by 102 publications

References 35 publications

Stereotactic Body Radiotherapy for Pancreatic Adenocarcinoma: Set-Up Error Correction Using Internal Markers and It’s Association with the Patient’s Body Mass Index

Stereotactic Body Radiotherapy for Pancreatic Adenocarcinoma: Set-Up Error Correction Using Internal Markers and It’s Association with the Patient’s Body Mass Index

Determination of optimal fiducial marker across image‐guided radiation therapy (IGRT) modalities: visibility and artifact analysis of gold, carbon, and polymer fiducial markers

A 3D conformal radiation therapy class solution for dose escalated prostate irradiation

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