Endoscopy/EUS-guided fiducial marker placement in patients with esophageal cancer: a comparative analysis of 3 types of markers

Machiels, Mélanie; Hooft, Jeanin E. van; Jin, Peng; Henegouwen, Mark I. van Berge; Laarhoven, Hanneke W. M. van; Alderliesten, Tanja; Hulshof, Maarten C.C.M.

doi:10.1016/j.gie.2015.03.1972

Cited by 59 publications

(59 citation statements)

References 16 publications

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“…The use of other liquid fiducial markers for CT and MR imaging has been reported in the literature. TraceIT ® (Augmenix Inc, Waltham, MA, USA), a hydrogel‐based marker, has been reported for use in gynecological, bladder, and esophageal cancer with sufficient visibility in both imaging modalities. However, due to their low X‐ray attenuation, rather large volumes > 0.4 mL had to be applied for sufficient visibility, preventing the formation of small discrete markers.…”

Section: Discussionmentioning

confidence: 99%

“…However, due to their low X‐ray attenuation, rather large volumes > 0.4 mL had to be applied for sufficient visibility, preventing the formation of small discrete markers. Furthermore, long‐term stability, which is crucial for fractionated radiotherapy of several weeks, has been reported to be limited . Terry et al reported the in vitro use of aqueous solutions of iopamidol for CT and MR imaging and concluded that a 10% aqueous solution proved to be optimal with respect to visibility and low degree of artifacts.…”

Section: Discussionmentioning

confidence: 99%

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Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

et al. 2017

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The liquid fiducial marker causes signal voids on MRI due to its absence of water hydrogen atoms without strongly affecting the magnetic field in the surrounding tissue. The alteration of the static magnetic field was found to be the main effect leading to the visibility of the solid fiducial markers. Hence, especially when a low level of image distortion is required, MRI characteristics of the liquid marker surpass those of solid gold markers currently being used for IGRT of PDAC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

et al. 2017

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“…In our opinion, the use of the Gold Anchor marker should be limited to use of the 25 G needle and in combination with the other types of markers. Only few studies have compared the use of different fiducial in the terms of efficacy and complications [32,33] . Our study differs from others because it compares the two different types of gold fiducial markers in terms of usability for CyberKnife treatment.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic usability of two different fiducial gold markers for robotic stereotactic radiosurgery of liver malignancies: A pilot study

Marsico¹,

Gabbani²,

Livi³

et al. 2016

WJH

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AIM:To assess how the application of different types of markers affects the tracking accuracy of CyberKnife's. METHODS:Fifteen patients were recruited and subjected to the ultrasound-guided placement of markers. Two different type of needles 25 gauge (G) and 17 G containing two different fiducial marker, gold notched flexible anchor wire 0.28 mm × 10 mm (25 G needle) and gold cylindrical grain 1 mm × 4 mm (17 G), were used. Seven days after the procedure, a CyberKnife planning computed tomography (CT) for the simulation of radiation treatment was performed on all patients. Therapeutic usability of two different fiducial gold markers for robotic stereotactic radiosurgery of liver malignancies: A pilot study Clinical Trials Study ORIGINAL ARTICLEA binary CT score was assigned to the fiducial markers visualization. Also, the CT number was calculated for each fiducial and the values compared with a specific threshold. RESULTS:For each patient from 1 to 5, intra-hepatic markers were placed (one in 2 patients, three in 8 patients, four in 3 patients, and five in 2 patients). A total of 48 needles were used (thirty-two 17 G and sixteen 25 G) and 48 gold markers were placed (32 Grain shaped markers and 16 Gold Anchor). The result showed that the CT visualization of the grain markers was better than the anchor markers (P = 5 × 10 -9 ). Furthermore, the grain markers were shown to present minor late complications (P = 3 × 10 -6 ), and the best CT threshold number (P = 0.0005). CONCLUSION:The study revealed that the Gold Anchor fiducial marker is correlated with a greater number of late minor complications and low visualization by the CT. Core tip: Robotic radiosurgery can employ different systems for the localization of the neoplastic targets to treat. The purpose of this study is to assess how the application of different types of markers affects the tracking accuracy of CyberKnife's. Fifteen patients have been recruited and analyzed for the study and two types of markers were used for the procedure. The computed tomography (CT) visualization of grain markers was better than anchor markers P = 5 × 10 -9. Grain markers presented minor late complications of P = 3 × 10 -6, and the best CT threshold number. The study revealed that the Gold Anchor fiducial marker is correlated with a greater number of late minor complication.Marsico M, Gabbani T, Livi L, Biagini MR, Galli A. Therapeutic usability of two different fiducial gold markers for robotic stereotactic radiosurgery of liver malignancies: A pilot study.

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“…In that particular study, motion in the cranial-caudal direction maximally reached 13.8 mm in the lower thoracic esophagus, 7.4 mm in the middle esophagus, and 4.3 mm in the upper esophagus. Investigators are beginning to realize the benefit of fiducials in radiation treatment planning for cancers of the esophagus 28 and studies have demonstrated that implantation of esophageal fiducial markers are both safe and feasible for target volume delineation purposes on CT 28 . However, to our knowledge, the discordance between endoscopically placed fiducial markers and PET MTV in esophageal cancer has not been investigated.…”

Section: Discussionmentioning

confidence: 99%

Fiducial markers coupled with 3D PET/CT offer more accurate radiation treatment delivery for locally advanced esophageal cancer

et al. 2017

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Background and aims The role of three-dimensional positron emission tomography/computed tomography (3 D PET/CT) in esophageal tumors that move with respiration and have potential for significant mucosal inflammation is unclear. The aim of this study was to determine the correlation between gross tumor volumes derived from 3 D PET/CT and endoscopically placed fiducial markers. Methods This was a retrospective, IRB approved analysis of 40 patients with esophageal cancer with fiducials implanted and PET/CT. The centroid of each fiducial was identified on PET/CT images. Distance between tumor volume and fiducials was measured using axial slices. Image features were extracted and tested for pathologic response predictability. Results The median adaptively calculated threshold value of the standardized uptake value (SUV) to define the metabolic tumor volume (MTV) border was 2.50, which corresponded to a median 23 % of the maximum SUV. The median distance between the inferior fiducial centroid and MTV was – 0.60 cm (– 3.9 to 2.7 cm). The median distance between the superior fiducial centroid and MTV was 1.25 cm (– 4.2 to 6.9 cm). There was no correlation between MTV-to-fiducial distances greater than 2 cm and the gastroenterologist who performed the fiducial implantation. Eccentricity demonstrated statistically significant correlations with pathologic response. Conclusions There was a stronger correlation between inferior fiducial location and MTV border compared to the superior extent. The etiology of the discordance superiorly is unclear, potentially representing benign secondary esophagitis, presence of malignant nodes, inflammation caused by technical aspects of the fiducial placement itself, or potential submucosal disease. Given the concordance inferiorly and the ability to more precisely set up the patient with daily image guidance matching to fiducials, it may be possible to minimize the planning tumor volume (PTV) margin in select patients, thereby, limiting dose to normal structures.

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Endoscopy/EUS-guided fiducial marker placement in patients with esophageal cancer: a comparative analysis of 3 types of markers

Cited by 59 publications

References 16 publications

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

Therapeutic usability of two different fiducial gold markers for robotic stereotactic radiosurgery of liver malignancies: A pilot study

Fiducial markers coupled with 3D PET/CT offer more accurate radiation treatment delivery for locally advanced esophageal cancer

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