Image-guided radiation therapy for prostate cancer: A computed tomography–based assessment of fiducial marker migration between placement and 7 days

Kumar, Kiran A; Wu, Tianming; Tonlaar, Nathan; Stepaniak, Christopher; Yenice, Kamil M.; Liauw, Stanley L.

doi:10.1016/j.prro.2014.11.007

Cited by 10 publications

(13 citation statements)

References 16 publications

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“…Three of these 8 patients showed a reduction in intermarker distance of approximately 6 mm within 52 days due to a global reduction in prostate volume. Kumar et al [6] has specifically evaluated fiducial marker migration following insertion and 7 days after in 100 patients and found a mean distance of 0.78±0.45 mm. In their study, 99 of 100 patients had migration less than 2 mm therefore they concluded that clinically significant migration does not occur immediately after insertion as well as marker insertion technique, prostate size and marker location do not affect migration considerably.…”

Section: Discussionmentioning

confidence: 99%

“…[ [6][7][8][9][10][11][12] The distance of marker migration was not statistically significant for the groups organized according to the timing of marker insertion, prostate volume, patient age, PSA level and Gleason score. Seven of 39 patients had a maximum distance of more than 2 mm which was accepted as clinically significant marker migration.…”

Section: Discussionmentioning

confidence: 99%

“…Seven of 39 patients had a maximum distance of more than 2 mm which was accepted as clinically significant marker migration. [6,9] A number of limitations exited in our study, first it was a retrospective study. The study has also small sample size.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12][13] It is not clear whether clinically significant fiducial marker migration happens immediately after insertion because of prostatic swelling or bleeding. To allow for an initial migration or settling of the fiducial markers, computed tomography (CT) for radiotherapy planning is generally performed several days after marker insertion.…”

Section: Introductionmentioning

confidence: 99%

“…Also this situation may result in increased cost and delayed radiotherapy because of recurrent patient visits. [6] The aim of this study was to determine whether significant fiducial marker migration occurs within the interval between the prostatic marker insertion and radiotherapy treatment planning CT and if a waiting period is necessary.…”

Section: Introductionmentioning

confidence: 99%

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Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation

Arpaci

Uğurluer

Ispir

et al. 2017

Turkish Journal of Urology

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Objective: The aim of this study was to determine whether significant fiducial marker migration occurs between the periods of prostatic marker insertion and computed tomography (CT) performed for radiotherapy planning and if a waiting period is necessary. Material and methods:Thirty-nine patients with prostate adenocarcinoma underwent fiducial marker insertion before radiotherapy between June 2013 and December 2015. Three markers were inserted by one radiologist under the guidance of transrectal ultrasonography. All patients underwent CT three hours after insertion to confirm the number and position of fiducial markers. Radiotherapy planning CT was performed on an average of 11 days (range 7-20) after insertion. CT images were imported into treatment planning system to analyze the position of fiducial markers. Point-based marker match algorithm was used to find the distance of marker migration. The mean and maximum distances between each fiducial markers were calculated. Results:The mean distance of migration was 1.029±0.42 mm (range 0.23-1.93 mm) and the maximum distance was 1.361±0.59 mm (range 0.25-2.74 mm). The distance of marker migration was not statistically significant for the groups organized according to the timing of marker insertion, prostate volume, patient age, prostate specific antigen level and Gleason score. Conclusion:According to our results significant fiducial marker migration did not occur during the interval between insertion and treatment planning CT. It should be taken into consideration that performing simulation on the same day as marker insertion might prevent increased cost and delayed radiation therapy by saving the patients from extra visits to the clinic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation

Arpaci

Uğurluer

Ispir

et al. 2017

Turkish Journal of Urology

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Using C‐Arm X‐ray images from marker insertion to confirm the gold fiducial marker identification in an MRI‐only prostate radiotherapy workflow

Gustafsson

Persson

Gunnlaugsson

et al. 2018

J Applied Clin Med Phys

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Prostate cancer radiotherapy workflows, solely based on magnetic resonance imaging (MRI), are now in clinical use. In these workflows, intraprostatic gold fiducial markers (GFM) show similar signal behavior as calcifications and bleeding in T2‐weighted MRI‐images. Accurate GFM identification in MRI‐only radiotherapy workflows is therefore a major challenge. C‐arm X‐ray images (CkV‐images), acquired at GFM implantation, could provide GFM position information and be used to confirm correct identification in T2‐weighted MRI‐images. This would require negligible GFM migration between implantation and MRI‐imaging. Marker migration was therefore investigated. The aim of this study was to show the feasibility of using CkV‐images to confirm GFM identification in an MRI‐only prostate radiotherapy workflow. An anterior‐posterior digitally reconstructed radiograph (DRR)‐image and a mirrored posterior‐anterior CkV‐image were acquired two weeks apart for 16 patients in an MRI‐only radiotherapy workflow. The DRR‐image originated from synthetic CT‐images (created from MRI‐images). A common image geometry was defined between the DRR‐ and CkV‐image for each patient. A rigid registration between the GFM center of mass (CoM) coordinates was performed and the distance between each of the GFM in the DRR‐ and registered CkV‐image was calculated. The same methodology was used to assess GFM migration for 31 patients in a CT‐based radiotherapy workflow. The distance calculated was considered a measure of GFM migration. A statistical test was performed to assess any difference between the cohorts. The mean absolute distance difference for the GFM CoM between the DRR‐ and CkV‐image in the MRI‐only cohort was 1.7 ± 1.4 mm. The mean GFM migration was 1.2 ± 0.7 mm. No significant difference between the measured total distances of the two cohorts could be detected (P = 0.37). This demonstrated that, a C‐Arm X‐ray image acquired from the GFM implantation procedure could be used to confirm GFM identification from MRI‐images. GFM migration was present but did not constitute a problem.

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Implanted fiducial markers are no longer needed for prostate cancer radiotherapy

2017

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Image-guided radiation therapy for prostate cancer: A computed tomography–based assessment of fiducial marker migration between placement and 7 days

Cited by 10 publications

References 16 publications

Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation

Computed tomography based evaluation of prostatic fiducial marker migration between the periods of insertion and simulation

Using C‐Arm X‐ray images from marker insertion to confirm the gold fiducial marker identification in an MRI‐only prostate radiotherapy workflow

Implanted fiducial markers are no longer needed for prostate cancer radiotherapy

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