A study of image-guided radiotherapy of bladder cancer based on lipiodol injection in the bladder wall

Søndergaard, Jimmi; Olsen, Kasper Ørding; Muren, L.P.; Elstrøm, U.V.; Grau, Cai; Høyer, Morten

doi:10.3109/02841861003789491

Cited by 42 publications

(66 citation statements)

References 15 publications

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“…Sondergaard et al, Chai et al, and Pos et al all reported increased accuracy when using a Lipiodol registration on kV cone beam computed tomography (CBCT) compared to other conventional methods of registration [14][15][16]. One study reported on the accuracy of using a general mask registration (one large spot) and a sub mask registration (multiple spots) [15].…”

Section: Impact On Reducing Set-up Errors and Enhancing Image Registrmentioning

confidence: 99%

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A review of the use of fiducial markers for image-guided bladder radiotherapy

Nolan

Forde

2015

Acta Oncologica

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Background: Enhancing target visualization and reducing set-up errors in image-guided radiotherapy (IGRT) are issues faced when trying to implement more conformal and partial bladder techniques. This review examines the evidence available pertaining to the clinical use of Lipiodol and gold fiducials for IGRT for bladder cancer. Material and methods: Nine published articles relating to the feasibility of using Lipiodol injections or gold fiducial markers in IGRT for bladder patients were recruited from a database search strategy. Set-up errors were evaluated in addition to the stability and visibility of each on verification imaging. Adverse reactions from the insertion of each method were also assessed. Results: Both Lipiodol and gold fiducials have the potential to remain stable and visible in the bladder, however, fading, washout and seed loss was also reported. Set-up errors can be reduced by using Lipiodol or fiducial registration when compared to other registration techniques. Adverse reactions reported were minimal for each. Conclusion: Current evidence suggests that Lipiodol injections and gold fiducial markers present as promising and highly accurate methods of overcoming interfraction bladder motion in IGRT.

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Section: Impact On Reducing Set-up Errors and Enhancing Image Registrmentioning

confidence: 99%

“…Sondergaard et al reported difficulty in the visualization of the Lipiodol spots on 2D kV images and did not report on accuracy of matches using this modality [14].…”

Section: Impact On Reducing Set-up Errors and Enhancing Image Registrmentioning

confidence: 99%

A review of the use of fiducial markers for image-guided bladder radiotherapy

Nolan

Forde

2015

Acta Oncologica

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“…Patients were treated with an empty bladder for all fractions, and received 48 Gy to the lymph nodes, 60 Gy to the bladder and an additional 10 Gy tumor boost dose. Both strategies have been described in further detail previously [3,6,11]; the CBCT-strategy was a combination of the strategy as described by Vestergaard et al [6], and an unpublished dose escalation study.…”

Section: Plan Selection Strategies and Fractionationmentioning

confidence: 99%

“…For each of these patients, two planning CT scans and 20 CBCT scans were available. For the CBCT-based strategy, we selected 10 patients from the AUH, previously included in a feasibility study on fiducial marker based image-guided radiotherapy [11]. These patients were treated between 2008 and 2013 with a non-adaptive treatment strategy.…”

Section: Patient and Image Datamentioning

confidence: 99%

“…Patient and treatment characteristics are detailed in Supplementary Table 1 (available online at http://www.informahealthcare.com). All patients had cystoscopically placed fiducial markers [10,11]. Ten consecutive patients were selected from the AMC, who were treated between 2013 and 2014, with plan selection ART based on the CT-based strategy.…”

Section: Patient and Image Datamentioning

confidence: 99%

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A biological modeling based comparison of two strategies for adaptive radiotherapy of urinary bladder cancer

et al. 2016

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Background Adaptive radiotherapy is introduced in the management of urinary bladder cancer to account for day-to-day anatomical changes. The purpose of this study was to determine whether an adaptive plan selection strategy using either the first four cone beam computed tomography scans (CBCT-based strategy) for plan creation, or the interpolation of bladder volumes on pretreatment CT scans (CT-based strategy), is better in terms of tumor control probability (TCP) and normal tissue sparing while taking the clinically applied fractionation schedules also into account. Material and methods With the CT-based strategy, a library of five plans was created. Patients received 55 Gy to the bladder tumor and 40 Gy to the non-involved bladder and lymph nodes, in 20 fractions. With the CBCT-based strategy, a library of three plans was created, and patients received 70 Gy to the tumor, 60 Gy to the bladder and 48 Gy to the lymph nodes, in 30-35 fractions. Ten patients were analyzed for each adaptive plan selection strategy. TCP was calculated applying the clinically used fractionation schedules, as well as a rescaling of the dose from 55 to 70 Gy for the CT-based strategy. For rectum and bowel, equivalent doses in 2 Gy fractions (EQD2) were calculated. Results The CBCT-based strategy resulted in a median TCP of 75%, compared to 49% for the CT-based strategy, the latter improving to 72% upon rescaling the dose to 70 Gy. A median rectum V30Gy (EQD2) of 26% [interquartile range (IQR): 8-52%] was found for the CT-based strategy, compared to 58% (IQR: 55-73%) for the CBCT-based strategy. Also the bowel doses were lower with the CT-based strategy. Conclusions Whereas the higher total bladder TCP for the CBCT-based strategy is due to prescription differences, the adaptive strategy based on CT scans results in the lowest rectum and bowel cavity doses.

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