Are lateral electronic portal images adequate for accurate on-line daily targeting of the prostate? Results of a prospective study

Lometti, M.; Thurston, D.; Aubin, Michèle; Lockhart, J. M.; Bland, R.; Roach, Mack; Pouliot, Jean

doi:10.1016/j.ijrobp.2004.07.384

Cited by 1 publication

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“…Image-guided radiotherapy (IGRT) using implanted gold fiducial markers is the gold standard treatment technique for prostate radiotherapy [14][15][16][17] as it does not have the dose associated with cone-beam computed tomography (CBCT), it is not open to variation in prostate delineation by practitioners 18 and has the potential for reducing PTV margins and thus enable greater dose escalation and reduce organ at risk (OAR) toxicity. [19][20][21] However, fiducial markers are invasive and expensive and it is unclear whether some patients would benefit more from IGRT than others.…”

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confidence: 99%

Does body mass index or subcutaneous adipose tissue thickness affect interfraction prostate motion in patients receiving radical prostate radiotherapy?

2016

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AimIt is unclear whether body mass index (BMI) is a useful measurement for examining prostate motion. Patient’s subcutaneous adipose tissue thickness (SAT) and weight has been shown to correlate with prostate shifts in the left/right direction. We sought to analyse the relationship between BMI and interfraction prostate movement in order to determine planning target volume (PTV) margins based on patient BMI.Materials and methodsIn all, 38 prostate cancer patients with three implanted gold fiducial markers in their prostate were recruited. Height, mass and SAT were measured, and the extent of interfraction prostate movement in the left/right, superior/inferior and anterior/posterior directions was recorded during each daily fiducial marker-based image-guided radiotherapy treatment. Mean corrective shift in each direction for each patient, along with BMI values, were calculated.ResultsThe median BMI value was 28·4 kg/m2 (range 21·4–44·7). Pearson’s product-moment correlation analysis showed no significant relationship between BMI, mass or SAT and the extent of prostate movement in any direction. Linear regression analysis also showed no relationship between any of the patient variables and the extent of prostate movement in any direction (BMI: R2=0·006 (ρ=0·65), 0·002 (ρ=0·80) and 0·001 (ρ=0·86); mass: R2=0·001 (ρ=0·87), 0·010 (ρ=0·54) and 0·000 (ρ=0·99); SAT: R2=0·012 (ρ=0·51), 0·013 (ρ=0·50) and 0·047 (ρ=0·19) for shifts in the X, Y and Z axis, respectively). Patients were grouped according to BMI, as BMI<30 (n=25, 65·8%) and BMI≥30 (n=13, 34·2%). A two-tailed t-test showed no significant difference between the mean prostate shifts for the two groups in any direction (ρ=0·320, 0·839 and 0·325 for shifts in the X, Y and Z axis, respectively).FindingsBMI is not a useful parameter for determining individualised PTV margins. Gold fiducial marker insertion should be used as standard to improve treatment accuracy.

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