Clinical feasibility study for the use of implanted gold seeds in the prostate as reliable positioning markers during megavoltage irradiation

Dehnad, Homan; Nederveen, Aart J.; Heide, Uulke A. van der; Moorselaar, R. Jeroen A. van; Hofman, P.; Lagendijk, J J W

doi:10.1016/s0167-8140(03)00078-1

Cited by 162 publications

(108 citation statements)

References 21 publications

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“…Where the position of the markers within the prostate has been stated in other studies it is either in both lobes and apex, when there were 3 markers used (27,19), or at the base and the apex (40,41,20,22). Only one study was specific in stating that the markers should be at some distance from the rectal wall and urethra (11) which is in accordance of our experience. There is a case for guidelines to be developed regarding best position of markers.…”

Section: Discussionsupporting

confidence: 78%

“…Cone beam CT is being explored but involves purchasing additional equipment for each linear accelerator and increased time on the treatment unit. An alternative approach, which is already routine in clinical practice in several centres (11,12,13,14,15) is to use fiducial marker seeds implanted within the prostate.…”

Section: Introductionmentioning

confidence: 99%

“…Other authors have shown that the use of gold markers is clinically feasible (18,11,19), that there is no significant marker migration within the prostate (20,21,22) and that there is independent prostate movement (23,24)relative to bony anatomy. The consequence of using bony anatomy for prostate position verification instead of gold markers using an off-line protocol has also been shown [29,24].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

McNair

Hansen

Parker

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

McNair

Hansen

Parker

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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“…The conclusion of the study was that with the currently used margins of more than 4 mm and the treatment divided into fractions, the increase of rectum dose caused by prostate deformation can be negligible. These findings are supported in the studies by van der Wielen et al, (16) Dehnad et al, (20) and Deurloo et al (17) where fiducial markers implanted into the prostate and CT prostate delineation, respectively, were used to investigate the prostate deformation. Other studies 18 , 19 have found that prostate deformation can occur and is an important source of uncertainty in radiotherapy of prostate cancer.…”

Section: Introductionsupporting

confidence: 63%

Comparison of manual and automatic MR‐CT registration for radiotherapy of prostate cancer

Korsager

Carl

Østergaard

2016

J Applied Clin Med Phys

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In image‐guided radiotherapy (IGRT) of prostate cancer, delineation of the clinical target volume (CTV) often relies on magnetic resonance (MR) because of its good soft‐tissue visualization. Registration of MR and computed tomography (CT) is required in order to add this accurate delineation to the dose planning CT. An automatic approach for local MR‐CT registration of the prostate has previously been developed using a voxel property‐based registration as an alternative to a manual landmark‐based registration. The aim of this study is to compare the two registration approaches and to investigate the clinical potential for replacing the manual registration with the automatic registration. Registrations and analysis were performed for 30 prostate cancer patients treated with IGRT using a Ni‐Ti prostate stent as a fiducial marker. The comparison included computing translational and rotational differences between the approaches, visual inspection, and computing the overlap of the CTV. The computed mean translational difference was 1.65, 1.60, and 1.80 mm and the computed mean rotational difference was 1.51°, 3.93°, and 2.09° in the superior/inferior, anterior/posterior, and medial/lateral direction, respectively. The sensitivity of overlap was 87%. The results demonstrate that the automatic registration approach performs registrations comparable to the manual registration.PACS number(s): 87.57.nj, 87.61.‐c, 87.57.Q‐, 87.56.J‐

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“…Shirato et al (26) and Nichol and colleagues (19) found a significant in‐migration of fiducial markers of 0.05 mm/fraction, while Dehnad et al (29) and Kupelian et al (30) concluded that fiducial migration was minimal. We plotted the average fiducial marker deviation from the true distance over the treatment course (Fig.…”

Section: Discussionmentioning

confidence: 99%

Quantification of the margin required for treating intraprostatic lesions

Studenski

Valenciaga

Abramowitz

et al. 2016

J Applied Clin Med Phys

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Advances in magnetic resonance imaging (MRI) sequences allow physicians to define the dominant intraprostatic lesion (IPL) in prostate radiation therapy treatments allowing for dose escalation and potentially increased tumor control. This work quantifies the margin required around the MRI‐defined IPL accounting for both prostate motion and deformation. Ten patients treated with a simultaneous integrated intraprostatic boost (SIIB) were retrospectively selected and replanned with incremental 1 mm margins from 0‐5 mm around the IPL to determine if there were any significant differences in dosimetric parameters. Sensitivity analysis was then performed accounting for random and systematic uncertainties in both prostate motion and deformation to ensure adequate dose was delivered to the IPL. Prostate deformation was assessed using daily CBCT imaging and implanted fiducial markers. The average IPL volume without margin was 2.3% of the PTV volume and increased to 11.8% with a 5 mm margin. Despite these changes in volume, the only statistically significant dosimetric difference was found for the PTV maximum dose, which increased with increasing margin. The sensitivity analysis demonstrated that a 3.0 mm margin ensures >95% IPL coverage accounting for both motion and deformation. We found that a margin of 3.0 mm around the MRI defined IPL is sufficient to account for random and systematic errors in IPL position for the majority of cases.PACS number(s): 87.55.de

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Clinical feasibility study for the use of implanted gold seeds in the prostate as reliable positioning markers during megavoltage irradiation

Cited by 162 publications

References 21 publications

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

A Comparison of the Use of Bony Anatomy and Internal Markers for Offline Verification and an Evaluation of the Potential Benefit of Online and Offline Verification Protocols for Prostate Radiotherapy

Comparison of manual and automatic MR‐CT registration for radiotherapy of prostate cancer

Quantification of the margin required for treating intraprostatic lesions

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