Clinical results from first use of prostate stent as fiducial for radiotherapy of prostate cancer

Carl, Jesper; Nielsen, Jesper; Holmberg, Mats; Larsen, Erik Hoejkjaer; Fabrin, Knud; Fisker, Rune Vincents

doi:10.3109/0284186x.2010.541935

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…They are visible on kV and MV images, create no artefact on CT and are suitable for MRI. 44 Further evidence is needed to justify the complex surgical procedure and associated risks required to implant these.…”

Section: Number and Types Of Fiducial Markersmentioning

confidence: 99%

Fiducial marker guided prostate radiotherapy: a review

O’Neill¹,

Jain²,

Hounsell³

et al. 2016

The British Journal of Radiology

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Image-guided radiotherapy (IGRT) is an essential tool in the accurate delivery of modern radiotherapy techniques. Prostate radiotherapy positioned using skin marks or bony anatomy may be adequate for delivering a relatively homogeneous whole-pelvic radiotherapy dose, but these surrogates are not reliable when using reduced margins, dose escalation or hypofractionated stereotactic radiotherapy. Fiducial markers (FMs) for prostate IGRT have been in use since the 1990s. They require surgical implantation and provide a surrogate for the position of the prostate gland. A variety of FMs are available and they can be used in a number of ways. This review aimed to establish the evidence for using prostate FMs in terms of feasibility, implantation procedures, types of FMs used, FM migration, imaging modalities used and the clinical impact of FMs. A search strategy was defined and a literature search was carried out in Medline. Inclusion and exclusion criteria were applied, which resulted in 50 articles being included in this review. The evidence demonstrates that FMs provide a more accurate surrogate for the position of the prostate than either external skin marks or bony anatomy. A combination of FM alignment and soft-tissue analysis is currently the most effective and widely available approach to ensuring accuracy in prostate IGRT. FM implantation is safe and well tolerated. FM migration is possible but minimal. Standardization of all techniques and procedures in relation to the use of prostate FMs is required. Finally, a clinical trial investigating a non-surgical alternative to prostate FMs is introduced.

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Section: Number and Types Of Fiducial Markersmentioning

confidence: 99%

Fiducial marker guided prostate radiotherapy: a review

O’Neill¹,

Jain²,

Hounsell³

et al. 2016

The British Journal of Radiology

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“…Carl et al 10 , 27 have presented a removable thermoexpandable Ni‐Ti prostate stent as an alternative to gold markers, which is now used in the clinic at Aalborg University Hospital. A recent study has found a significantly smaller CTV and reduced urinary frequency and urinary retention toxicity scores using MR images followed by a MR‐CT registration using the stent as a fiducial marker, when compared to long‐term toxicity when CT was used for prostate delineation (28) …”

Section: Introductionmentioning

confidence: 99%

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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“…However, in a previous study two different MR scans in the same patients were coregistered using the same method and very minor difference in shape was observed. 31 The registration was a local constrained registration of the prostate using a prostate stent as the fiducial marker. The pelvic bones were used as a first registration to establish an initial registration and to facilitate rotational constrains to prevent unrealistic rotations around the center axes of the stent.…”

Section: Discussionmentioning

confidence: 99%