Intraprostatic fiducials for localization of the prostate gland: Monitoring intermarker distances during radiation therapy to test for marker stability

Kupelian, Patrick A.; Willoughby, Twyla R.; Meeks, Sanford L.; Forbes, Alan; Wagner, Thomas H.; Maach, Mourad; Langen, K

doi:10.1016/j.ijrobp.2005.01.005

Cited by 146 publications

(111 citation statements)

References 26 publications

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“…There is a case for guidelines to be developed regarding best position of markers. The absence of marker migration during treatment agrees with that in previous studies (12,11,22,19,20).…”

Section: Discussionsupporting

confidence: 92%

“…There was no indication of either prostate swelling (increased separation of markers) or shrinking (decreased separation of markers) which might have been caused by prostate swelling or constriction due to radiotherapy or continual hormone therapy respectively. 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.…”

Section: Discussionsupporting

confidence: 77%

“…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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“…There is a case for guidelines to be developed regarding best position of markers. The absence of marker migration during treatment agrees with that in previous studies (12,11,22,19,20).…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 77%

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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“…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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“…[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%

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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Intraprostatic fiducials for localization of the prostate gland: Monitoring intermarker distances during radiation therapy to test for marker stability

Cited by 146 publications

References 26 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

Quantification of the margin required for treating intraprostatic lesions

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

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