MRI visibility of gold fiducial markers for image-guided radiotherapy of rectal cancer

Ende, Roy P.J. van den; Rigter, Lisanne S.; Kerkhof, Ellen M.; Meerten, Els van Persijn van L.; Rijkmans, E.C.; Lambregts, Doenja M. J.; Triest, Baukelien van; Leerdam, Monique E. van; Staring, Marius; Marijnen, Corrie A.M.; Heide, Uulke A. van der

doi:10.1016/j.radonc.2018.11.016

Cited by 15 publications

(15 citation statements)

References 33 publications

(43 reference statements)

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“…Positioning of prostate cancer patients using fiducial markers has been subject to a relatively large number of studies. These markers are visible on MR, but not with 100% sensitivity or specificity [13], [26], [27], [28], [29]. There is therefore an obvious need for patient specific quality control measures.…”

Section: Resultsmentioning

confidence: 99%

“…the use of S-CT for positioning of prostate cancer patients with fiducial markers is a scenario which highlighted in literature. The markers are not directly visualized with MR, but appear as a signal void, which may be confused with for example calcifications [13], [26], [27], [28], [29]. The challenges connected to MR-only treatment planning have been described in a recent review [18].…”

Section: Introductionmentioning

confidence: 99%

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The rationale for MR-only treatment planning for external radiotherapy

Jönsson

Nyholm

Söderkvist

2019

Clinical and Translational Radiation Oncology

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The rationale for MR-only treatment planning for external radiotherapy

Jönsson

Nyholm

Söderkvist

2019

Clinical and Translational Radiation Oncology

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“…The generalizability of this algorithm for MRI-only radiotherapy simulation of other anatomical sites such as the rectum and pancreas may also be worth investigating. 34,35…”

Section: Discussionmentioning

confidence: 99%

A generative adversarial network‐based (GAN‐based) architecture for automatic fiducial marker detection in prostate MRI‐only radiotherapy simulation images

Singhrao

Parikh

et al. 2020

Medical Physics

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Purpose Clinical sites utilizing magnetic resonance imaging (MRI)‐only simulation for prostate radiotherapy planning typically use fiducial markers for pretreatment patient positioning and alignment. Fiducial markers appear as small signal voids in MRI images and are often difficult to discern. Existing clinical methods for fiducial marker localization require multiple MRI sequences and/or manual interaction and specialized expertise. In this study, we develop a robust method for automatic fiducial marker detection in prostate MRI simulation images and quantify the pretreatment alignment accuracy using automatically detected fiducial markers in MRI. Methods and Materials In this study, a deep learning‐based algorithm was used to convert MRI images into labeled fiducial marker volumes. Seventy‐seven prostate cancer patients who received marker implantation prior to MRI and CT simulation imaging were selected for this study. Multiple‐Echo T1‐VIBE MRI images were acquired, and images were stratified (at the patient level) based on the presence of intraprostatic calcifications. Ground truth (GT) contours were defined by an expert on MRI using CT images. Training was done using the pix2pix generative adversarial network (GAN) image‐to‐image translation package and model testing was done using fivefold cross validation. For performance comparison, an experienced medical dosimetrist and a medical physicist each manually contoured fiducial markers in MRI images. The percent of correct detections and F1 classification scores are reported for markers detected using the automatic detection algorithm and human observers. The patient positioning errors were quantified by calculating the target registration errors (TREs) from fiducial marker driven rigid registration between MRI and CBCT images. Target registration errors were quantified for fiducial marker contours defined on MRI by the automatic detection algorithm and the two expert human observers. Results Ninety‐six percent of implanted fiducial markers were correctly identified using the automatic detection algorithm. Two expert raters correctly identified 97% and 96% of fiducial markers, respectively. The F1 classification score was 0.68, 0.75, and 0.72 for the automatic detection algorithm and two human raters, respectively. The main source of false discoveries was intraprostatic calcifications. The mean TRE differences between alignments from automatic detection algorithm and human detected markers and GT were <1 mm. Conclusions We have developed a deep learning‐based approach to automatically detect fiducial markers in MRI‐only simulation images in a clinically representative patient cohort. The automatic detection algorithm‐predicted markers can allow for patient setup with similar accuracy to independent human observers.

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“…In an earlier study, we evaluated the MRI visibility of the fiducials, and we identified 17 out of 34 fiducials on the first MRI and 9 out of 30 fiducials on the second MRI. 27 The Visicoil 0.75 and the Gold Anchor were the best visible fiducials on MRI. In addition, a consensus meeting with a radiologist (EP) and a resident radiation oncologist (ER) was held to identify more fiducials for this study.…”

Section: Mri Processingmentioning

confidence: 93%

Feasibility of Gold Fiducial Markers as a Surrogate for Gross Tumor Volume Position in Image-Guided Radiation Therapy of Rectal Cancer

Ende

Kerkhof

Rigter

et al. 2019

International Journal of Radiation Oncology*Biology*Physics

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This study evaluated the feasibility of fiducials as a surrogate for gross tumor volume position in rectal cancer. Setup correction based on fiducials reduces required margins in the anterior-posterior and craniocaudal directions for a gross tumor volume boost compared with bony anatomy setup correction. Reduction of these marginsPurpose: To evaluate the feasibility of fiducial markers as a surrogate for gross tumor volume (GTV) position in image-guided radiation therapy of rectal cancer. Methods and Materials: We analyzed 35 fiducials in 19 patients with rectal cancer who received short-course radiation therapy or long-course chemoradiation therapy. Magnetic resonance imaging examinations were performed before and after the first week of radiation therapy, and daily pre-and postirradiation cone beam computed tomography scans were acquired in the first week of radiation therapy. Between the 2 magnetic resonance imaging examinations, the fiducial displacement relative to the center of gravity of the GTV (COG GTV ) and the COG GTV displacement relative to bony anatomy were determined. Using the cone beam computed tomography scans, inter-and intrafraction fiducial displacement relative to bony anatomy were determined. Results: The systematic error of the fiducial displacement relative to the COG GTV was 2.8, 2.4, and 4.2 mm in the left-right, anterior-posterior (AP), and craniocaudal (CC) directions, respectively. Large interfraction systematic errors of up to 8.0 mm and

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MRI visibility of gold fiducial markers for image-guided radiotherapy of rectal cancer

Abstract: R.P.J. van den Ende). Radiotherapy and Oncology 132 (2019) 93-99

Cited by 15 publications

References 33 publications

The rationale for MR-only treatment planning for external radiotherapy

The rationale for MR-only treatment planning for external radiotherapy

A generative adversarial network‐based (GAN‐based) architecture for automatic fiducial marker detection in prostate MRI‐only radiotherapy simulation images

Feasibility of Gold Fiducial Markers as a Surrogate for Gross Tumor Volume Position in Image-Guided Radiation Therapy of Rectal Cancer

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