Transarterial Fiducial Marker Placement for Image-guided Proton Therapy for Malignant Liver Tumors

Ohta, Kengo; Sasaki, Shigeru; Iwata, Hiromitsu; Nishikawa, Hiroko; Ogino, Hiroyuki; Hara, Masaki; Hashizume, Takumi; Shibamoto, Yuta

doi:10.1007/s00270-014-1013-z

Cited by 9 publications

(5 citation statements)

References 22 publications

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“…Ohta et al [ 14 ] previously reported that the transarterial placement of a fiducial marker resulted in a low complications rate (2%) and a high technical success rate (100%). However, complications such as femoral pseudoaneurysms have also been reported to occur after angiography [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous fiducial marker placement prior to stereotactic body radiotherapy for malignant liver tumors: an initial experience

et al. 2016

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The aim of this study was to describe our initial experience with a gold flexible linear fiducial marker and to evaluate the safety and technical and clinical efficacy of stereotactic body radiotherapy using this marker for malignant liver tumors. Between July 2012 and February 2015, 18 patients underwent percutaneous fiducial marker placement before stereotactic body radiotherapy for malignant liver tumors. We evaluated the technical and clinical success rates of the procedure and the associated complications. Technical success was defined as successful placement of the fiducial marker at the target site, and clinical success was defined as the completion of stereotactic body radiotherapy without the marker dropping out of position. All 18 fiducial markers were placed successfully, so the technical success rate was 100% (18/18). All 18 patients were able to undergo stereotactic body radiotherapy without marker migration. Thus, the clinical success rate was 100% (18/18). Slight pneumothorax occurred as a minor complication in one case. No major complications such as coil migration or bleeding were observed. The examined percutaneous fiducial marker was safely placed in the liver and appeared to be useful for stereotactic body radiotherapy for malignant liver tumors.

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Section: Discussionmentioning

confidence: 99%

Percutaneous fiducial marker placement prior to stereotactic body radiotherapy for malignant liver tumors: an initial experience

et al. 2016

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“…The dimensions of the HTM would be similar to those of solid fiducial markers used in PT treatment planning of ocular (Newhauser et al 2007), liver (Ohta et al 2015) and prostate cancers (Huang et al 2011, Giebeler et al 2009, which are already clinically employed and are already being studied in the context of in-vivo proton RV (Cho et al 2016). The effect of artifacts on planning CT images and dose shadowing from beam perturbations, which can lead to changes to the planned dose, are already being investigated for various fiducial markers (Huang et al 2011, Cheung et al 2010, Giebeler et al 2009, Newhauser et al 2007, Habermehl et al 2013, Saini et al 2017, and will need to be carefully evaluated for each HTM.…”

Section: Clinical Applicationmentioning

confidence: 99%

Proton therapy range verification method via delayed γ-ray spectroscopy of a molybdenum tumour marker

Burbadge

Kasanda²,

Bildstein³

et al. 2021

Phys. Med. Biol.

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In this work, a new method of range verification for proton therapy (PT) is experimentally demonstrated for the first time. If a metal marker is implanted near the tumour site, its response to proton activation will result in the emission of characteristic γ rays. The relative intensity of γ rays originating from competing fusion-evaporation reaction channels provides a unique signature of the average proton energy at the marker, and by extension the beam’s range, in vivo and in real time. The clinical feasibility of this method was investigated at the PT facility at TRIUMF with a proof-of-principle experiment which irradiated a naturally-abundant molybdenum foil at various proton beam energies. Delayed characteristic γ rays were measured with two Compton-shielded LaBr3 scintillators. The technique was successfully demonstrated by relating the relative intensity of two γ-ray peaks to the energy of the beam at the Mo target, opening the door to future clinical applications where the range of the beam can be verified in real time.

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“…As a surrogate marker for hepatic tumors, the fiducial marker is required to be implanted as close as possible to the tumor [9]. There have been several reports regarding the transarterial hepatic implantation of an embolization coil [10] and percutaneous transhepatic implantation of a gold marker [11][12][13][14][15][16][17]. The former is more time-consuming, while the latter is technically simpler and more often used.…”

Section: Introductionmentioning

confidence: 99%

“…The former is more time-consuming, while the latter is technically simpler and more often used. In both techniques, non-spherical markers with a size of approximately 1 × 3 mm have generally been used [10][11][12][13][14][15][16][17]. In contrast, true-spherical markers with 2.0-mm diameters 7 are used for automatic precise calculation of the gravity center of the marker in RAR for hepatic malignant tumors [18,19].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous insertion of hepatic fiducial true-spherical markers for real-time adaptive radiotherapy

Morita

Abo

Sakuhara

et al. 2019

Minimally Invasive Therapy & Allied Technologies

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Percutaneous insertion of hepatic fiducial true-spherical markers for real-time adaptive radiotherapy Purpose: This study evaluated the success rate and complications of percutaneous implantation of hepatic fiducial true-spherical gold markers for real-time adaptive radiotherapy (RAR), which constitutes real-time image-guided radiotherapy with gating. Materials and Methods: We retrospectively evaluated 100 patients who underwent 116 percutaneous intrahepatic implantations of 2-mm-diameter, spherical, gold fiducial markers before RAR from 1999 to 2016, using Seldinger's method. We defined technical success as marker placement at intended liver parenchyma, without mispositioning, and clinical success as successful tracking of the gold marker and completion of planned RAR. Complications related to marker placement were assessed. Results: The technical success rate for true-spherical gold marker implantation was 92.2% (107/116). Nine of 116 markers migrated (intraprocedurally in 7 patients, delayed in 2 patients). Migration out of the liver (n = 4) or intrahepatic vessels (n = 5) occurred without complications; these markers were not retrieved. The clinical success rate was 100.0% (115/115). Abdominal pain occurred in 16 patients, fever and hemorrhage in 7 5 patients each, and pneumothorax and nausea in patient each. No major complications were encountered. Conclusions: Percutaneous transhepatic implantation of true-spherical gold markers for RAR is feasible and can be conducted with a high success rate and low complication rate.

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Transarterial Fiducial Marker Placement for Image-guided Proton Therapy for Malignant Liver Tumors

Abstract: Transarterial fiducial marker placement appears to be a useful and safe procedure for proton therapy for malignant liver tumors.

Cited by 9 publications

References 22 publications

Percutaneous fiducial marker placement prior to stereotactic body radiotherapy for malignant liver tumors: an initial experience

Percutaneous fiducial marker placement prior to stereotactic body radiotherapy for malignant liver tumors: an initial experience

Proton therapy range verification method via delayed γ-ray spectroscopy of a molybdenum tumour marker

Percutaneous insertion of hepatic fiducial true-spherical markers for real-time adaptive radiotherapy

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