Utilization of cone‐beam CT for reconstruction of dose distribution delivered in image‐guided radiotherapy of prostate carcinoma — bony landmark setup compared to fiducial markers setup

Paluska, Petr; Hanus, Jozef; Sefrova, Jana; Rousková, Lucie; J, Grepl; Jansa, Jan; Kašaová, Linda; Hodek, Miroslav; Zouhar, Milan; Vošmik, Milan; Petera, Jiřı́

doi:10.1120/jacmp.v14i3.4203

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…Crook et al findings 6 from 1995 were supported by Schallenkamp et al 9 in 2005 using MV electronic portal imaging (MV EPI) and digitally reconstructed radiographs, and then reconfirmed in 2013 by Paluska et al 11 using modern planning and imaging techniques. Paluska et al acquired weekly CBCT scans following setup to retrospectively reconstruct and verify dose delivered to patients receiving IMRT to the prostate with a simultaneous integrated boost to the proximal seminal vesicles (SVs).…”

Section: Fiducial Markers For Prostate Image-guided Radiotherapy Feasmentioning

confidence: 82%

“…It is less clear what clinical impact this has in terms of patientreported toxicity and overall survival and no prospective randomized controlled trials have been performed. Paluska et al, 11 Cheung et al 64 and Skarsgard et al 65 have all demonstrated the feasibility of reducing PTV margins with the use of FMs. Paluska et al proposed that a 10-mm CTV-PTV margin used with daily bone setup could be reduced to 7 mm using FMs and daily imaging.…”

Section: Clinical Impact Of Prostate Fiducial Marker Image-guided Radmentioning

confidence: 99%

“…[6][7][8][9][10][11] Before in-room imaging was widely available, Crook et al 6 demonstrated significant prostate gland motion based on FM positions relative to bony landmarks on repeat CT scans in a study of 55 patients. They found the average prostate displacement in the posterior and inferior directions to be 6 mm and that 30% had displacements .10 mm posteriorly, which standard treatment planning margins would not have encompassed.…”

Section: Fiducial Markers For Prostate Image-guided Radiotherapy Feasmentioning

confidence: 99%

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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: Fiducial Markers For Prostate Image-guided Radiotherapy Feasmentioning

confidence: 82%

Section: Clinical Impact Of Prostate Fiducial Marker Image-guided Radmentioning

confidence: 99%

Section: Fiducial Markers For Prostate Image-guided Radiotherapy Feasmentioning

confidence: 99%

See 1 more Smart Citation

Fiducial marker guided prostate radiotherapy: a review

O’Neill¹,

Jain²,

Hounsell³

et al. 2016

The British Journal of Radiology

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“…18,53,54 In one study, implantation of fiducial markers allowed PTV margin reduction from 10 to 7 mm as verified by reconstruction of dose distributions after correction using verification CBCT studies. 55,56 In another study, set-up margins calculated to encompass 98% of prostate set-up shifts were 11-14 mm with offline corrections based on alignment to the bone, and the PTV margins needed were reduced to 4-7 mm with the use of online correction using fiducial markers. 57 Similarly, Skarsgard et al 58 using set-up to skin markings without IG noted that margins of 5.7 cm, and 7.9 and 7.7 mm, along the LP, and SI and AP axes, respectively, were required to give 95% probability of complete CTV coverage each day.…”

Section: Use Of Daily Ultrasoundmentioning

confidence: 99%

Target margins in radiotherapy of prostate cancer

Yartsev

2016

BJR

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We reviewed the literature on the use of margins in radiotherapy of patients with prostate cancer, focusing on different options for image guidance (IG) and technical issues. The search in PubMed database was limited to include studies that involved external beam radiotherapy of the intact prostate. Post-prostatectomy studies, brachytherapy and particle therapy were excluded. Each article was characterized according to the IG strategy used: positioning on external marks using room lasers, bone anatomy and soft tissue match, usage of fiducial markers, electromagnetic tracking and adapted delivery. A lack of uniformity in margin selection among institutions was evident from the review. In general, introduction of pre- and in-treatment IG was associated with smaller planning target volume (PTV) margins, but there was a lack of definitive experimental/clinical studies providing robust information on selection of exact PTV values. In addition, there is a lack of comparative research regarding the cost-benefit ratio of the different strategies: insertion of fiducial markers or electromagnetic transponders facilitates prostate gland localization but at a price of invasive procedure; frequent pre-treatment imaging increases patient in-room time, dose and labour; online plan adaptation should improve radiation delivery accuracy but requires fast and precise computation. Finally, optimal protocols for quality assurance procedures need to be established.

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“…13,14 However, the benefits of daily IG should be weighed against the drawbacks of increased workload for staff and in-room time and imaging radiation exposure for patients. 15,16 Several groups investigated a possibility of reducing the number of imaging sessions, [17][18][19][20][21][22][23][24][25] but relatively small patient cohorts from a single institution included in the studies limited their results.…”

Section: Introductionmentioning

confidence: 99%