Visibility and artifacts of gold fiducial markers used for image guided radiation therapy of pancreatic cancer on MRI

Gurney‐Champion, Oliver J.; Lens, E.; Horst, Astrid van der; Houweling, Antonetta C.; Klaassen, Remy; Hooft, Jeanin E. van; Stoker, Jaap; Tienhoven, Geertjan van; Nederveen, Aart J.; Bel, Arjan

doi:10.1118/1.4918753

Cited by 46 publications

(47 citation statements)

References 40 publications

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“…As found in Ref. for the solid markers, the potential to be visibility and cause artifacts strongly correlated (R S = 1.0), that is, better visibility came with the cost of stronger artifacts. Both solid markers showed a linear dependency (R² = 0.996) between visible size and size of artifacts.…”

Section: Discussionsupporting

confidence: 64%

“…In this study, a method of MRI visibility and artifact quantification was used to compare a new liquid fiducial marker BioXmark ® against the two commonly used solid markers, Gold Anchor™ and VisiCoil™. All fiducial markers were implanted within a gel phantom, mimicking the relaxation properties of pancreatic tissue at 3.0 T. The approach of quantifying the markers’ visibility by determining the reduction in the surrounding

T_{2}^{*}

relaxation time was extended by additionally mapping the proton density ρ(H) relative to water to accurately describe the characteristics of BioXmark ® .…”

Section: Discussionmentioning

confidence: 99%

“…Both visibility and artifact were evaluated in terms of size and magnitude, based on the approach of Ref. . Since the visibility of the investigated markers arises from the signal void they induce, the potentially visible size for the solid markers was defined as the volume of short relaxation time

V (T_{2}^{*} \leq T_{2 l o w}^{*})

.…”

Section: Methodsmentioning

confidence: 99%

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Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

et al. 2017

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The liquid fiducial marker causes signal voids on MRI due to its absence of water hydrogen atoms without strongly affecting the magnetic field in the surrounding tissue. The alteration of the static magnetic field was found to be the main effect leading to the visibility of the solid fiducial markers. Hence, especially when a low level of image distortion is required, MRI characteristics of the liquid marker surpass those of solid gold markers currently being used for IGRT of PDAC.

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Section: Discussionsupporting

confidence: 64%

T_{2}^{*}

relaxation time was extended by additionally mapping the proton density ρ(H) relative to water to accurately describe the characteristics of BioXmark ® .…”

Section: Discussionmentioning

confidence: 99%

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Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

et al. 2017

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“…However, during treatment delivery, external respiratory surrogates are often preferred to X-ray imaging, in order to limit the amount of additional non-therapeutic dose for the patient. As such, optical surface imaging and electromagnetic tracking of implanted transponders are increasingly popular solutions for motion monitoring in radiotherapy, despite the risks of the latter approach of clinical complications [7, 8], artefacts in CT and MR imaging [9, 10] or detrimental effects on range and dose calculations for particle therapy [11–13]. …”

Section: Introductionmentioning

confidence: 99%

Monitoring of breathing motion in image-guided PBS proton therapy: comparative analysis of optical and electromagnetic technologies

et al. 2017

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BackgroundMotion monitoring is essential when treating non-static tumours with pencil beam scanned protons. 4D medical imaging typically relies on the detected body surface displacement, considered as a surrogate of the patient's anatomical changes, a concept similarly applied by most motion mitigation techniques. In this study, we investigate benefits and pitfalls of optical and electromagnetic tracking, key technologies for non-invasive surface motion monitoring, in the specific environment of image-guided, gantry-based proton therapy.MethodsPolaris SPECTRA optical tracking system and the Aurora V3 electromagnetic tracking system from Northern Digital Inc. (NDI, Waterloo, CA) have been compared both technically, by measuring tracking errors and system latencies under laboratory conditions, and clinically, by assessing their practicalities and sensitivities when used with imaging devices and PBS treatment gantries. Additionally, we investigated the impact of using different surrogate signals, from different systems, on the reconstructed 4D CT images.ResultsEven though in controlled laboratory conditions both technologies allow for the localization of static fiducials with sub-millimetre jitter and low latency (31.6 ± 1 msec worst case), significant dynamic and environmental distortions limit the potential of the electromagnetic approach in a clinical setting. The measurement error in case of close proximity to a CT scanner is up to 10.5 mm and precludes its use for the monitoring of respiratory motion during 4DCT acquisitions. Similarly, the motion of the treatment gantry distorts up to 22 mm the tracking result.ConclusionsDespite the line of sight requirement, the optical solution offers the best potential, being the most robust against environmental factors and providing the highest spatial accuracy. The significant difference in the temporal location of the reconstructed phase points is used to speculate on the need to apply the same monitoring system for imaging and treatment to ensure the consistency of detected phases.

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“…The precision of radiotherapy for prostate cancer has been improving, and intensity-modulated radiotherapy (IMRT) is commonly performed using fiducial markers [1][2][3], because the treatment is repeated and markers capable of being depicted on magnetic resonance imaging (MRI) are necessary. However, there are many fiducial markers in the world and they can sometimes be difficult to recognize on MR.…”

Section: Introductionmentioning

confidence: 99%

Initial experience of using an iron-containing fiducial marker for radiotherapy of prostate cancer: Advantages in the visualization of markers in Computed Tomography and Magnetic Resonance Imaging

Tanaka

Iida

Komeda

et al. 2016

Polish Journal of Medical Physics and Engineering

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Visualization of markers is critical for imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). However, the size of the marker varies according to the imaging technique. While a large-sized marker is more useful for visualization in MRI, it results in artifacts on CT and causes substantial pain on administration. In contrast, a small-sized marker reduces the artifacts on CT but hampers MRI detection. Herein, we report a new ironcontaining marker and compare its utility with that of non-iron-containing markers. Five patients underwent CT/MRI fusion-based intensity-modulated radiotherapy, and the markers were placed by urologists. A Gold Anchor™ (GA; diameter, 0.28 mm; length, 10 mm) was placed using a 22G needle on the right side of the prostate. A VISICOIL™ (VIS; diameter, 0.35 mm; length, 10 mm) was placed using a 19G needle on the left side. MRI was performed using T2*-weighted imaging. Three observers evaluated and scored the visual qualities of the acquired images. The mean score of visualization was almost identical between the GA and VIS in radiography and cone-beam CT (Novalis Tx). The artifacts in planning CT were slightly larger using the GA than using the VIS. The visualization of the marker on MRI using the GA was superior to that using the VIS. In conclusion, the visualization quality of radiography, conebeam CT, and planning CT was roughly equal between the GA and VIS. However, the GA was more strongly visualized than was the VIS on MRI due to iron containing.

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Visibility and artifacts of gold fiducial markers used for image guided radiation therapy of pancreatic cancer on MRI

Cited by 46 publications

References 40 publications

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

Quantification of MRI visibility and artifacts at 3T of liquid fiducial marker in a pancreas tissue‐mimicking phantom

Monitoring of breathing motion in image-guided PBS proton therapy: comparative analysis of optical and electromagnetic technologies

Initial experience of using an iron-containing fiducial marker for radiotherapy of prostate cancer: Advantages in the visualization of markers in Computed Tomography and Magnetic Resonance Imaging

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