Exploratory models comparing ethiodized oil-glue and gold fiducials for bladder radiotherapy image-guidance

Physics and Imaging in Radiation Oncology

Alexandra Berlangieri¹  Nathan Lawrentschuk²  Vincent Khoo³  Kerryn Brown³  Farshad Foroudi³  Morikatsu Wada³  Trish Jenkins³  Colleen Berry³  Michael Chao³  Benjamin Harris³  Daryl Lim Joon³  Shomik Sengupta³  Rachel O'Meara³  Mark Tacey³  Brent Pitt³  Michal Schneider³  Angela Viotto³ 

[1] Monash University, Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Wellington Rd, Clayton, Victoria 3800, Australia;Monash University, Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Wellington Rd, Clayton, Victoria 3800, Australia;Olivia Newton John Cancer Center, Radiation Oncology, 145 Studley Rd, Heidelberg, Victoria 3084, Australia;

关键词: Bladder cancer;    Prostate cancer;    Radiotherapy;    Glue fiducials;    Liquid fiducials;    Image-guided radiotherapy;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background and purpose: Image-guidance with fiducials has been shown to improve pelvic radiotherapy outcome. However, bladder fiducials using ethiodized oil (EO) alone can disperse widely, and gold causes Computed Tomography scan (CT) metal artifacts. The study's purpose was to investigate the ability to deliver EO-tissue glue fiducials and compare them to gold for bladder radiotherapy image guidance. Materials and methods: A fluid-filled porcine bladder model was used to assess the ability to cystoscopically inject visible EO glue fiducials into the submucosa. We then transferred the bladders into a porcine pelvis for imaging and compared them to gold fiducials using CT, Cone Beam CT (CBCT), and kilovoltage (KV) planar views. A tissue-equivalent phantom was utilized to analyze the CT number Hounsfield Unit (HU) characteristics and artifacts of the glue and gold fiducials. Percentile ranges and normal tissue voxel percentages of the subsequent CT number voxel histogram from a 2 cm sphere surrounding the fiducial was used to characterize the artifact. Results: We successfully delivered all EO glue fiducials into the porcine bladders as discrete fiducials. They were well seen on CT, CBCT, and KV imaging. The glue fiducials had lower CT number values, but less CT number spread of the voxel percentile ranges consistent with the diminished contrast and less artifact than gold. The glue fiducial types had similar CT number characteristics. Conclusion: This study has shown that EO glue fiducials can be delivered with online visualization qualities comparable to gold fiducials without metal-related artifacts.

【 授权许可】

Unknown