A clinical study comparing polymer and gold fiducials for prostate cancer radiotherapy

Frontiers in Oncology

Oncology

Nathan Lawrentschuk¹  Shomik Sengupta¹  Vincent Khoo²  Michal Elisabeth Schneider³  Mark Tacey⁴  Morikatsu Wada⁵  Farshad Foroudi⁵  Benjamin Harris⁵  Michael Chao⁵  Megan Hall⁵  Trish Jenkins⁵  Daryl Lim Joon⁵  Colleen Berry⁵  Drew Smith⁵  David Angus⁵  Olivia Fraser⁵ 

[1] Austin Health, University of Melbourne, Melbourne, VIC, Australia;Department of Clinical Oncology, Royal Marsden Hospital, London, United Kingdom;Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, VIC, Australia;Office of Research, The Northern Hospital, Epping, VIC, Australia;Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, VIC, Australia;Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia;

关键词: radiotherapy;    prostate cancer;    polymer fiducials;    image guided radiotherapy;    verification;   

DOI  :  10.3389/fonc.2022.1023288

 received in 2022-08-19, accepted in 2022-12-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionImage guidance with gold fiducials improves outcomes of prostate radiotherapy. However, gold produces artefact on CT imaging, interfering with contouring and verification. The purpose of this study was to compare polymer to standard gold fiducials using radiotherapy imaging modalities to assess the visibility and artefact.MethodsTwenty eight patients with locally advanced prostate cancer were enrolled, half had three polymer fiducials implanted into the prostate and half underwent insertion of gold fiducials. Patients were imaged with CT, T2 weighted MRI, cone-beam CT (CBCT) and planar KV images. Fiducials were scored for visibility and assessed for CT artefact in surrounding prostate tissue. The artefact was quantified from Hounsfield number histograms and separated into percentile ranges and proportion of voxels in HU normal tissue range of a 2cm sphere surrounding the fiducial.ResultsGold and polymer fiducials were sufficiently visible for CT and CBCT verification. The gold fiducials could be visualized well on KV planar imaging; however, the polymer markers were obscured by pelvic bones. Neither polymer nor gold fiducials could be visualized on MRI. The polymer fiducial produced less artefact than gold on CT, having less voxel spread for the HU percentile ranges and a greater proportion of voxels in the normal tissue range.ConclusionsPolymer fiducials are a more suitable fiducial than gold for CT/CBCT in prostate cancer radiotherapy, demonstrating minimal artefact and good visibility on CT. However, they were not well seen on MRI or KV imaging and thus not suitable for co-registration or planar KV verification.

【 授权许可】

Unknown   
Copyright © 2023 Lim Joon, Berry, Harris, Tacey, Smith, Lawrentschuk, Schneider, Fraser, Hall, Chao, Foroudi, Jenkins, Angus, Wada, Sengupta and Khoo