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Radiation Oncology
Published in: Radiation Oncology 1/2019

Open Access 01-12-2019 | Prostate Cancer | Research

Fiducial markers visibility and artefacts in prostate cancer radiotherapy multi-modality imaging

Authors: Sarah O. S. Osman, Emily Russell, Raymond B. King, Karen Crowther, Suneil Jain, Cormac McGrath, Alan R. Hounsell, Kevin M. Prise, Conor K. McGarry

Published in: Radiation Oncology | Issue 1/2019

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Abstract

Background

In this study, a novel pelvic phantom was developed and used to assess the visibility and presence of artefacts from different types of commercial fiducial markers (FMs) on multi-modality imaging relevant to prostate cancer.

Methods and materials

The phantom was designed with 3D printed hollow cubes in the centre. These cubes were filled with gel to mimic the prostate gland and two parallel PVC rods were used to mimic bones in the pelvic region. Each cube was filled with gelatine and three unique FMs were positioned with a clinically-relevant spatial distribution. The FMs investigated were; Gold Marker (GM) CIVCO, GM RiverPoint, GM Gold Anchor (GA) line and ball shape, and polymer marker (PM) from CIVCO. The phantom was scanned using several imaging modalities typically used to image prostate cancer patients; MRI, CT, CBCT, planar kV-pair, ExacTrac, 6MV, 2.5MV and integrated EPID imaging. The visibility of the markers and any observed artefacts in the phantom were compared to in-vivo scans of prostate cancer patients with FMs.

Results

All GMs were visible in volumetric scans, however, they also had the most visible artefacts on CT and CBCT scans, with the magnitude of artefacts increasing with FM size. PM FMs had the least visible artefacts in volumetric scans but they were not visible on portal images and had poor visibility on lateral kV images. The smallest diameter GMs (GA) were the most difficult GMs to identify on lateral kV images.

Conclusion

The choice between different FMs is also dependent on the adopted IGRT strategy. PM was found to be superior to investigated gold markers in the most commonly used modalities in the management of prostate cancer; CT, CBCT and MRI imaging.
Appendix
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Metadata
Title
Fiducial markers visibility and artefacts in prostate cancer radiotherapy multi-modality imaging
Authors
Sarah O. S. Osman
Emily Russell
Raymond B. King
Karen Crowther
Suneil Jain
Cormac McGrath
Alan R. Hounsell
Kevin M. Prise
Conor K. McGarry
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2019
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-019-1447-1

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