open access

Vol 20, No 1 (2015)
Original research articles
Published online: 2015-01-01
Submitted: 2013-10-21
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Displacements of fiducial markers in patients with prostate cancer treated with image guided radiotherapy: A single-institution descriptive study

Ricardo Cendales, Felipe Torres, Juan Arbelaez, Armando Gaitan, Jaider Vasquez, Ivan Bobadilla
DOI: 10.1016/j.rpor.2014.08.002
·
Rep Pract Oncol Radiother 2015;20(1):38-42.

open access

Vol 20, No 1 (2015)
Original research articles
Published online: 2015-01-01
Submitted: 2013-10-21

Abstract

Aim

To describe daily displacements when using fiducial markers as surrogates for the target volume in patients with prostate cancer treated with IGRT.

Background

The higher grade of conformity achieved with the use of modern radiation technologies in prostate cancer can increase the risk of geographical miss; therefore, an associated protocol of IGRT is recommended.

Materials and methods

A single-institution, retrospective, consecutive study was designed. 128 prostate cancer patients treated with daily on-line IGRT based on 2D kV orthogonal images were included. Daily displacement of the fiducial markers was considered as the difference between the position of the patient when using skin tattoos and the position after being relocated using fiducial markers. Measures of central tendency and dispersion were used to describe fiducial displacements.

Results

The implant itself took a mean time of 15[[ce:hsp sp="0.25"/]]min. We did not detect any complications derived from the implant. 4296 sets of orthogonal images were identified, 128 sets of images corresponding to treatment initiation were excluded; 91 (2.1%) sets of images were excluded from the analysis after having identified that these images contained extreme outlier values. If IGRT had not been performed 25%, 10% or 5% of the treatments would have had displacements superior to 4, 7 or 9[[ce:hsp sp="0.25"/]]mm respectively in any axis.

Conclusions

Image guidance is required when using highly conformal techniques; otherwise, at least 10% of daily treatments could have significant displacements. IGRT based on fiducial markers, with 2D kV orthogonal images is a convenient and fast method for performing image guidance.

Abstract

Aim

To describe daily displacements when using fiducial markers as surrogates for the target volume in patients with prostate cancer treated with IGRT.

Background

The higher grade of conformity achieved with the use of modern radiation technologies in prostate cancer can increase the risk of geographical miss; therefore, an associated protocol of IGRT is recommended.

Materials and methods

A single-institution, retrospective, consecutive study was designed. 128 prostate cancer patients treated with daily on-line IGRT based on 2D kV orthogonal images were included. Daily displacement of the fiducial markers was considered as the difference between the position of the patient when using skin tattoos and the position after being relocated using fiducial markers. Measures of central tendency and dispersion were used to describe fiducial displacements.

Results

The implant itself took a mean time of 15[[ce:hsp sp="0.25"/]]min. We did not detect any complications derived from the implant. 4296 sets of orthogonal images were identified, 128 sets of images corresponding to treatment initiation were excluded; 91 (2.1%) sets of images were excluded from the analysis after having identified that these images contained extreme outlier values. If IGRT had not been performed 25%, 10% or 5% of the treatments would have had displacements superior to 4, 7 or 9[[ce:hsp sp="0.25"/]]mm respectively in any axis.

Conclusions

Image guidance is required when using highly conformal techniques; otherwise, at least 10% of daily treatments could have significant displacements. IGRT based on fiducial markers, with 2D kV orthogonal images is a convenient and fast method for performing image guidance.

Get Citation

Keywords

IMRT; IGRT; Prostate cancer; Fiducial markers; Developing countries

About this article
Title

Displacements of fiducial markers in patients with prostate cancer treated with image guided radiotherapy: A single-institution descriptive study

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 20, No 1 (2015)

Pages

38-42

Published online

2015-01-01

DOI

10.1016/j.rpor.2014.08.002

Bibliographic record

Rep Pract Oncol Radiother 2015;20(1):38-42.

Keywords

IMRT
IGRT
Prostate cancer
Fiducial markers
Developing countries

Authors

Ricardo Cendales
Felipe Torres
Juan Arbelaez
Armando Gaitan
Jaider Vasquez
Ivan Bobadilla

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