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A cone beam CT-based study on fiducial seed migration and planning target volume margin in prostate radiotherapy

Published online by Cambridge University Press:  21 November 2019

Divya K. Thuruthiyil Open the ORCID record for Divya K. Thuruthiyil [Opens in a new window] ,
Martin Cawley  and
Mohamed Metwaly
Divya K. Thuruthiyil*
Affiliation:
Department of Radiotherapy, United Lincolnshire Hospitals NHS Trust, Lincoln, UK
Martin Cawley
Affiliation:
Department of Radiotherapy, United Lincolnshire Hospitals NHS Trust, Lincoln, UK
Mohamed Metwaly
Affiliation:
Department of Radiotherapy, United Lincolnshire Hospitals NHS Trust, Lincoln, UK
*
Author for correspondence: Divya K. Thuruthiyil, Department of Radiotherapy Physics, United Lincolnshire Hospitals NHS Trust, Lincoln LN2 5QY, UK. E-mail: [email protected]
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Abstract

Aim:

This study attempts to investigate fiducial marker (FM) migration and calculate the prostate planning target volume (PTV) margin considering the setup errors after translation corrections alone (T) and translation plus rotational corrections (T+R) and anatomy variation with respect to the corrected fiducial position, analysed on cone beam computed tomography (CBCT) images.

Methods and materials:

CBCT images from 25 patients are analysed for FM movements, setup error and anatomy variation with respect to the seed match positions. Systematic and random components of setup error and prostate movements are used to calculate the PTV margin for CBCT-based FM localisation in two scenarios, translation corrections only and translation plus rotational correction. MTNW887825 soft tissue gold markers (Civco, Orange City, FL, USA) were used with the department-specific immobilisation system and rectal and bladder filling protocols.

Results:

The average directional inter-marker distance variation is −0·05 ± 0·90 mm. The systematic setup errors for T+R are 0·40, 0·63 and 0·80 mm in right–left (RL), anterior–posterior (AP) and superior–inferior (SI), respectively. The corresponding values for T only are 0·54, 0·69 and 0·90 mm. The systematic prostate movement from T+R corrected FM positions are 0·65, 1·27 and 1·32 mm in the RL, AP and SI directions.

Findings:

Minimal FM movements are noted from the study. The PTV margins to incorporate the daily T+R corrected setup error and prostate deformation are found to be 2·5, 4·5 and 5·2 mm in the RL, AP and SI directions, respectively. The corresponding margins for T only corrected scenario are found to be 2·8, 4·8 and 5·7 mm.

Keywords

anatomy variationcone beam CTfiducial markersinter-marker distancePTV margin
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 19 , Issue 4 , December 2020 , pp. 315 - 320
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Copyright
© Cambridge University Press 2019

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References

Michel, J. High Dose delivered by intensity modulated conformal radiotherapy improves the outcome of localised prostate cancer. J Urol 2001; 166 (3): 876–881.Google Scholar
Zelefsky, M J, Levin, E J, Hunt, M et al. Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity modulated radiotherapy for localised prostate. Int J Radiat Oncol Biol Phys 2008; 70 (4): 1124–1129.Google Scholar
Michalski, J M, Moughan, J, Purdy, J. et al. Effect of standard vs dose-escalated radiation therapy for patients with intermediate-risk prostate cancer: the NRG Oncology RTOG 0126 randomized clinical trial. JAMA Oncol 2018; 4 (6): e180039. doi: 10.1001/jamaoncol.2018.0039. CrossRefGoogle ScholarPubMed
LKuban, D A, Tucker, S L, Dong, L et al. Long-term results of the M. D. Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys 2008; 70 (1): 67–74 Google Scholar
Beckendorf, V, Guerif, S, Le Prisé, E et al.. P70 Gy versus 80 Gy in localized prostate cancer: 5-year results of GETUG 06 randomized trial. Int J Radiat Oncol Biol Phys 2011; 80 (4): 1056–1063.Google Scholar
Heemsbergen, W D, Al-Mamgani, A, Slot, A et al. Long-term results of the Dutch randomized prostate cancer trial: impact of dose-escalation on local, biochemical, clinical failure, and survival. Radiother Oncol 2014; 110 (1): 104–109 CrossRefGoogle ScholarPubMed
Dearnaley, D, Syndikus, I, Mossop, H et al. CHHiP Investigators Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol 2016; 17 (8): 1047–1060. doi: 10.1016/S1470-2045(16)30102-4. Epub Jun 20.CrossRefGoogle ScholarPubMed
Katz, A J, Kang, J. Quality of life and toxicity after SBRT for organ-confined prostate cancer, a 7-year study. Front Oncol. 2014; 4: 301. doi: 10.3389/fonc.2014.00301 CrossRefGoogle ScholarPubMed
Vigneault, E, Pouliot, J, Laverdiere, J et al. EPID detection of radio- opaque markers for the evaluation of prostate position during megavoltage irradiation: a clinical study. Int J Radiat Oncol Biol Phys 1995; 32 (971): 205–212 doi: 10.1016/s0360-3016(96)00341-0. CrossRefGoogle Scholar
Litzenberg, D, Dawson, L A, Sandler, H et al. Daily prostate targeting using implanted radiopaque markers. Int J Radiat Oncol Biol Phys 2002; 52: 699–703.CrossRefGoogle ScholarPubMed
Paluska, P, Hanus, J, Sefrova, J et al. Utilization of cone beam CT for reconstruction of dose distribution delivered in image-guided radiotherapy of prostate carcinoma—bony landmark setup compared to fiducial markers setup. J Appl Clin Med Phys 2013; 14 (4203): 99–112.CrossRefGoogle ScholarPubMed
Liang, J, Wu, Q, Yan, D. The role of seminal vesicle motion in target margin assessment for online image-guided radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2009; 73 (3): 935–943.CrossRefGoogle ScholarPubMed
Mutanga, T F, de Boer, H C J, van der Wielen, G J et al. Margin evaluation in the presence of deformation, rotation, and translation in prostate and entire seminal vesicle irradiation with daily marker-based setup corrections. Int J Radiat Oncol Biol Phys 2011; 81 (4): 1160–1167.CrossRefGoogle ScholarPubMed
Beard, C J, Kijewski, P, Bussiere, M et al. Analysis of prostate and seminal vesicle motion: implications for treatment planning. Int J Radiat Oncol Biol Phys 1997; 38: 73–81.Google Scholar
Melain, E, Mageras, G S, Fuks, Z et al. Variation in prostate position quantitation and implications for three-dimensional conformal treatment planning. Int J Radiat Oncol Biol Phys 1997; 38: 73–81 CrossRefGoogle Scholar
Crook, J M, Raymond, Y, Salhani, D et al. Prostate motion during standard radiotherapy as assessed by fiducial markers. Radiother Oncol 1995; 37: 35–42.CrossRefGoogle ScholarPubMed
Schallenkamp, J M, Herman, M G, Kruse, J J et al. Prostate position relative to pelvic bony anatomy based on intraprostatic gold markers and electronic portal imaging. Int J Radiat Oncol Biol Phys 2005; 63: 800–801.CrossRefGoogle ScholarPubMed
Liszewski, B, Choo, E, D’Alimonte, L. A retrospective analysis of prostate cone beam computed tomography (CBCT) image registration: a tale of two techniques. J Med Imaging Radiat Sci 2010; 41: 207–214.CrossRefGoogle ScholarPubMed
Moseley, D J, White, E A, Wiltshire, K L et al. Comparison of localization performance with implanted fiducial markers and cone- beam computed tomography for on-line image-guided radiotherapy of the prostate. Int J Radiat Oncol Biol Phys 2007; 67: 942–953.CrossRefGoogle Scholar
Ng, M, Brown, E, Williams, A, Chao, M, Lawrentschuk, N, Chee, R. Fiducial markers and spacers in prostate radiotherapy: current applications. BJU Int 2014; 113 (2): 13–20 CrossRefGoogle ScholarPubMed
Van der Heide, U A, Kotte, A N, Dehnad, H et al. Analysis of fiducial marker-based position verification in the external beam radiotherapy of patients with prostate cancer. Radiother Oncol 2007; 82: 38–45.CrossRefGoogle ScholarPubMed
Pouliot, J, Aubin, M, Langen, K M et al. (Non)migration of radiopaque markers used for online localization of the prostate with an electronic portal imaging device. Int J RadiatOncol Biol Phys 2003; 56: 862–866.CrossRefGoogle Scholar
Poggi, M M, Gant, D A, Sewchand, W et al. Marker seed migration in prostate localization. Int J Radiat Oncol Biol Phys 2003; 56: 1248–1251.CrossRefGoogle ScholarPubMed
Kupelian, P A, Willoughby, T R, Meeks, S L et al. Intra-prostatic fiducials for localization of the prostate gland: monitoring inter marker distances during radiation therapy to test for marker stability. Int J Radiat Oncol Biol Phys 2005; 62: 1291–1296.CrossRefGoogle Scholar
Tiberi, D A, Carrier, J F, Beauchemin, M C et al. Impact of concurrent androgen deprivation on fiducial marker migration in external-beam radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 2012; 84: e7–e12.CrossRefGoogle ScholarPubMed
Delouya, G, Carrier, J F, B’eliveau-Nadeau, D et al. Migration of intra- prostatic fiducial markers and its influence on the matching quality in external beam radiation therapy for prostate cancer. Radiother Oncol 2010; 96: 43–47.CrossRefGoogle Scholar
Camacho, C, Valduvieco, I, Sáez, J, et al. Polymark TM fiducial markers migration in prostate image guided radiation therapy using CBCT images. Estro 2017; 36: EP-1653.Google Scholar
Hammoud, R W, Pradhan, D, Kim, J et al. Prostate localization: fiducial marker versus Cone Beam CT (CBCT) 3D image fusion. Int J Radiat Oncol Biol Phys Nov 2012; 24 (9): 640–645.Google Scholar
Barney, B M, Lee, R J, Handrahan, D et al. Image-guided radio-therapy (IGRT) for prostate cancer comparing kV imaging of fiducial markers with cone beam computed tomography (CBCT). Int J Radiat Oncol Biol Phys 2011; 80: 301–305.CrossRefGoogle Scholar
Van der Wielen, G J, Mutanga, T F, Incrocci, L et al. Deformation of prostate and seminal vesicles relative to intraprostatic fiducial markers. Int J Radiat Oncol Biol Phys 2008; 72 (5): 1604–1611.CrossRefGoogle ScholarPubMed
Hoskin, P, Gaze, M, Greener, T, et al. On Target: Ensuring Geometric Accuracy in Radiotherapy. London, United Kingdom: Royal College of Radiologists, Institute of Physics and Engineering in Medicine, Society and College of Radiographers, 2008.Google Scholar
van Herk, M Errors and margins in radiotherapy. Semin Radiat Oncol 2004; 14 (1): 52–64.CrossRefGoogle ScholarPubMed
Yahya, S, Zarkar, A, Soutgate, E, Nightingale, P, Webster, G. Which bowel preparation is best? Comparison of a high-fibre diet leaflet, daily microenema and no preparation in prostate cancer patients treated with radical radiotherapy to assess the effect on planned target volume shifts due to rectal distension. Br J Radiol 2013; 86: 20130457. doi: 10.1259/bjr.20130457. CrossRefGoogle ScholarPubMed
Oehler, C, Lang, S, Dimmerling, P et al. PTV margin definition in hypo fractionated IGRT of localized prostate cancer using cone beam CT and orthogonal image pairs with fiducial markers. Radiat Oncol 2014; 9: 229. doi: 10.1186/s13014-014-0229-z.CrossRefGoogle Scholar
Sukhdeep, K G, Reddy, K, Campbell, N, Chen, C. Determination of optimal PTV margin for patients receiving CBCT guided prostate IMRT: comparative analysis based on CBCT dose calculation with four different margins. J Appl Clin Med Phys 2015; 16 (6): 252–262.Google Scholar
Gert, J, Meijer, J K, Kartl, B et al. What CTV to PTV Margins should be applied for prostate irradiation? Four-dimensional quantitative assessment using model – based deformable image registration techniques. Int J Radiat Oncol Biol Phys 2008; 72 (5): 1416–1425.Google Scholar
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