Maria F Chan1, Gil'ad N Cohen2, Joseph O Deasy2. 1. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA chanm@mskcc.org. 2. Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Abstract
PURPOSE: To evaluate visibility, artifacts, and distortions of various commercial markers in magnetic resonance imaging (MRI), computer tomography (CT), and ultrasound imaging used for radiotherapy planning and treatment guidance. METHODS: We compare 2 solid gold markers, 4 gold coils, and 1 polymer marker from 3 vendors. Imaging modalities used were 3-T and 1.5-T GE MRIs, Siemens Sequoia 512 Ultrasound, Phillips Big Bore CT, Varian Trilogy linear accelerator (cone-beam CT [CBCT], on-board imager kilovoltage [OBI-kV], electronic portal imaging device megavoltage [EPID-MV]), and Medtronic O-ARM CBCT. Markers were imaged in a 30 × 30 × 10 cm(3) custom bolus phantom. In one experiment, Surgilube was used around the markers to reduce air gaps. Images were saved in Digital Imaging and Communications in Medicine (DICOM) format and analyzed using an in-house software. Profiles across the markers were used for objective comparison of the markers' signals. The visibility and artifacts/distortions produced by each marker were assessed qualitatively and quantitatively. RESULTS: All markers are visible in CT, CBCT, OBI-kV, and ultrasound. Gold markers below 0.75 mm in diameter are not visible in EPID-MV images. The larger the markers, the more CT and CBCT image artifacts there are, yet the degree of the artifact depends on scan parameters and the scanner itself. Visibility of gold coils of 0.75 mm diameter or larger is comparable across all imaging modalities studied. The polymer marker causes minimal artifacts in CT and CBCT but has poor visibility in EPID-MV. Gold coils of 0.5 mm exhibit poor visibility in MRI and EPID-MV due to their small size. Gold markers are more visible in 3-T T1 gradient-recalled echo than in 1.5-T T1 fast spin-echo, depending on the scan sequence. In this study, all markers are clearly visible on ultrasound. CONCLUSION: All gold markers are visible in CT, CBCT, kV, and ultrasound; however, only the large diameter markers are visible in MV. When MR and EPID-MV imagers are used, the selection of fiducial markers is not straightforward. For hybrid kV/MV image-guided radiotherapy imaging, larger diameter markers are suggested. If using kV imaging alone, smaller sized markers may be used in smaller sized patients in order to reduce artifacts. Only larger diameter gold markers are visible across all imaging modalities.
PURPOSE: To evaluate visibility, artifacts, and distortions of various commercial markers in magnetic resonance imaging (MRI), computer tomography (CT), and ultrasound imaging used for radiotherapy planning and treatment guidance. METHODS: We compare 2 solid gold markers, 4 gold coils, and 1 polymer marker from 3 vendors. Imaging modalities used were 3-T and 1.5-T GE MRIs, Siemens Sequoia 512 Ultrasound, Phillips Big Bore CT, Varian Trilogy linear accelerator (cone-beam CT [CBCT], on-board imager kilovoltage [OBI-kV], electronic portal imaging device megavoltage [EPID-MV]), and Medtronic O-ARM CBCT. Markers were imaged in a 30 × 30 × 10 cm(3) custom bolus phantom. In one experiment, Surgilube was used around the markers to reduce air gaps. Images were saved in Digital Imaging and Communications in Medicine (DICOM) format and analyzed using an in-house software. Profiles across the markers were used for objective comparison of the markers' signals. The visibility and artifacts/distortions produced by each marker were assessed qualitatively and quantitatively. RESULTS: All markers are visible in CT, CBCT, OBI-kV, and ultrasound. Gold markers below 0.75 mm in diameter are not visible in EPID-MV images. The larger the markers, the more CT and CBCT image artifacts there are, yet the degree of the artifact depends on scan parameters and the scanner itself. Visibility of gold coils of 0.75 mm diameter or larger is comparable across all imaging modalities studied. The polymer marker causes minimal artifacts in CT and CBCT but has poor visibility in EPID-MV. Gold coils of 0.5 mm exhibit poor visibility in MRI and EPID-MV due to their small size. Gold markers are more visible in 3-T T1 gradient-recalled echo than in 1.5-T T1 fast spin-echo, depending on the scan sequence. In this study, all markers are clearly visible on ultrasound. CONCLUSION: All gold markers are visible in CT, CBCT, kV, and ultrasound; however, only the large diameter markers are visible in MV. When MR and EPID-MV imagers are used, the selection of fiducial markers is not straightforward. For hybrid kV/MV image-guided radiotherapy imaging, larger diameter markers are suggested. If using kV imaging alone, smaller sized markers may be used in smaller sized patients in order to reduce artifacts. Only larger diameter gold markers are visible across all imaging modalities.
Authors: Robin Khosa; Sapna Nangia; Kundan S Chufal; D Ghosh; Rakesh Kaul; Lalit Sharma Journal: J Cancer Res Ther Date: 2010 Apr-Jun Impact factor: 1.805
Authors: Henkjan J Huisman; Jurgen J Fütterer; Emile N J T van Lin; Arjan Welmers; Tom W J Scheenen; Jorn A van Dalen; Andries G Visser; J A Witjes; Jelle O Barentsz Journal: Radiology Date: 2005-06-27 Impact factor: 11.105
Authors: A M Henry; J Stratford; J Davies; C McCarthy; R Swindell; J Sykes; C J Moore; P Price; V S Khoo Journal: Br J Radiol Date: 2005-08 Impact factor: 3.039
Authors: Jessie Y Huang; Wayne D Newhauser; X Ronald Zhu; Andrew K Lee; Rajat J Kudchadker Journal: Phys Med Biol Date: 2011-07-28 Impact factor: 3.609
Authors: Eugene Huang; Lei Dong; Anurag Chandra; Deborah A Kuban; Isaac I Rosen; Anissa Evans; Alan Pollack Journal: Int J Radiat Oncol Biol Phys Date: 2002-06-01 Impact factor: 7.038
Authors: David Skarsgard; Pat Cadman; Ali El-Gayed; Robert Pearcey; Patricia Tai; Nadeem Pervez; Jackson Wu Journal: Radiat Oncol Date: 2010-06-10 Impact factor: 3.481
Authors: Gerard J van der Wielen; Theodore F Mutanga; Luca Incrocci; Wim J Kirkels; Eliana M Vasquez Osorio; Mischa S Hoogeman; Ben J M Heijmen; Hans C J de Boer Journal: Int J Radiat Oncol Biol Phys Date: 2008-12-01 Impact factor: 7.038
Authors: Rubens Spin-Neto; Louise H Matzen; Lars W Schropp; Thomas S Sørensen; Ann Wenzel Journal: Dentomaxillofac Radiol Date: 2018-03-22 Impact factor: 2.419
Authors: William A Hall; Eric Paulson; X Allen Li; Beth Erickson; Christopher Schultz; Alison Tree; Musaddiq Awan; Daniel A Low; Brigid A McDonald; Travis Salzillo; Carri K Glide-Hurst; Amar U Kishan; Clifton D Fuller Journal: CA Cancer J Clin Date: 2021-11-18 Impact factor: 508.702
Authors: Kathryn H Brown; Mihaela Ghita; Giuseppe Schettino; Kevin M Prise; Karl T Butterworth Journal: Cancers (Basel) Date: 2020-05-18 Impact factor: 6.639