Jonas Scherman Rydhög1, Steen Riisgaard Mortensen2, Klaus Richter Larsen3, Paul Clementsen4, Rasmus Irming Jølck5, Mirjana Josipovic6, Marianne Camille Aznar6, Lena Specht2, Thomas Lars Andresen7, Per Munck Af Rosenschöld6, Gitte Fredberg Persson2. 1. Department of Oncology, University of Copenhagen, Denmark; Niels Bohr Institute, University of Copenhagen, Denmark. Electronic address: jonas.scherman.rydhoeg@regionh.dk. 2. Department of Oncology, University of Copenhagen, Denmark. 3. Department of Clinical Medicine, Bispebjerg Hospital, Denmark. 4. Copenhagen Academy for Medical Education and Simulation (CAMES), University of Copenhagen, Denmark; Department of Respiratory Medicine, Gentofte University Hospital, Hellerup, Denmark. 5. DTU Nanotech, Department of Micro-and Nanotechnology, Technical University of Denmark, Lyngby, Denmark; Nanovi Radiotherapy A/S, Lyngby, Denmark. 6. Department of Oncology, University of Copenhagen, Denmark; Niels Bohr Institute, University of Copenhagen, Denmark. 7. DTU Nanotech, Department of Micro-and Nanotechnology, Technical University of Denmark, Lyngby, Denmark.
Abstract
BACKGROUND AND PURPOSE: We analysed the positional and structural stability of a long-term biodegradable liquid fiducial marker (BioXmark) for radiotherapy in patients with locally advanced lung cancer. MATERIAL AND METHODS: Markers were injected via endoscopic- or endobronchial ultrasound in lymph nodes and reachable primary tumours. Marker volume and Hounsfield Units (HU) changing rates were estimated using breath-hold CBCT. Inter-fraction variation in marker position relative to gross tumour volume (GTV) position was established, as well as the inter-fraction variation in mediastinal marker registration relative to a carina registration through the treatment. RESULTS: Fifteen patients were included and 29 markers analysed. All markers that were in situ at planning were visible through the treatment. Mean HU was 902±165HU for lymph node and 991±219HU for tumour markers. Volume degradation rates were -5% in lymph nodes and -23% in primary tumours. Three-dimensional inter-fraction variation for marker position relative to the GTV position was -0.1±0.7mm in lymph nodes and -1.5±2.3mm in primary tumours. Inter-fraction variations in marker registration relative to carina registration were -0.4±1.2mm in left-right, 0.2±2.0mm in anterior-posterior and -0.5±2.0mm in cranio-caudal directions. CONCLUSIONS: The liquid fiducial markers were visible and stable in size and position throughout the treatment course.
BACKGROUND AND PURPOSE: We analysed the positional and structural stability of a long-term biodegradable liquid fiducial marker (BioXmark) for radiotherapy in patients with locally advanced lung cancer. MATERIAL AND METHODS: Markers were injected via endoscopic- or endobronchial ultrasound in lymph nodes and reachable primary tumours. Marker volume and Hounsfield Units (HU) changing rates were estimated using breath-hold CBCT. Inter-fraction variation in marker position relative to gross tumour volume (GTV) position was established, as well as the inter-fraction variation in mediastinal marker registration relative to a carina registration through the treatment. RESULTS: Fifteen patients were included and 29 markers analysed. All markers that were in situ at planning were visible through the treatment. Mean HU was 902±165HU for lymph node and 991±219HU for tumour markers. Volume degradation rates were -5% in lymph nodes and -23% in primary tumours. Three-dimensional inter-fraction variation for marker position relative to the GTV position was -0.1±0.7mm in lymph nodes and -1.5±2.3mm in primary tumours. Inter-fraction variations in marker registration relative to carina registration were -0.4±1.2mm in left-right, 0.2±2.0mm in anterior-posterior and -0.5±2.0mm in cranio-caudal directions. CONCLUSIONS: The liquid fiducial markers were visible and stable in size and position throughout the treatment course.
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Authors: Steen Riisgaard de Blanck; Jonas Scherman Rydhög; Klaus Richter Larsen; Paul Frost Clementsen; Mirjana Josipovic; Marianne Camille Aznar; Per Munck Af Rosenschöld; Rasmus Irming Jølck; Lena Specht; Thomas Lars Andresen; Gitte Fredberg Persson Journal: Clin Transl Radiat Oncol Date: 2018-08-02