Osamu Tanaka1, Hisao Komeda2, Masayoshi Tamaki2, Kensaku Seike2, Shota Fujimoto2, Eiichi Yama3, Shigeki Hirose3, Masayuki Matsuo4. 1. 1 Department of Radiation Oncology, Murakami Memorial Hospital , Murakami Memorial Hospital , Gifu city, Gifu , Japan. 2. 2 Department of Urology, Gifu Municipal Hospital , Gifu Municipal Hospital , Gifu city , Japan. 3. 3 Division of Radiation Service, Gifu Municipal Hospital , Gifu Municipal Hospital , Gifu city , Japan. 4. 4 Department of Radiology, Gifu University School of Medicine , Gifu University School of Medicine , Gifu City , Japan.
Abstract
OBJECTIVE: Visualizing the gold marker (GM) in CT and MRI is critical, especially for registration in high-precision radiotherapy. GM sizes vary. Large markers are easily visualized in MRI. Small GMs show fewer artefacts in CT but are harder to detect in MRI because the signal is influenced by metal in MRI. Therefore, we compared MRI visualization between linearly placed new iron-containing marker and non-iron containing marker. METHODS: 27 patients underwent CT/MRI fusion-based intensity-modulated radiotherapy. The gold markers were placed by urologists. An iron-containing Gold Anchor™ (GA) marker (diameter, 0.28 mm; length, 10 mm) was placed by using a 22 G needle on one side of the prostate linearly. A non-iron-containing VISICOIL™ (VIS) marker (diameter, 0.35 mm; length, 10 mm) was placed by using a 19 G needle on the opposite side linearly. T2* weighted MRI was mostly performed. Two Radiation Oncologists and one Radiation Technologist evaluated and assigned visual quality scores (GA shape, CT artefacts, MRI signal voids). RESULTS: The mean visualization scores of artefacts were similar between GA and VIS in planning CT. GM visualization in MRI of the prostate was better for GA than for VIS. The visibility of the linear shape of the GA was 3.4-4.1 points when the VIS was 5 points (1 is worst and 5 is best). CONCLUSION: Visualization quality was similar between GA (iron-containing marker) and VIS (non-iron-containing marker) in planning CT, but was better for GA than for VIS in MRI. To achieve high-precision radiotherapy, an iron-containing gold marker was useful for CT and MRI registration. Advances in knowledge: An iron-containing fiducial marker was useful for CT and MRI registration, especially in high-precision radiotherapy, such as stereotactic body radiotherapy and intensity-modulated radiotherapy.
OBJECTIVE: Visualizing the gold marker (GM) in CT and MRI is critical, especially for registration in high-precision radiotherapy. GM sizes vary. Large markers are easily visualized in MRI. Small GMs show fewer artefacts in CT but are harder to detect in MRI because the signal is influenced by metal in MRI. Therefore, we compared MRI visualization between linearly placed new iron-containing marker and non-iron containing marker. METHODS: 27 patients underwent CT/MRI fusion-based intensity-modulated radiotherapy. The gold markers were placed by urologists. An iron-containing Gold Anchor™ (GA) marker (diameter, 0.28 mm; length, 10 mm) was placed by using a 22 G needle on one side of the prostate linearly. A non-iron-containing VISICOIL™ (VIS) marker (diameter, 0.35 mm; length, 10 mm) was placed by using a 19 G needle on the opposite side linearly. T2* weighted MRI was mostly performed. Two Radiation Oncologists and one Radiation Technologist evaluated and assigned visual quality scores (GA shape, CT artefacts, MRI signal voids). RESULTS: The mean visualization scores of artefacts were similar between GA and VIS in planning CT. GM visualization in MRI of the prostate was better for GA than for VIS. The visibility of the linear shape of the GA was 3.4-4.1 points when the VIS was 5 points (1 is worst and 5 is best). CONCLUSION: Visualization quality was similar between GA (iron-containing marker) and VIS (non-iron-containing marker) in planning CT, but was better for GA than for VIS in MRI. To achieve high-precision radiotherapy, an iron-containing gold marker was useful for CT and MRI registration. Advances in knowledge: An iron-containing fiducial marker was useful for CT and MRI registration, especially in high-precision radiotherapy, such as stereotactic body radiotherapy and intensity-modulated radiotherapy.
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