Vimoj J Nair1,2,3, Janos Szanto4,2,3, Eric Vandervoort4,2,3, Elizabeth Henderson4,2,5,3, Leonard Avruch6,2, Shawn Malone1,2,3, Pantarotto Jason R1,2,3. 1. Division of Radiation Oncology, The Ottawa Hospital , Ottawa, Ontario, Canada. 2. University of Ottawa, Ottawa, Ontario, Canada. 3. Ottawa Hospital Research Institute (OHRI), Ottawa, Ontario, Canada. 4. Department of Medical Physics, The Ottawa Hospital , Ottawa, Ontario, Canada. 5. Carleton University, Ottawa, Ontario, Canada. 6. Department of Medical Imaging, The Ottawa Hospital , Ottawa, Ontario, Canada.
Abstract
BACKGROUND AND PURPOSE: The purpose of this study is to review our experience with platinum fiducials in terms of feasibility of placement and detectability by both MRI and orthogonal x-ray images used in robotic SABR.Materials and Methods: 29 consecutive SABR patients (30 tumors) treated using fiducial tracking between January 2011 and February 2012 were reviewed. A total of 108 fiducials implanted in or around various tumor sites were identified. The pixel value contrast (PVC) of fiducials seen on MRI mages and treatment unit x-ray images of patients and phantoms were analysed. RESULTS: Migration rates were similar for PS versus GS and GC (6.2%). No difference was noted between the mean PVC in cirrhotic versus non-cirrhotic liver (60.4 vs. 47.9; p = 0.074). MRI sequences for tumors in the liver and other organs revealed a mean PVC for platinum superior to that of gold (p<0.001). No PVC difference was seen between gold and platinum on analysis of the treatment unit x-rays. CONCLUSION: Platinum seeds provide a superior detectability in comparison to gold seeds or coils on MRI images and are detected equally well by an image guidance system using orthogonal x-rays, making them a better choice for fiducial-based CT-MRI registration.
BACKGROUND AND PURPOSE: The purpose of this study is to review our experience with platinum fiducials in terms of feasibility of placement and detectability by both MRI and orthogonal x-ray images used in robotic SABR.Materials and Methods: 29 consecutive SABR patients (30 tumors) treated using fiducial tracking between January 2011 and February 2012 were reviewed. A total of 108 fiducials implanted in or around various tumor sites were identified. The pixel value contrast (PVC) of fiducials seen on MRI mages and treatment unit x-ray images of patients and phantoms were analysed. RESULTS: Migration rates were similar for PS versus GS and GC (6.2%). No difference was noted between the mean PVC in cirrhotic versus non-cirrhotic liver (60.4 vs. 47.9; p = 0.074). MRI sequences for tumors in the liver and other organs revealed a mean PVC for platinum superior to that of gold (p<0.001). No PVC difference was seen between gold and platinum on analysis of the treatment unit x-rays. CONCLUSION: Platinum seeds provide a superior detectability in comparison to gold seeds or coils on MRI images and are detected equally well by an image guidance system using orthogonal x-rays, making them a better choice for fiducial-based CT-MRI registration.
Authors: Michael K Sanders; Arthur J Moser; Asif Khalid; Kenneth E Fasanella; Herbert J Zeh; Steven Burton; Kevin McGrath Journal: Gastrointest Endosc Date: 2010-04-01 Impact factor: 9.427
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