Steen Riisgaard de Blanck1, Jonas Scherman-Rydhög2,3, Mette Siemsen4, Merete Christensen4, Lene Baeksgaard1, Rasmus Irming Jølck5,6, Lena Specht1, Thomas Lars Andresen5, Gitte Fredberg Persson1. 1. 1Department of Oncology, Section of Radiotherapy, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark. 2. 2Department of Physics, Niels Bohr Institute, University of Copenhagen , Copenhagen , Denmark. 3. 3 Department of Radiation Physics, Skane University Hospital , Lund , Sweden. 4. 4 Department of Thoracic Surgery, Rigshospitalet, University of Copenhagen , Copenhagen , Denmark. 5. 5 DTU Nanotech, Department of Micro-and Nanotechnology, Center for Nanomedicine and Theranostics, Technical University of Denmark , Kongens Lyngby , Denmark. 6. 6 Nanovi A/S, DTU Scion , Kongens Lyngby , Denmark.
Abstract
OBJECTIVE: : To evaluate the feasibility of a new liquid fiducial marker for use in image-guided radiotherapy for oesophageal cancer. METHODS: : Liquid fiducial markers were implanted in patients with metastatic or inoperable locally advanced oesophageal or gastro-oesophageal junction cancer receiving radiotherapy. Markers were implanted using a conventional gastroscope equipped with a 22 G Wang needle. Marker visibility was evaluated on fluoroscopy, CT, MRI and cone beam CT scans. RESULTS: : Liquid markers (n = 16) were injected in four patients. No Grade 2 or worse adverse events were observed in relation to the implantation procedure, during treatment or in the follow-up period. 12/16 (75%) markers were available at the planning CT-scan and throughout the treatment- and follow-up period. The implanted markers were adequately visible in CT and cone beam CT but were difficult to distinguish in fluoroscopy and MRI without information from the corresponding CT image. CONCLUSION: : Liquid fiducial marker placement in the oesophagus proved safe and clinically feasible. ADVANCES IN KNOWLEDGE:: This paper presents the first clinical use of a new liquid fiducial marker in patients with oesophageal cancer and demonstrates that marker implantation using standard gastroscopic equipment and subsequent use in three-dimensional image-guided radiation therapy is safe and clinically feasible.
OBJECTIVE: : To evaluate the feasibility of a new liquid fiducial marker for use in image-guided radiotherapy for oesophageal cancer. METHODS: : Liquid fiducial markers were implanted in patients with metastatic or inoperable locally advanced oesophageal or gastro-oesophageal junction cancer receiving radiotherapy. Markers were implanted using a conventional gastroscope equipped with a 22 G Wang needle. Marker visibility was evaluated on fluoroscopy, CT, MRI and cone beam CT scans. RESULTS: : Liquid markers (n = 16) were injected in four patients. No Grade 2 or worse adverse events were observed in relation to the implantation procedure, during treatment or in the follow-up period. 12/16 (75%) markers were available at the planning CT-scan and throughout the treatment- and follow-up period. The implanted markers were adequately visible in CT and cone beam CT but were difficult to distinguish in fluoroscopy and MRI without information from the corresponding CT image. CONCLUSION: : Liquid fiducial marker placement in the oesophagus proved safe and clinically feasible. ADVANCES IN KNOWLEDGE:: This paper presents the first clinical use of a new liquid fiducial marker in patients with oesophageal cancer and demonstrates that marker implantation using standard gastroscopic equipment and subsequent use in three-dimensional image-guided radiation therapy is safe and clinically feasible.
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