Mark Ostyn1, Aidan M Burke2, Emma Fields1, Dorin Todor3. 1. Virginia Commonwealth University Health System, Department of Radiation Oncology, 401 College St., Richmond, VA 23298. 2. Georgetown University, 3700 O St NW, Washington, DC 20057. 3. Virginia Commonwealth University Health System, Department of Radiation Oncology, 401 College St., Richmond, VA 23298. Electronic address: dorin.todor@vcuhealth.org.
Abstract
PURPOSE: Implanted fiducial markers are a commonly used tool in delineating the CTV in high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancy, but their reliability in gynacological sites is not well understood. These markers and interstitial applicators can experience interfractional motion due to organ swelling or other anatomical changes. The purpose of this study was to evaluate the spatial variation of these features. METHODS AND MATERIALS: The spatial positions of 50 implanted markers and 202 needles were tracked in 15 patients treated over 70 fractions of HDR brachytherapy. Marker and/or needle coordinates were extracted from CT images with contours and dose distributions. Automated analysis determined marker self-consistency and displacements between various elements of the implant. RESULTS: From start to end fraction, the relative positions of the markers experienced an average magnitude displacement of 4.5 ± 3.0 mm while the average displacement of the applicator tips was 11 ± 8 mm, relative to their respective centers of mass (CM). CONCLUSIONS: Markers implanted lateral and superior to the CTV experience greater drift than other implant locations.
PURPOSE: Implanted fiducial markers are a commonly used tool in delineating the CTV in high-dose-rate interstitial brachytherapy (HDR-ISBT) for gynecologic malignancy, but their reliability in gynacological sites is not well understood. These markers and interstitial applicators can experience interfractional motion due to organ swelling or other anatomical changes. The purpose of this study was to evaluate the spatial variation of these features. METHODS AND MATERIALS: The spatial positions of 50 implanted markers and 202 needles were tracked in 15 patients treated over 70 fractions of HDR brachytherapy. Marker and/or needle coordinates were extracted from CT images with contours and dose distributions. Automated analysis determined marker self-consistency and displacements between various elements of the implant. RESULTS: From start to end fraction, the relative positions of the markers experienced an average magnitude displacement of 4.5 ± 3.0 mm while the average displacement of the applicator tips was 11 ± 8 mm, relative to their respective centers of mass (CM). CONCLUSIONS: Markers implanted lateral and superior to the CTV experience greater drift than other implant locations.
Authors: ByongYong Yi; Sina Mossahebi; Arezoo Modiri; Elizabeth M Nichols; Mariana Guerrero; Narottam Lamichhane; Pranshu Mohindra Journal: Int J Part Ther Date: 2022-06-28