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Marker seed migration in prostate localization.

Matthew M Poggi1, Dean A Gant, Wilfred Sewchand

  • 1Radiation Oncology Service, Department of Radiology, Walter Reed Army Medical Center, Washington, DC, USA. mpoggi@usuhs.mil

International Journal of Radiation Oncology, Biology, Physics
|July 23, 2003
PubMed
Summary
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Prostate marker seeds show negligible migration during radiotherapy, confirming their reliability for tracking gland location. Minor individual seed movements occur but do not compromise accuracy for external beam radiation therapy.

Area of Science:

  • Oncology
  • Medical Physics
  • Radiotherapy

Background:

  • Implanted seeds (fiducial markers) are increasingly used for prostate gland localization in radiotherapy.
  • Data evaluating the validity of marker seed localization, especially throughout external beam radiation therapy, is limited.

Purpose of the Study:

  • To analyze marker seed location and test the hypothesis of no intraseed migration within the prostate.
  • To assess the reliability of marker seeds as surrogates for prostate gland location during radiotherapy.

Main Methods:

  • Nine early-stage prostate cancer patients received 4-5 porous gold marker seeds (1.2 x 2.0 mm) implanted under ultrasound guidance.
  • Seed locations were digitized from weekly orthogonal radiographs using a CMS Focus planning system to determine intraseed spacing.

Related Experiment Videos

  • Digitizing error was assessed using the isocenter and other anatomical landmarks.
  • Main Results:

    • Average overall seed migration was 1.2 ± 0.2 mm over a 7-week radiotherapy course.
    • The maximum average seed movement in any patient was 1.9 mm; minimum average movement was 0.6 mm.
    • The greatest change in intraseed spacing observed was 6.6 mm; digitizing error was 0.20 ± 0.03 mm.

    Conclusions:

    • Marker seeds demonstrate negligible migration within the prostate during definitive radiotherapy.
    • Small, detectable movements in individual seeds may occur due to anatomical or treatment-related changes.
    • Prostate marker seeds are accurate and reliable surrogates for gland location throughout radiotherapy.