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Updated: Jun 23, 2026
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Multimodal Cross-Device and Marker-Free Co-Registration of Preclinical Imaging Modalities
Published on: October 27, 2023
Effectiveness of using fewer implanted fiducial markers for prostate target alignment
Rajat J Kudchadker1, Andrew K Lee, Zhiqian H Yu
1Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. rkudchad@mdanderson.org
Summary
Using two or more intraprostatic fiducial markers improves prostate cancer treatment alignment accuracy. Optimal marker placement, like apex and base, enhances reliability, with minimal marker migration observed.
Area of Science:
- Radiation Oncology
- Medical Physics
- Prostate Cancer Treatment
Background:
- Accurate daily prostate target alignment is crucial for effective radiation therapy.
- Fiducial markers are used to improve the accuracy of prostate alignment.
- Understanding the impact of marker number and location is essential for optimizing treatment.
Purpose of the Study:
- To assess how the number and placement of intraprostatic fiducial markers influence daily prostate target alignment accuracy and reproducibility.
- To evaluate the migration patterns of these fiducial markers during radiation therapy.
Main Methods:
- Ten prostate cancer patients received three gold fiducial markers implanted near the prostate's apex, middle, and base.
- Over 1280 alignments were analyzed using computed tomography (CT) scans, comparing soft tissue, bone, and various fiducial marker-based alignment strategies.
- Fiducial marker migration was also assessed.
Main Results:
- Single fiducial marker alignment surpassed bone alignment in accuracy and reproducibility but had limitations due to organ deformation.
- Two-fiducial marker alignment demonstrated superior accuracy and reproducibility compared to single markers.
- The combination of apex and base fiducial markers provided accuracy comparable to using all three markers, with minimal observed migration.
Conclusions:
- The number and location of intraprostatic fiducial markers significantly impact the accuracy and reliability of daily prostate target alignment.
- Employing two or more fiducial markers is recommended for enhanced prostate cancer radiotherapy precision.
