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Published on: June 7, 2015
Fiducial markers for image-guided partial breast irradiation
Marco Trovo1, Jerry Polesel, Cristina Biasutti
1Department of Radiation Oncology, Centro di Riferimento Oncologico, CRO, Via F. Gallini 2, 33081, Aviano (PN), Italy, marcotrovo33@hotmail.com.
Purpose:
This study was undertaken to study the role of fiducial markers for image-guided partial breast irradiation (IG-PBI), and to compare the shifts based on bony anatomy and fiducial markers.
Materials And Methods:
Fifteen patients underwent IGPBI. Three fiducial markers were placed in the tumour bed at the time of surgery. Daily orthogonal anterior/ posterior and lateral kV-images were taken before each fraction and compared with the digitally-reconstructed radiographs, both using bony landmarks and fiducial markers as reference. The Student's t test was used to detect a meaningful difference of 3 mm in between the two methods.
Results:
A total of 105 image-guided radiation therapy (IGRT) sessions were obtained. The mean superior/inferior, right/left, and anterior/posterior shifts obtained using the bony landmarks vs. the fiducial markers were 2 mm [standard deviation (SD) 10 mm] vs. 0 mm (SD 7 mm), 0 mm (SD 7 mm) vs. 1 mm (SD 4 mm), and 1 mm (SD 7 mm) vs. 0 mm (SD 5 mm), respectively. The mean shift differences in absolute value between the two methods, along the superior/inferior, right/left and anterior/posterior directions were 5 mm (p=0.001), 3 mm [p=not significant (ns)], and 3 mm (p=ns), respectively.
Conclusions:
Fiducial markers for IG-PBI increase set-up accuracy compared to the bony landmarks, in particular along the superior/inferior direction.
