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SU-E-J-205: Modeling Fiducial Marker Movement in Prostate.

W Yao1, M Corsten1

  • 1Eastern Health, St. John's, NL.

Medical Physics
|May 19, 2017
PubMed
Summary
This summary is machine-generated.

Fiducial marker migration in prostate cancer patients can exceed 2 mm, impacting patient positioning accuracy. This highlights that small registration errors do not guarantee precise positioning for treatments like SBRT.

Keywords:
Computed tomographyCone beam computed tomographyData analysisEclipsesError analysisImage registrationMedical imagingRadiation therapyTissues

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Image-Guided Therapy

Background:

  • Accurate patient positioning is crucial for effective radiation therapy, particularly for prostate cancer.
  • Fiducial markers are commonly used to guide patient setup and treatment delivery.
  • Understanding fiducial marker behavior is essential for optimizing treatment accuracy.

Purpose of the Study:

  • To investigate the movement of fiducial markers within prostate cancer patients.
  • To enhance prostate patient positioning strategies utilizing fiducial markers.

Main Methods:

  • Retrospective analysis of planning CT and cone-beam CT (CBCT) scans.
  • Automatic registration of CBCT to CT based on bony anatomy.
  • Development of an algorithm for optimal fiducial marker registration to isolate prostate deformation and marker migration.
  • Mathematical modeling to quantify marker migration and correlate it with bladder and rectal filling status.

Main Results:

  • Developed an optimal registration algorithm to minimize patient setup error, with average registration errors ranging from 0.62 to 1.27 mm.
  • Identified potential marker migration up to 2.9 mm, exceeding the 2 mm tolerance often required for Stereotactic Body Radiation Therapy (SBRT).
  • Quantified the relative contribution of bladder filling (43%), rectal filling (31%), and rectal gas (26%) to prostate deformation in one patient.

Conclusions:

  • Fiducial marker migration can exceed 2 mm, potentially compromising treatment accuracy.
  • A small registration error does not necessarily equate to accurate patient positioning when significant marker migration occurs.
  • Soft tissue-based registration may be preferable when optimal registration errors exceed 2 mm or when marker migration is substantial.