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"MRI visibility of gold fiducial markers for image-guided radiotherapy of rectal cancer"
R.P.J. van den Ende, L.S. Rigter, E.M. Kerkhof, E.L. van Persijn van Meerten, E.C. Rijkmans, D.M.J. Lambregts, B. van Triest, M.E. van Leerdam, M. Staring, C.A.M. Marijnen and U.A. van der Heide
Abstract
Background and purpose: A GTV boost is suggested to result in higher complete response rates in rectal cancer patients, which is attractive for organ preservation. Fiducials may offer GTV position verification on (CB)CT, if the fiducial-GTV spatial relationship can be accurately defined on MRI. The study aim was to evaluate the MRI visibility of fiducials inserted in the rectum.
Materials and methods: We tested four fiducial types (two Visicoil types, Cook and Gold Anchor), inserted in five patients each. Four observers identified fiducial locations on two MRI exams per patient in two scenarios: without (scenario A) and with (scenario B) (CB)CT available. A fiducial was defined to be consistently identified if 3 out of 4 observers labeled that fiducial at the same position on MRI. Fiducial visibility was scored on an axial and sagittal T2-TSE sequence and a T1 3D GRE sequence.
Results: Fiducial identification was poor in scenario A for all fiducial types. The Visicoil 0.75 and Gold Anchor were the most consistently identified fiducials in scenario B with 7 out of 9 and 8 out of 11 consistently identified fiducials in the first MRI exam and 2 out of 7 and 5 out of 10 in the second MRI exam, respectively. The consistently identified Visicoil 0.75 and Gold Anchor fiducials were best visible on the T1 3D GRE sequence.
Conclusion: The Visicoil 0.75 and Gold Anchor fiducials were the most visible fiducials on MRI as they were most consistently identified. The use of a registered (CB)CT and a T1 3D GRE MRI sequence is recommended.
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Copyright © 2019 by the authors.
Published version © 2019 by Elsevier Science.
Personal use of this material is permitted. However, permission to reprint or republish this material for advertising or promotional purposes or for creating new collective works for resale or redistribution to servers or lists, or to reuse any copyrighted component of this work in other works, must be obtained from the copyright holder.
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BibTeX entry
| @article{vandenEnde:2019, |
| author |
= {van den Ende, R.P.J. and Rigter, L.S. and Kerkhof, E.M. and van Persijn van Meerten, E.L. and Rijkmans, E.C. and Lambregts, D.M.J. and van Triest, B. and van Leerdam, M.E. and Staring, M. and Marijnen, C.A.M. and van der Heide, U.A.}, |
| title |
= {MRI visibility of gold fiducial markers for image-guided radiotherapy of rectal cancer}, |
| journal |
= {Radiotherapy & Oncology}, |
| volume |
= {132}, |
| number |
= {3}, |
| pages |
= {93 - 99}, |
| month |
= {March}, |
| year |
= {2019}, |
| } |
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