Exploratory models comparing ethiodized oil-glue and gold fiducials for bladder radiotherapy image-guidance.
Bladder cancer
Glue fiducials
Image-guided radiotherapy
Liquid fiducials
Prostate cancer
Radiotherapy
Journal
Physics and imaging in radiation oncology
ISSN: 2405-6316
Titre abrégé: Phys Imaging Radiat Oncol
Pays: Netherlands
ID NLM: 101704276
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
22
07
2020
revised:
23
01
2021
accepted:
28
01
2021
entrez:
26
4
2021
pubmed:
27
4
2021
medline:
27
4
2021
Statut:
epublish
Résumé
Image-guidance with fiducials has been shown to improve pelvic radiotherapy outcome. However, bladder fiducials using ethiodized oil (EO) alone can disperse widely, and gold causes Computed Tomography scan (CT) metal artifacts. The study's purpose was to investigate the ability to deliver EO-tissue glue fiducials and compare them to gold for bladder radiotherapy image guidance. A fluid-filled porcine bladder model was used to assess the ability to cystoscopically inject visible EO glue fiducials into the submucosa. We then transferred the bladders into a porcine pelvis for imaging and compared them to gold fiducials using CT, Cone Beam CT (CBCT), and kilovoltage (KV) planar views. A tissue-equivalent phantom was utilized to analyze the CT number Hounsfield Unit (HU) characteristics and artifacts of the glue and gold fiducials. Percentile ranges and normal tissue voxel percentages of the subsequent CT number voxel histogram from a 2 cm sphere surrounding the fiducial was used to characterize the artifact We successfully delivered all EO glue fiducials into the porcine bladders as discrete fiducials. They were well seen on CT, CBCT, and KV imaging. The glue fiducials had lower CT number values, but less CT number spread of the voxel percentile ranges consistent with the diminished contrast and less artifact than gold. The glue fiducial types had similar CT number characteristics. This study has shown that EO glue fiducials can be delivered with online visualization qualities comparable to gold fiducials without metal-related artifacts.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Image-guidance with fiducials has been shown to improve pelvic radiotherapy outcome. However, bladder fiducials using ethiodized oil (EO) alone can disperse widely, and gold causes Computed Tomography scan (CT) metal artifacts. The study's purpose was to investigate the ability to deliver EO-tissue glue fiducials and compare them to gold for bladder radiotherapy image guidance.
MATERIALS AND METHODS
METHODS
A fluid-filled porcine bladder model was used to assess the ability to cystoscopically inject visible EO glue fiducials into the submucosa. We then transferred the bladders into a porcine pelvis for imaging and compared them to gold fiducials using CT, Cone Beam CT (CBCT), and kilovoltage (KV) planar views. A tissue-equivalent phantom was utilized to analyze the CT number Hounsfield Unit (HU) characteristics and artifacts of the glue and gold fiducials. Percentile ranges and normal tissue voxel percentages of the subsequent CT number voxel histogram from a 2 cm sphere surrounding the fiducial was used to characterize the artifact
RESULTS
RESULTS
We successfully delivered all EO glue fiducials into the porcine bladders as discrete fiducials. They were well seen on CT, CBCT, and KV imaging. The glue fiducials had lower CT number values, but less CT number spread of the voxel percentile ranges consistent with the diminished contrast and less artifact than gold. The glue fiducial types had similar CT number characteristics.
CONCLUSION
CONCLUSIONS
This study has shown that EO glue fiducials can be delivered with online visualization qualities comparable to gold fiducials without metal-related artifacts.
Identifiants
pubmed: 33898783
doi: 10.1016/j.phro.2021.01.008
pii: S2405-6316(21)00008-7
pmc: PMC8058020
doi:
Types de publication
Journal Article
Langues
eng
Pagination
77-83Informations de copyright
© 2021 The Author(s).
Déclaration de conflit d'intérêts
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Providers: KARL STORZ Endoscopy Australia Pty Ltd supplied the cystoscopes, William A. Cook Australia PTY LTD supplied the Williams Cystoscopic Injection needles, Guerbet USA supplied the Lipiodol Ethiodized Oil, B.Braun Australia Pty.Ltd supplied the Histoacryl, MatrixSurgical supplied the Glubran2 (GEM), Sinclair’s Abattoir, Benalla Victoria, supplied the pig bladders and Brenta’s Butcher, Fairfield Victoria supplied the pigs pelvis.
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