Absence of prostate oedema obviates the need for delay between fiducial marker insertion and radiotherapy simulation

Patel, Deepti, Tan, Alex, Brown, Amy, and Pain, Tilley (2020) Absence of prostate oedema obviates the need for delay between fiducial marker insertion and radiotherapy simulation. Journal of Medical Radiation Sciences, 67 (4). pp. 302-309.

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Abstract

Introduction: Fiducial markers (FMs) are commonly inserted into the prostate for image guided radiation therapy. This study aimed to quantify prostate oedema immediately following FM insertion compared to prostate volumes measured a week later, at the time of simulation for radiation therapy.

Methods: Thirty patients underwent a verification computed tomography (VCT) scan in treatment position immediately after the fiducial insertion and their planning computed tomography scan (PCT) one week after. Patient data sets were retrospectively evaluated, comparing prostate volumes and planning target volumes (PTV). Volumes were delineated by a single radiation oncologist, blinded to whether the scan was VCT or PCT. Distances between the FMs were measured on both scans. Descriptive statistics described the data, DICE similarity co-efficient (DSC) calculated, and paired t-tests were used to compare paired data. Results: The median prostate volume was 35.09 cc and 36.31 cc for VCT and PCT data sets, respectively, and median PTV was 118.56 cc and 127.04 cc for VCT and PCT, respectively. There was no significant difference in prostate volumes (P = 0.3037) or PTV (P = 0.1279), with a DSC of 0.87 (range 0.76-0.91) and 0.91 (range 0.85 to 0.95), respectively. Similarly, there was no significant difference in distance between fiducial markers (P > 0.05).

Conclusion: This study demonstrates no statistically significant difference in prostate or PTV volumes (P > 0.05) between the CT acquired at fiducial marker insertion compared with the CT acquired a week later. Therefore, oedema is not significant enough to justify a delay between FM insertion and simulation.

Item ID: 63846
Item Type: Article (Research - C1)
ISSN: 2051-3909
Keywords: prostate cancer, external beam radiotherapy, fiducial markers, planning target volumes
Copyright Information: © 2020 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Funders: HP Research Scheme
Projects and Grants: HP Research Scheme (2014–2015)
Date Deposited: 22 Jul 2020 07:36
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320215 Nuclear medicine @ 100%
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