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Using fiducial markers in the prostate bed in postprostatectomy external beam radiation therapy improves accuracy over surgical clips

Goldmarker im Prostatabett bei der Strahlenbehandlung nach Prostatektomie: erhöhte Genauigkeit im Vergleich zu Operationsklammern

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Abstract

Background and purpose

The purpose of this work was to assess the stability of fiducial markers in the prostate bed and compared their use to surgical clips.

Patients and methods

In this study, 3–4 gold fiducial markers were transrectally implanted in the prostate bed of 14 patients. The stability of the fiducial markers position (fiducial markers fixity) over an EBRT course was assessed. Furthermore, the advantages of the fiducial markers compared to the surgical clips were assessed and the interobserver variation between the two technologies was compared.

Results

The mean fiducial marker migration during a course of EBRT was small with 1.2 mm (SD ± 0.8 mm). Compared to fiducial markers, the matches with surgical clips were mismatched ≥ 2 mm in 68 % of treatments. This discrepancy of > 2 mm was on average 3.7 ± 1.3 mm. There was less interobserver variability for matching of fiducial markers (0.8 ± 0.7 mm) than for surgical clips (2.0 ± 1.6 mm).

Conclusion

Fiducial markers showed less interobserver variability in matching and less variation in position than surgical clips. Fiducial markers could ultimately help in reducing treatment margins.

Zusammenfassung

Hintergrund und Ziel

Es wurde die Stabilität von Goldmarkern im Prostatabett untersucht und ihr Nutzen mit dem von Operationsklammern verglichen.

Patienten und Methoden

Bei 14 untersuchten Patienten wurden 3–4 Goldmarker transrektal in das Prostatabett eingesetzt. Während der Bestrahlung wurde die Stabilität der Position der Marker gemessen. Ferner wurden die Vorteile der Goldmarker mit denen der Operationsklammern sowie die Interbeobachtervariation bei beiden verglichen.

Ergebnisse

Die Migration der Goldmarker im Prostatabett war während der Bestrahlung mit einem Durschnitt von 1,2 mm (Standardabweichung ± 0,8 mm) klein. Wenn man das „matching“ von Operationsklammern mit dem „matching“ von Goldmarkern vergleicht, so gab es in 68 % der Bestrahlungen eine Diskrepanz von > 2 mm (durchschnittlich 3,7 ± 1,3 mm). Die Interbeobachtervariation war für den Gebrauch von Goldmarkern (0,8 ± 0,7 mm) im Vergleich zu Operationsklammern (2,0 ± 1,6 mm) geringer.

Schlussfolgerung

Goldmarker waren zuverlässiger als Operationsklammern, da sie eine kleinere Variabilität beim „matching“ zeigten. Nach Ansicht der Autoren können Goldmarker helfen, den Sicherheitsrand zu verringern.

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Acknowledgment

We thank Genevieve Robitaille and Sara Dufort-Venne for their work and Dr. David Roberge for help with the preparation of the manuscript

Compliance with ethicalguidelines

Conflict of interest

I. Fortin, J. F. Carrier, M. C. Beauchemin, D. Béliveau-Nadeau, G. Delouya, and D. Taussky state that there are no conflicts of interest.

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Authors and Affiliations

  1. Département de Radio-Oncologie, Centre Hospitalier de l’Université de Montréal, Centre de recherche du Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, Sherbrooke St. E., 1560, Montréal, Québec, Canada

    I. Fortin MD, MSc, J.-F. Carrier PhD, M.-C. Beauchemin MD, D. Béliveau-Nadeau MSc, G. Delouya MD & D. Taussky MD

Authors
  1. I. Fortin MD, MSc
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  2. J.-F. Carrier PhD
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  3. M.-C. Beauchemin MD
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  4. D. Béliveau-Nadeau MSc
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  5. G. Delouya MD
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  6. D. Taussky MD
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Corresponding author

Correspondence to D. Taussky MD.

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Fortin, I., Carrier, JF., Beauchemin, MC. et al. Using fiducial markers in the prostate bed in postprostatectomy external beam radiation therapy improves accuracy over surgical clips. Strahlenther Onkol 190, 467–471 (2014). https://doi.org/10.1007/s00066-014-0631-3

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  • DOI: https://doi.org/10.1007/s00066-014-0631-3

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