Arpacı Taner, Uğurluer Gamze, İspir Emine Burçin, Eken Alper, Akbaş Tuğana, Serin Meltem
Department of Radiology, Acıbadem University, Acıbadem Adana Hospital, Adana, Turkey.
Department of Radiation Oncology, Acıbadem University, Acıbadem Adana Hospital, Adana, Turkey.
Turk J Urol. 2017 Dec;43(4):451-455. doi: 10.5152/tud.2017.29726. Epub 2017 Dec 1.
The aim of this study was to determine whether significant fiducial marker migration occurs between the periods of prostatic marker insertion and computed tomography (CT) performed for radiotherapy planning and if a waiting period is necessary.
Thirty-nine patients with prostate adenocarcinoma underwent fiducial marker insertion before radiotherapy between June 2013 and December 2015. Three markers were inserted by one radiologist under the guidance of transrectal ultrasonography. All patients underwent CT three hours after insertion to confirm the number and position of fiducial markers. Radiotherapy planning CT was performed on an average of 11 days (range 7-20) after insertion. CT images were imported into treatment planning system to analyze the position of fiducial markers. Point- based marker match algorithm was used to find the distance of marker migration. The mean and maximum distances between each fiducial markers were calculated.
The mean distance of migration was 1.029±0.42 mm (range 0.23-1.93 mm) and the maximum distance was 1.361±0.59 mm (range 0.25-2.74 mm). The distance of marker migration was not statistically significant for the groups organized according to the timing of marker insertion, prostate volume, patient age, prostate specific antigen level and Gleason score.
According to our results significant fiducial marker migration did not occur during the interval between insertion and treatment planning CT. It should be taken into consideration that performing simulation on the same day as marker insertion might prevent increased cost and delayed radiation therapy by saving the patients from extra visits to the clinic.
本研究旨在确定在前列腺标志物插入期与用于放射治疗计划的计算机断层扫描（CT）之间是否发生明显的基准标志物迁移，以及是否需要等待期。
2013年6月至2015年12月期间，39例前列腺腺癌患者在放疗前接受了基准标志物插入。由一名放射科医生在经直肠超声引导下插入三个标志物。所有患者在插入后三小时接受CT检查，以确认基准标志物的数量和位置。放射治疗计划CT在插入后平均11天（范围7 - 20天）进行。将CT图像导入治疗计划系统以分析基准标志物的位置。使用基于点的标志物匹配算法来查找标志物迁移的距离。计算每个基准标志物之间的平均距离和最大距离。
迁移的平均距离为1.029±0.42毫米（范围0.23 - 1.93毫米），最大距离为1.361±0.59毫米（范围0.25 - 2.74毫米）。根据标志物插入时间、前列腺体积、患者年龄、前列腺特异性抗原水平和 Gleason评分分组，标志物迁移的距离无统计学意义。
根据我们的结果，在插入与治疗计划CT之间的间隔期未发生明显的基准标志物迁移。应考虑在标志物插入当天进行模拟，这样可以避免增加成本和延迟放射治疗，使患者无需额外到诊所就诊。
