一种用于图像引导放射治疗的具有正信号对比度的新型聚合物封装多成像模态基准标记物。

A Novel Polymer-Encapsulated Multi-Imaging Modality Fiducial Marker with Positive Signal Contrast for Image-Guided Radiation Therapy.

作者信息

Wang Li, Sanders Jeremiah, Ward John F, Lee Stephen R, Poenisch Falk, Swanson David Michael, Sahoo Narayan, Zhu Xiaorong Ronald, Ma Jingfei, Kudchadker Rajat J, Choi Seungtaek L, Nguyen Quynh-Nhu, Mayo Lauren L, Shah Shalin J, Frank Steven J

机构信息

Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Cancers (Basel). 2024 Jan 31;16(3):625. doi: 10.3390/cancers16030625.

DOI:10.3390/cancers16030625

PMID:38339376

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10854757/

Abstract

BACKGROUND

Current fiducial markers (FMs) in external-beam radiotherapy (EBRT) for prostate cancer (PCa) cannot be positively visualized on magnetic resonance imaging (MRI) and create dose perturbation and significant imaging artifacts on computed tomography (CT) and MRI. We report our initial experience with clinical imaging of a novel multimodality FM, NOVA.

METHODS

We tested Gold Anchor [G-FM], BiomarC [carbon, C-FM], and NOVA FMs in phantoms imaged with kilovoltage (kV) X-rays, transrectal ultrasound (TRUS), CT, and MRI. Artifacts of the FMs on CT were quantified by the relative streak artifacts level (rSAL) metric. Proton dose perturbations (PDPs) were measured with Gafchromic EBT3 film, with FMs oriented either perpendicular to or parallel with the beam axis. We also tested the performance of NOVA-FMs in a patient.

RESULTS

NOVA-FMs were positively visualized on all 4 imaging modalities tested. The rSAL on CT was 0.750 ± 0.335 for 2-mm reconstructed slices. In F-tests, PDP was associated with marker type and depth of measurement ( < 10); at 5-mm depth, PDP was significantly greater for the G-FM (12.9%, = 10) and C-FM (6.0%, = 0.011) than NOVA (4.5%). EBRT planning with MRI/CT image co-registration and daily alignments using NOVA-FMs in a patient was feasible and reproducible.

CONCLUSIONS

NOVA-FMs were positively visible and produced less PDP than G-FMs or C-FMs. NOVA-FMs facilitated MRI/CT fusion and identification of regions of interest.

摘要

背景

目前用于前列腺癌（PCa）外照射放疗（EBRT）的基准标记物（FMs）在磁共振成像（MRI）上无法清晰显影，并且在计算机断层扫描（CT）和MRI上会产生剂量扰动和明显的成像伪影。我们报告了我们使用新型多模态FM——NOVA进行临床成像的初步经验。

方法

我们在使用千伏（kV）X射线、经直肠超声（TRUS）、CT和MRI成像的体模中测试了金锚[G-FM]、BiomarC[碳，C-FM]和NOVA FMs。通过相对条纹伪影水平（rSAL）指标对CT上FMs的伪影进行量化。使用Gafchromic EBT3胶片测量质子剂量扰动（PDPs），FMs的方向与束轴垂直或平行。我们还在一名患者中测试了NOVA-FMs的性能。

结果

在所有测试的4种成像模态上，NOVA-FMs均能清晰显影。对于2毫米重建切片，CT上的rSAL为0.750±0.335。在F检验中，PDP与标记物类型和测量深度（<10）相关；在5毫米深度处，G-FM（12.9%，P = 10）和C-FM（6.0%，P = 0.011）的PDP明显大于NOVA（4.5%）。在一名患者中，使用NOVA-FMs进行MRI/CT图像配准的EBRT计划和每日校准是可行且可重复的。