TY - JOUR
T1 - Evaluation of the Visibility and Artifacts of 11 Common Fiducial Markers for Image Guided Stereotactic Body Radiation Therapy in the Abdomen
AU - Slagowski, Jordan M.
AU - Colbert, Lauren E.
AU - Cazacu, Irina M.
AU - Singh, Ben S.
AU - Martin, Rachael
AU - Koay, Eugene J.
AU - Taniguchi, Cullen M.
AU - Koong, Albert C.
AU - Bhutani, Manoop S.
AU - Herman, Joseph M.
AU - Beddar, Sam
N1 - Funding Information:
The authors thank the following companies for donating their respective fiducial markers for this project: Acculoc Carbon Marker (Carbon Medical Technologies, Inc, St. Paul, MN), Gold Anchor (Naslund Medical AB, Huddinge, Sweden), Beacon FNF Needle (Medtronic, Minneapolis, MN), Cook Medical (Bloomington, IN), Best Medical International, Inc. (Springfield, VA), and Visicoil and Visicoil MR (RadioMed Corporation, Bartlett, TN). None of the vendors participated in the study design. The authors also thank the following radiation oncologists for their participation in the fiducial marker survey: Drs. Jennifer Logan, Shane Stecklein, Penny Fang, Amy Moreno, Courtney Pollard III, Tommy Sheu, and Ahsan Farooqi. Disclosures: Drs. Jordan M. Slagowski, Lauren E. Colbert, Irina M. Cazacu, Rachael Martin, Cullen M. Taniguchi, Albert C. Koong, Joseph M. Herman, Sam Beddar, and Mr. Ben S. Singh have nothing to disclose. Dr. Eugene J. Koay reports a sponsored research agreement with Philips Health Care and grants from GE Health Care outside of the submitted work. Dr. Manoop S. Bhutani reports grants from Augmenix, Silenseed, Oncosil, and Galera outside of the submitted work.
Publisher Copyright:
© 2020 American Society for Radiation Oncology
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Purpose: The purpose of this study was to quantitatively evaluate the visibility and artifacts of commercially available fiducial markers to optimize their selection for image guided stereotactic body radiation therapy. Methods and Materials: From 6 different vendors, we selected 11 fiducials commonly used in image guided radiation therapy. The fiducials varied in material composition (e.g., gold, platinum, carbon), shape (e.g., cylindrical, notched/linear, coiled, ball-like, step), and size measured in terms of diameter (0.28-1.0 mm) and length (3.0-20.0 mm). Each fiducial was centered in 4-mm bolus within a 13-cm-thick water-equivalent phantom. Fiducials were imaged with the use of a simulation computed tomography (CT) scanner, a CT-on-rails system, and an onboard cone beam CT system. Acquisition parameters were set according to clinical protocols. Visibility was assessed in terms of contrast (Δ Hounsfield unit [HU]) and the Michelson visibility metric. Artifacts were quantified in terms of relative standard deviation and relative streak artifacts level (rSAL). Twelve radiation oncologists ranked each fiducial in terms of clinical usefulness. Results: Contrast and artifacts increased with fiducial size. For CT imaging, maximum contrast (2722 HU) and artifacts (rSAL = 2.69) occurred for the largest-diameter (0.75 mm) platinum fiducial. Minimum contrast (551 HU) and reduced artifacts (rSAL = 0.65) were observed for the smallest-diameter (0.28 mm) gold fiducial. Carbon produced the least severe artifacts (rSAL = 0.29). The survey indicated that physicians preferred gold fiducials with a 0.35- to 0.43-mm diameter, 5- to 10-mm length, and coiled or cylindrical shape that balanced contrast and artifacts. Conclusions: We evaluated 11 different fiducials in terms of visibility and artifacts. The results of this study may assist radiation oncologists who seek to maximize contrast, minimize artifacts, or balance contrast versus artifacts by fiducial selection.
AB - Purpose: The purpose of this study was to quantitatively evaluate the visibility and artifacts of commercially available fiducial markers to optimize their selection for image guided stereotactic body radiation therapy. Methods and Materials: From 6 different vendors, we selected 11 fiducials commonly used in image guided radiation therapy. The fiducials varied in material composition (e.g., gold, platinum, carbon), shape (e.g., cylindrical, notched/linear, coiled, ball-like, step), and size measured in terms of diameter (0.28-1.0 mm) and length (3.0-20.0 mm). Each fiducial was centered in 4-mm bolus within a 13-cm-thick water-equivalent phantom. Fiducials were imaged with the use of a simulation computed tomography (CT) scanner, a CT-on-rails system, and an onboard cone beam CT system. Acquisition parameters were set according to clinical protocols. Visibility was assessed in terms of contrast (Δ Hounsfield unit [HU]) and the Michelson visibility metric. Artifacts were quantified in terms of relative standard deviation and relative streak artifacts level (rSAL). Twelve radiation oncologists ranked each fiducial in terms of clinical usefulness. Results: Contrast and artifacts increased with fiducial size. For CT imaging, maximum contrast (2722 HU) and artifacts (rSAL = 2.69) occurred for the largest-diameter (0.75 mm) platinum fiducial. Minimum contrast (551 HU) and reduced artifacts (rSAL = 0.65) were observed for the smallest-diameter (0.28 mm) gold fiducial. Carbon produced the least severe artifacts (rSAL = 0.29). The survey indicated that physicians preferred gold fiducials with a 0.35- to 0.43-mm diameter, 5- to 10-mm length, and coiled or cylindrical shape that balanced contrast and artifacts. Conclusions: We evaluated 11 different fiducials in terms of visibility and artifacts. The results of this study may assist radiation oncologists who seek to maximize contrast, minimize artifacts, or balance contrast versus artifacts by fiducial selection.
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U2 - 10.1016/j.prro.2020.01.007
DO - 10.1016/j.prro.2020.01.007
M3 - Article
C2 - 31988039
AN - SCOPUS:85080102025
VL - 10
SP - 434
EP - 442
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
SN - 1879-8500
IS - 6
ER -