EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types
Background and study aims To facilitate image guidance during radiotherapy of rectal cancer, we investigated the feasibility of fiducial marker placement. This study aimed to evaluate technical success rate and safety of two endoscopic ultrasound (EUS)-guided placement strategies and four fiducial t...
Main Authors: | , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Georg Thieme Verlag KG
2019-10-01
|
Series: | Endoscopy International Open |
Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0958-2148 |
id |
doaj-fe0fc615d2c64dfc827acb3de80d5c88 |
---|---|
record_format |
Article |
spelling |
doaj-fe0fc615d2c64dfc827acb3de80d5c882020-11-25T03:16:24ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362019-10-010711E1357E136410.1055/a-0958-2148EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial typesLisanne S. Rigter0Eva C. Rijkmans1Akin Inderson2Roy P.J. van den Ende3Ellen M. Kerkhof4Martijn Ketelaars5Jolanda van Dieren6Roeland A. Veenendaal7Baukelien van Triest8Corrie A.M. Marijnen9Uulke A. van der Heide10Monique E. van Leerdam11Department of Gastroenterology, the Netherlands Cancer Institute, Amsterdam, The NetherlandsDepartment of Radiotherapy, Leiden University Medical Center, Leiden, The NetherlandsLeiden Center for Interventional Endoscopy, Department of Gastroenterology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Radiotherapy, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Radiotherapy, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Radiotherapy, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Gastroenterology, the Netherlands Cancer Institute, Amsterdam, The NetherlandsLeiden Center for Interventional Endoscopy, Department of Gastroenterology, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, The NetherlandsDepartment of Radiotherapy, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, The NetherlandsDepartment of Gastroenterology, the Netherlands Cancer Institute, Amsterdam, The NetherlandsBackground and study aims To facilitate image guidance during radiotherapy of rectal cancer, we investigated the feasibility of fiducial marker placement. This study aimed to evaluate technical success rate and safety of two endoscopic ultrasound (EUS)-guided placement strategies and four fiducial types for rectal cancer patients. Patients and methods This prospective multicenter study included 20 participants who were scheduled to undergo rectal cancer treatment with neoadjuvant short-course radiotherapy or chemoradiation. EUS-guided endoscopy was used for fiducial placement at the tumor site (n = 10) or in the mesorectal fat and in the tumor (n = 10). Four fiducial types were used (Visicoil 0.75 mm, Visicoil 0.50 mm, Cook, Gold Anchor). The endpoints were technical success rate and retention of fiducials, the latter of which was evaluated on cone-beam computed tomography scans during the first five radiotherapy fractions. Results A total of 64 fiducials were placed in 20 patients. For each fiducial type, at least three fiducials were successfully placed in all patients. Technical failure consisted of fiducial blockage within the needle (n = 2) and ejection of two preloaded fiducials at once (n = 4). No serious adverse events were reported. In three patients, one of the fiducials was misplaced without clinical consequences; two in the prostate and one in the intraperitoneal cavity. After a median time of 17 days after placement (range 7 – 47 days), a total of 42/64 (66 %) fiducials were still present (24/44 intratumoral vs. 18/20 mesorectal fiducials, P = 0.009). Conclusions Placement of fiducials in rectal cancer patients is feasible, however, retention rates for intratumoral fiducials were lower (55 %) than for mesorectal fiducials (90 %).http://www.thieme-connect.de/DOI/DOI?10.1055/a-0958-2148 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lisanne S. Rigter Eva C. Rijkmans Akin Inderson Roy P.J. van den Ende Ellen M. Kerkhof Martijn Ketelaars Jolanda van Dieren Roeland A. Veenendaal Baukelien van Triest Corrie A.M. Marijnen Uulke A. van der Heide Monique E. van Leerdam |
spellingShingle |
Lisanne S. Rigter Eva C. Rijkmans Akin Inderson Roy P.J. van den Ende Ellen M. Kerkhof Martijn Ketelaars Jolanda van Dieren Roeland A. Veenendaal Baukelien van Triest Corrie A.M. Marijnen Uulke A. van der Heide Monique E. van Leerdam EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types Endoscopy International Open |
author_facet |
Lisanne S. Rigter Eva C. Rijkmans Akin Inderson Roy P.J. van den Ende Ellen M. Kerkhof Martijn Ketelaars Jolanda van Dieren Roeland A. Veenendaal Baukelien van Triest Corrie A.M. Marijnen Uulke A. van der Heide Monique E. van Leerdam |
author_sort |
Lisanne S. Rigter |
title |
EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types |
title_short |
EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types |
title_full |
EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types |
title_fullStr |
EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types |
title_full_unstemmed |
EUS-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types |
title_sort |
eus-guided fiducial marker placement for radiotherapy in rectal cancer: feasibility of two placement strategies and four fiducial types |
publisher |
Georg Thieme Verlag KG |
series |
Endoscopy International Open |
issn |
2364-3722 2196-9736 |
publishDate |
2019-10-01 |
description |
Background and study aims To facilitate image guidance during radiotherapy of rectal cancer, we investigated the feasibility of fiducial marker placement. This study aimed to evaluate technical success rate and safety of two endoscopic ultrasound (EUS)-guided placement strategies and four fiducial types for rectal cancer patients.
Patients and methods This prospective multicenter study included 20 participants who were scheduled to undergo rectal cancer treatment with neoadjuvant short-course radiotherapy or chemoradiation. EUS-guided endoscopy was used for fiducial placement at the tumor site (n = 10) or in the mesorectal fat and in the tumor (n = 10). Four fiducial types were used (Visicoil 0.75 mm, Visicoil 0.50 mm, Cook, Gold Anchor). The endpoints were technical success rate and retention of fiducials, the latter of which was evaluated on cone-beam computed tomography scans during the first five radiotherapy fractions.
Results A total of 64 fiducials were placed in 20 patients. For each fiducial type, at least three fiducials were successfully placed in all patients. Technical failure consisted of fiducial blockage within the needle (n = 2) and ejection of two preloaded fiducials at once (n = 4). No serious adverse events were reported. In three patients, one of the fiducials was misplaced without clinical consequences; two in the prostate and one in the intraperitoneal cavity. After a median time of 17 days after placement (range 7 – 47 days), a total of 42/64 (66 %) fiducials were still present (24/44 intratumoral vs. 18/20 mesorectal fiducials, P = 0.009).
Conclusions Placement of fiducials in rectal cancer patients is feasible, however, retention rates for intratumoral fiducials were lower (55 %) than for mesorectal fiducials (90 %). |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/a-0958-2148 |
work_keys_str_mv |
AT lisannesrigter eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT evacrijkmans eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT akininderson eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT roypjvandenende eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT ellenmkerkhof eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT martijnketelaars eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT jolandavandieren eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT roelandaveenendaal eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT baukelienvantriest eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT corrieammarijnen eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT uulkeavanderheide eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes AT moniqueevanleerdam eusguidedfiducialmarkerplacementforradiotherapyinrectalcancerfeasibilityoftwoplacementstrategiesandfourfiducialtypes |
_version_ |
1724636378930610176 |