Abstract
Purpose To gather statistics about the probability of fiducial migration during the process of treating liver tumor with CyberKnife and analyze the risks brought by fiducial migration. Methods Between March 2011 and June 2012, 552 patients of liver tumors accepted CyberKnife treatment in the Oncology Radiotherapy Center, among whom the youngest was 21 years old and the oldest was 78. In total, 2378 fiducial markers were implanted in patients, at least 2 fiducials per patient, at most 9 fiducials per patient, and on average, 4.37 fiducials are implanted per patient. We gathered statistics about the fiducial migration before and during the treatment, got the number of cases with fiducial migration and the number of migrated fiducials in these two situations, and studied the risks brought by the migration according to fiducial tracking principle. Results 78 of the 552 patients had fiducial migration, with a migration probability of 14.13 %; 93 of the 2378 implanted fiducials migrated, with a migration probability of 3.91 %. Before the treatment, 47 patients had fiducial migration, taking 8.51 % of the total; 58 fiducials migrated, taking 2.44 % of the total; during the treatment, 31 patients (5.62 %) had 35 fiducials (1.47 %) migrated. Conclusion The problem of fiducial migration before treatment, which results in the reduction of trackable fiducials, could be resolved by a re-implantation. If fiducials migrate to other organs before treatment, the selection of fiducials used for tracking may be affected, so we need to recognize them carefully. If fiducials migrate during the treatment, the safety and accuracy of treatment may be influenced, and then CT localization shall be implemented when necessary. No matter fiducial migration happens before or during the treatment, we should take measures proactively to avoid influencing the safety and accuracy of radiotherapy.
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References
Kuo JS, Yu C, Petrovich Z, Apuzzo ML (2003) The CyberKnife stereotactic radiosurgery system: description, installation, and an initial evaluation of use and functionality. Neurosurgery 53:1235–1239
Quinn AM (2002) CyberKnife: a robotic radiosurgery system. Clin J Oncol Nurs 6:149–156
Wunderink W, Romero AM, de Kruijf W et al (2008) Reuduction of respiratory liver tumor motion by abdominal compression in stereotactic body frame, analyzed by tracking fiducial markers implanted in liver. Int J Radiat Oncol Biol Phys 71:907–915
Hoogeman M, Prevost JB, Nuyttens J et al (2009) Clinical accuracy of the respiratory tumor tracking system of the Cyberknife: assessment by analysis of log files. Int J Radiat Oncol Biol Phys 74:297–303
Ho AK, Fu D, Cotrutz C, Hancock SL, Chang SD, Gibbs IC, Maurer Jr CR (2007) A study of the accuracy of CyberKnife spinal radiosurgery using skeletal structure tracking. Neurosurgery 60, ONS147-156 discussion ONS156
Pantelis E, Petrokokkinos L, Antypas C (2009) Image guidance quality assurance of a G4 Cyberknife robotic stereotactic radiosurgery system. JINST 4 P05009
Yu C, Main W, Taylor D, Kuduvalli G, Apuzzo ML, Adler JR Jr (2004) An anthropomorphic phantom study of the accuracy of Cyberknife spinal radiosurgery. Neurosurgery 55:1138–1149
Sotiropoulou E, Stathochristopoulou I, Stathopoulos K et al (2010) CT-guided fiducial placement for CyberKnife stereotactic radiosurgery: an initial experience. Cardiovasc Intervent Radiol 33:586–589
Kupelian P, Forbes A, Willoughby T et al (2007) Implantation and stability of metallic fiducials within pulmonary lesions. Int J Radiat Oncol Biol Phys 69:777–785
Mallarajapatna GJ, Susheela SP, Kallur KG et al (2011) Image guided internal fiducial placement for stereotactic radiosurgery (CyberKnife). Indian J Radiol Imaging 21:3–5
Antypas C, Pantelis E (2008) Performance evaluation of a CyberKnife® G4 image-guided robotic stereotactic radiosurgery system. Phys Med Biol 53:4697–4718
Change SD, Main W, Martin DP, Gibbs IC, Heibrun MP (2003) An analysis of the accuracy of the CyberKnife: a robotic frameless stereotactic radiosurgical system. Neurosurgery 52:140–147
Dieterich Sonja et al (2011) Quality assurance for robotic radiosurgery: report of the AAPM task group 135. Med Phys 38(6):2924–2926
Shirato H, Harada T, Harabayshi T, Hida K, Endo H, Kitamura K et al (2003) Feasibility of insertion/implantation of 2.0 mm-diameter gold internal fiducial markers for precise setup and real-time tumor tracking in radiotherapy. Int J Radiat Oncol Biol Phys 56:240–247
Kim JH, Hong SS, Kim JH et al (2012) Safety and efficacy of ultrasound-guide fiducial marker implantation for CyberKnife radiation therapy. Korean J Radiol 13(3):307–313
Kothary N, Dieterich S, Louie JD et al (2009) Percutaneous implantation of fiducial markers for imaging-guided radiation therapy.AJR 192:1090–1095
Lee Christopher (2012) Airway migration of lung fiducial marker after autologous blood-patch injection. Cardiovasc Intervent Radiol 35:711–713
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Yu, L., Xu, Hj., Zhang, Sj. (2014). On the Statistics and Risks of Fiducial Migration in the CyberKnife Treatment of Liver Cancer Tumors. In: Li, S., Jin, Q., Jiang, X., Park, J. (eds) Frontier and Future Development of Information Technology in Medicine and Education. Lecture Notes in Electrical Engineering, vol 269. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7618-0_16
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DOI: https://doi.org/10.1007/978-94-007-7618-0_16
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