Liquid fiducial marker performance during radiotherapy of locally advanced non small cell lung cancer

Jonas Scherman Rydhög, Steen Riisgaard Mortensen, Klaus Richter Larsen, Paul Clementsen, Rasmus Irming Jølck, Mirjana Josipovic, Marianne Camille Aznar, Lena Specht, Thomas Lars Andresen, Per Munck Af Rosenschöld, Gitte Fredberg Persson

    Research output: Contribution to journalJournal articleResearchpeer-review

    Abstract

    We analysed the positional and structural stability of a long-term biodegradable liquid fiducial marker (BioXmark) for radiotherapy in patients with locally advanced lung cancer. Markers were injected via endoscopic- or endobronchial ultrasound in lymph nodes and reachable primary tumours. Marker volume and Hounsfield Units (HU) changing rates were estimated using breath-hold CBCT. Inter-fraction variation in marker position relative to gross tumour volume (GTV) position was established, as well as the inter-fraction variation in mediastinal marker registration relative to a carina registration through the treatment. Fifteen patients were included and 29 markers analysed. All markers that were in situ at planning were visible through the treatment. Mean HU was 902±165HU for lymph node and 991±219HU for tumour markers. Volume degradation rates were -5% in lymph nodes and -23% in primary tumours. Three-dimensional inter-fraction variation for marker position relative to the GTV position was -0.1±0.7mm in lymph nodes and -1.5±2.3mm in primary tumours. Inter-fraction variations in marker registration relative to carina registration were -0.4±1.2mm in left-right, 0.2±2.0mm in anterior-posterior and -0.5±2.0mm in cranio-caudal directions. The liquid fiducial markers were visible and stable in size and position throughout the treatment course.
    Original languageEnglish
    JournalRadiotherapy & Oncology
    Volume121
    Issue number1
    Pages (from-to)64-69
    Number of pages6
    ISSN0167-8140
    DOIs
    Publication statusPublished - 2016

    Keywords

    • Image-guided radiotherapy
    • Liquid fiducial marker
    • Marker visibility
    • NSCLC

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