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Exploratory models comparing ethiodized oil-glue and gold fiducials for bladder radiotherapy image-guidance. | LitMetric

AI Article Synopsis

  • The study explores the use of ethiodized oil (EO) and tissue glue fiducials for bladder radiotherapy image guidance, addressing issues with traditional gold fiducials that cause metal artifacts on CT scans.
  • A porcine bladder model was used to successfully inject EO glue fiducials, which were later compared to gold fiducials using various imaging techniques (CT, Cone Beam CT, and kilovoltage).
  • Results indicated that EO glue fiducials were clearly visible and produced less artifact than gold, suggesting they may be a more effective option for improving radiotherapy outcomes.

Article Abstract

Background And Purpose: Image-guidance with fiducials has been shown to improve pelvic radiotherapy outcome. However, bladder fiducials using ethiodized oil (EO) alone can disperse widely, and gold causes Computed Tomography scan (CT) metal artifacts. The study's purpose was to investigate the ability to deliver EO-tissue glue fiducials and compare them to gold for bladder radiotherapy image guidance.

Materials And Methods: A fluid-filled porcine bladder model was used to assess the ability to cystoscopically inject visible EO glue fiducials into the submucosa. We then transferred the bladders into a porcine pelvis for imaging and compared them to gold fiducials using CT, Cone Beam CT (CBCT), and kilovoltage (KV) planar views. A tissue-equivalent phantom was utilized to analyze the CT number Hounsfield Unit (HU) characteristics and artifacts of the glue and gold fiducials. Percentile ranges and normal tissue voxel percentages of the subsequent CT number voxel histogram from a 2 cm sphere surrounding the fiducial was used to characterize the artifact

Results: We successfully delivered all EO glue fiducials into the porcine bladders as discrete fiducials. They were well seen on CT, CBCT, and KV imaging. The glue fiducials had lower CT number values, but less CT number spread of the voxel percentile ranges consistent with the diminished contrast and less artifact than gold. The glue fiducial types had similar CT number characteristics.

Conclusion: This study has shown that EO glue fiducials can be delivered with online visualization qualities comparable to gold fiducials without metal-related artifacts.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8058020PMC
http://dx.doi.org/10.1016/j.phro.2021.01.008DOI Listing

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