1
|
Okihara K, Ueda T, Fujihara A, Shiraishi T, Iwasaki H, Nomoto T, Masui K, Ito-Ihara T, Hara E, Nakai R, Shiina T, Ukimura O. Novel image-guided marker aimed at organ-preserving therapies for prostate cancer. Int J Urol 2024; 31:500-506. [PMID: 38193342 DOI: 10.1111/iju.15389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/24/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE We developed fiducial imaging-guidance markers for the prostate with less imaging artifacts than currently commercially available markers. The aim of this study was to evaluate the imaging artifacts and potential usefulness and safety of these novel fiducial imaging markers in preclinical experiments. METHODS We selected specific metal materials and a shape that can minimize artifacts in line with a license we obtained for a metal with a gold-platinum (Au-Pt) alloy composition that maximized artifact-free MRI images. Both phantom and canine prostate tests were conducted in order to evaluate the imaging artifacts for three imaging modalities, MRI, CT and ultrasound, and the risk of migration of the markers from the site of insertion to elsewhere, as well as crushing. RESULTS The newly developed Au-Pt material had less imaging artifacts in the MRI, CT and ultrasound imaging modalities in comparison with current commercially available fiducial markers made from gold materials only. The Au-Pt markers had sufficient strength and durability and were considered to be potentially clinically useful and safe markers. CONCLUSION The developed Au-Pt markers could be potential tools for accurate lesion-targeted, organ-preserving therapies such as lesion-targeted focal therapy and active surveillance in addition to conventional radiation therapies.
Collapse
Affiliation(s)
- Koji Okihara
- Department of Urology, Maizuru Kyosai Hospital, Maizuru, Japan
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takashi Ueda
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Atsuko Fujihara
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takumi Shiraishi
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Iwasaki
- Department of Urology, Maizuru Kyosai Hospital, Maizuru, Japan
| | - Takeshi Nomoto
- Department of Urology, Maizuru Kyosai Hospital, Maizuru, Japan
| | - Koji Masui
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshiko Ito-Ihara
- The Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Eri Hara
- Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Ryusuke Nakai
- Institute for the Future of Human Society, Kyoto University, Kyoto, Japan
| | - Tsuyoshi Shiina
- Graduate School of Science and Engineering, Shibaura Institute of Technology, Tokyo, Japan
| | - Osamu Ukimura
- Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
2
|
Lim Joon D, Berry C, Harris B, Tacey M, Smith D, Lawrentschuk N, Schneider ME, Fraser O, Hall M, Chao M, Foroudi F, Jenkins T, Angus D, Wada M, Sengupta S, Khoo V. A clinical study comparing polymer and gold fiducials for prostate cancer radiotherapy. Front Oncol 2023; 12:1023288. [PMID: 36818674 PMCID: PMC9930895 DOI: 10.3389/fonc.2022.1023288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/30/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Image guidance with gold fiducials improves outcomes of prostate radiotherapy. However, gold produces artefact on CT imaging, interfering with contouring and verification. The purpose of this study was to compare polymer to standard gold fiducials using radiotherapy imaging modalities to assess the visibility and artefact. Methods Twenty eight patients with locally advanced prostate cancer were enrolled, half had three polymer fiducials implanted into the prostate and half underwent insertion of gold fiducials. Patients were imaged with CT, T2 weighted MRI, cone-beam CT (CBCT) and planar KV images. Fiducials were scored for visibility and assessed for CT artefact in surrounding prostate tissue. The artefact was quantified from Hounsfield number histograms and separated into percentile ranges and proportion of voxels in HU normal tissue range of a 2cm sphere surrounding the fiducial. Results Gold and polymer fiducials were sufficiently visible for CT and CBCT verification. The gold fiducials could be visualized well on KV planar imaging; however, the polymer markers were obscured by pelvic bones. Neither polymer nor gold fiducials could be visualized on MRI. The polymer fiducial produced less artefact than gold on CT, having less voxel spread for the HU percentile ranges and a greater proportion of voxels in the normal tissue range. Conclusions Polymer fiducials are a more suitable fiducial than gold for CT/CBCT in prostate cancer radiotherapy, demonstrating minimal artefact and good visibility on CT. However, they were not well seen on MRI or KV imaging and thus not suitable for co-registration or planar KV verification.
Collapse
Affiliation(s)
- Daryl Lim Joon
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia,*Correspondence: Daryl Lim Joon,
| | - Colleen Berry
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Benjamin Harris
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Mark Tacey
- Office of Research, The Northern Hospital, Epping, VIC, Australia,Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, VIC, Australia
| | - Drew Smith
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | | | | | - Olivia Fraser
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Megan Hall
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Michael Chao
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Farshad Foroudi
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Trish Jenkins
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - David Angus
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Morikatsu Wada
- Radiation Oncology Department, Olivia Newton-John Cancer Centre, Heidelberg, VIC, Australia
| | - Shomik Sengupta
- Austin Health, University of Melbourne, Melbourne, VIC, Australia,*Correspondence: Daryl Lim Joon,
| | - Vincent Khoo
- Department of Clinical Oncology, Royal Marsden Hospital, London, United Kingdom,*Correspondence: Daryl Lim Joon,
| |
Collapse
|
3
|
Cellini F, Tagliaferri L, Frascino V, Alitto AR, Fionda B, Boldrini L, Romano A, Casà C, Catucci F, Mattiucci GC, Valentini V. Radiation therapy for prostate cancer: What's the best in 2021. Urologia 2022; 89:5-15. [PMID: 34496707 DOI: 10.1177/03915603211042335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Radiotherapy is highly involved in the management of prostate cancer. Its features and potential applications experienced a radical evolution over last decades, as they are associated to the continuous evolution of available technology and current oncological innovations. Some application of radiotherapy like brachytherapy have been recently enriched by innovative features and multidisciplinary dedications. In this report we aim to put some questions regarding the following issues regarding multiple aspects of modern application of radiation oncology: the current application of radiation oncology; the modern role of stereotactic body radiotherapy (SBRT) for both the management of primary lesions and for lymph-nodal recurrence; the management of the oligometastatic presentations; the role of brachytherapy; the aid played by the application of the organ at risk spacer (spacer OAR), fiducial markers, electromagnetic tracking systems and on-line Magnetic Resonance guided radiotherapy (MRgRT), and the role of the new opportunity represented by radiomic analysis.
Collapse
Affiliation(s)
- Francesco Cellini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Luca Tagliaferri
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Vincenzo Frascino
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Anna Rita Alitto
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Bruno Fionda
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Luca Boldrini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Angela Romano
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - Calogero Casà
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | | - Gian Carlo Mattiucci
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia
- Radiation Oncology, Mater Olbia Hospital, Olbia, Italy
| | - Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia
| |
Collapse
|
4
|
Pickford Scienti OLP, Darambara DG. An Overview of X-ray Photon Counting Spectral Imaging (x-CSI) with a Focus on Gold Nanoparticle Quantification in Oncology. J Imaging 2021; 8:4. [PMID: 35049845 PMCID: PMC8778032 DOI: 10.3390/jimaging8010004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/24/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
This review article offers an overview of the differences between traditional energy integrating (EI) X-ray imaging and the new technique of X-ray photon counting spectral imaging (x-CSI). The review is motivated by the need to image gold nanoparticles (AuNP) in vivo if they are to be used clinically to deliver a radiotherapy dose-enhancing effect (RDEE). The aim of this work is to familiarise the reader with x-CSI as a technique and to draw attention to how this technique will need to develop to be of clinical use for the described oncological applications. This article covers the conceptual differences between x-CSI and EI approaches, the advantages of x-CSI, constraints on x-CSI system design, and the achievements of x-CSI in AuNP quantification. The results of the review show there are still approximately two orders of magnitude between the AuNP concentrations used in RDEE applications and the demonstrated detection limits of x-CSI. Two approaches to overcome this were suggested: changing AuNP design or changing x-CSI system design. Optimal system parameters for AuNP detection and general spectral performance as determined by simulation studies were different to those used in the current x-CSI systems, indicating potential gains that may be made with this approach.
Collapse
Affiliation(s)
- Oliver L. P. Pickford Scienti
- Joint Department of Physics, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London SM2 5NG, UK;
| | | |
Collapse
|