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Assessment of post implant migration of anchor type gold fiducial marker in carcinoma prostate: A single institution experience

Author: 
Narendra Kumar, Anindya Mukherjee, Gedela L Deepthi, Arun S Oinam, Renu Madan and Santosh Kumar
Subject Area: 
Health Sciences
Abstract: 

Objective: Accuracy of target localization is of paramount importance in dose escalation of prostate cancer radiotherapy by Intensity Modulated Radiotherapy (IMRT) technique. Intraprostatic fiducial implantation is a standard procedure for localization of target volume. However, the possibility of fiducial migration confers uncertainty in radiotherapy planning. In this study, we have tried to evaluate whether there is significant migration of anchor type fiducials one week after their implantation when planning computed tomography (CT) scan is usually acquired. Material and methods: We have analysed fiducial migration (FM) in 8 localized prostate cancer patients treated with IMRT. The median variation of Intermarker distances (IMD) between the apex, left and right fiducials were calculated to assess FM between day of implantation and day of planning CT acquisition. Results: Between February 2015 and December 2016, 10 patients of prostate cancer were treated with IMRT based on fiducial markers. The FM came out to be 0.01, 0.03 and 0.1 cm respectively for apex-right, apex-left and left-right IMD. Conclusions: FM was within 3 mm of our institutional Planning Target Volume (PTV) margins. Anchor type fiducials were found to be quite reliable for target volume localization and radiotherapy planning. Hence, planning CT scan can be taken on the day of fiducial implantation.

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