Use of implanted gold fiducial markers with MV-CBCT image-guided IMRT for pancreatic tumours.

摘要: Introduction Visualisation of soft tissues such as pancreatic tumours by mega-voltage cone beam CT (MV-CBCT) is frequently difficult and daily localisation often based on more easily seen adjacent bony anatomy. Fiducial markers implanted into serve surrogates for tumour position may accurately represent absolute position. Differences in shifts alignment to fiducial vs. anatomy were compared. Methods Gold placed the under endoscopic ultrasound (EUS) guidance 12 patients. Patients subsequently received image-guided intensity-modulated radiation therapy (IG-IMRT). MV-CBCT was performed prior each fraction isocentre markers. We retrospectively reviewed archived datasets calculated shift differences left-right (LR), superior-inferior (SI) anterior-posterior (AP) axes relative anatomy. Results Two hundred forty-three fractions analysed. The mean difference between those aligned 3.4 mm (range 0–13 mm), 6.3 mm 0–21 mm) 2.6 mm 0–12 mm), LR, SI AP directions, respectively. three-dimensional vector 8.6 mm. Conclusions These data suggest that used conjunction with improve accuracy target delineation compared using gold are a viable option during IG-IMRT.