AIM: To assess how the application of different types of markers affects the tracking accuracy of Cyber Knife's.METHODS: Fifteen patients were recruited and subjected to the ultrasound-guided placement of markers....AIM: To assess how the application of different types of markers affects the tracking accuracy of Cyber Knife's.METHODS: Fifteen patients were recruited and subjected to the ultrasound-guided placement of markers. Two different type of needles 25 gauge(G) and 17 G containing two different fiducial marker, gold notched flexible anchor wire 0.28 mm × 10 mm(25 G needle) and gold cylindrical grain 1 mm × 4 mm(17 G), were used. Seven days after the procedure, a Cyber Knife planning computed tomography(CT) for the simulation of radiation treatment was performed on all patients.A binary CT score was assigned to the fiducial markers visualization. Also, the CT number was calculated for each fiducial and the values compared with a specific threshold.RESULTS: For each patient from 1 to 5, intra-hepatic markers were placed(one in 2 patients, three in 8 patients, four in 3 patients, and five in 2 patients). A total of 48 needles were used(thirty-two 17 G and sixteen 25 G) and 48 gold markers were placed(32 Grain shaped markers and 16 Gold Anchor). The result showed that the CT visualization of the grain markers was better than the anchor markers(P = 5 × 10^(-9)). Furthermore, the grain markers were shown to present minor late complications(P = 3 × 10^(-6)), and the best CT threshold number(P = 0.0005). CONCLUSION: The study revealed that the Gold Anchor fiducial marker is correlated with a greater number of late minor complications and low visualization by the CT.展开更多
Re-irradiation(Re-RT)in liver tumours is rarely reported owing to poor tolerance of liver and high incidence of radiation induced liver disease incidence.Fiducial based robotic radiosurgery allows to deliver high dose...Re-irradiation(Re-RT)in liver tumours is rarely reported owing to poor tolerance of liver and high incidence of radiation induced liver disease incidence.Fiducial based robotic radiosurgery allows to deliver high dose radiation to the liver tumour and restricts the dose to healthy uninvolved liver,thereby increasing the potential for Re-RT.Tolerance to radiation is low for entire liver and hence re-radiation is a challenge.On the other hand,as regenerative potential of hepatocytes is rapid,replacement of necrotic liver tissue occurs with regenerated hepatocytes.These regenerated hepatocytes are radiation na?ve,do not have"memory"of radation therapy treatment and hence have potential of Re-RT.We are reporting a series of two breast cancer patients presented with liver oligometastasis treated with fiducial based CyberKnife system(CK).Both the patients were treated multiple times with CK and had long-term survival(>2 years)without any clinical features of radiation induced liver injury.Appropriately selected patients are suitable for multiple sessions of CK for liver lesions with long-term outcome.展开更多
文摘AIM: To assess how the application of different types of markers affects the tracking accuracy of Cyber Knife's.METHODS: Fifteen patients were recruited and subjected to the ultrasound-guided placement of markers. Two different type of needles 25 gauge(G) and 17 G containing two different fiducial marker, gold notched flexible anchor wire 0.28 mm × 10 mm(25 G needle) and gold cylindrical grain 1 mm × 4 mm(17 G), were used. Seven days after the procedure, a Cyber Knife planning computed tomography(CT) for the simulation of radiation treatment was performed on all patients.A binary CT score was assigned to the fiducial markers visualization. Also, the CT number was calculated for each fiducial and the values compared with a specific threshold.RESULTS: For each patient from 1 to 5, intra-hepatic markers were placed(one in 2 patients, three in 8 patients, four in 3 patients, and five in 2 patients). A total of 48 needles were used(thirty-two 17 G and sixteen 25 G) and 48 gold markers were placed(32 Grain shaped markers and 16 Gold Anchor). The result showed that the CT visualization of the grain markers was better than the anchor markers(P = 5 × 10^(-9)). Furthermore, the grain markers were shown to present minor late complications(P = 3 × 10^(-6)), and the best CT threshold number(P = 0.0005). CONCLUSION: The study revealed that the Gold Anchor fiducial marker is correlated with a greater number of late minor complications and low visualization by the CT.
文摘Re-irradiation(Re-RT)in liver tumours is rarely reported owing to poor tolerance of liver and high incidence of radiation induced liver disease incidence.Fiducial based robotic radiosurgery allows to deliver high dose radiation to the liver tumour and restricts the dose to healthy uninvolved liver,thereby increasing the potential for Re-RT.Tolerance to radiation is low for entire liver and hence re-radiation is a challenge.On the other hand,as regenerative potential of hepatocytes is rapid,replacement of necrotic liver tissue occurs with regenerated hepatocytes.These regenerated hepatocytes are radiation na?ve,do not have"memory"of radation therapy treatment and hence have potential of Re-RT.We are reporting a series of two breast cancer patients presented with liver oligometastasis treated with fiducial based CyberKnife system(CK).Both the patients were treated multiple times with CK and had long-term survival(>2 years)without any clinical features of radiation induced liver injury.Appropriately selected patients are suitable for multiple sessions of CK for liver lesions with long-term outcome.
