文章：

一种用于图像引导放射治疗的新型聚合物封装多模态成像基准标记物，具有正信号对比度

A Novel Polymer-Encapsulated Multi-Imaging Modality Fiducial Marker with Positive Signal Contrast for Image-Guided Radiation Therapy

原文发布日期：31 January 2024

DOI: 10.3390/cancers16030625

类型: Article

开放获取: 是

英文摘要：

Background: Current fiducial markers (FMs) in external-beam radiotherapy (EBRT) for prostate cancer (PCa) cannot be positively visualized on magnetic resonance imaging (MRI) and create dose perturbation and significant imaging artifacts on computed tomography (CT) and MRI. We report our initial experience with clinical imaging of a novel multimodality FM, NOVA. Methods: We tested Gold Anchor [G-FM], BiomarC [carbon, C-FM], and NOVA FMs in phantoms imaged with kilovoltage (kV) X-rays, transrectal ultrasound (TRUS), CT, and MRI. Artifacts of the FMs on CT were quantified by the relative streak artifacts level (rSAL) metric. Proton dose perturbations (PDPs) were measured with Gafchromic EBT3 film, with FMs oriented either perpendicular to or parallel with the beam axis. We also tested the performance of NOVA-FMs in a patient. Results: NOVA-FMs were positively visualized on all 4 imaging modalities tested. The rSAL on CT was 0.750 ± 0.335 for 2-mm reconstructed slices. In F-tests, PDP was associated with marker type and depth of measurement (p< 10−6); at 5-mm depth, PDP was significantly greater for the G-FM (12.9%,p= 10−6) and C-FM (6.0%,p= 0.011) than NOVA (4.5%). EBRT planning with MRI/CT image co-registration and daily alignments using NOVA-FMs in a patient was feasible and reproducible. Conclusions: NOVA-FMs were positively visible and produced less PDP than G-FMs or C-FMs. NOVA-FMs facilitated MRI/CT fusion and identification of regions of interest.

摘要翻译： 

背景：当前用于前列腺癌外照射放疗的基准标记物在磁共振成像中无法被清晰显影，并在计算机断层扫描和磁共振成像中产生剂量扰动及显著伪影。本研究报道一种新型多模态基准标记物NOVA的临床影像学初步应用经验。方法：我们在体模中测试了金锚标记物、碳基BiomarC标记物及NOVA标记物在千伏级X射线、经直肠超声、CT及MRI四种成像模式下的表现。通过相对条纹伪影水平指标量化标记物在CT图像上的伪影程度。使用Gafchromic EBT3胶片测量质子剂量扰动，标记物分别设置为垂直或平行于射束轴线方向。同时在一例患者体内测试了NOVA标记物的实际性能。结果：NOVA标记物在全部四种成像模式下均呈现清晰显影。在2毫米重建层厚的CT图像中，相对条纹伪影水平为0.750±0.335。方差分析显示质子剂量扰动与标记物类型及测量深度显著相关（p<10⁻⁶）；在5毫米深度处，金锚标记物（12.9%，p=10⁻⁶）和碳基标记物（6.0%，p=0.011）的剂量扰动显著高于NOVA标记物（4.5%）。临床病例中基于NOVA标记物进行MRI/CT图像配准及每日摆位验证的外照射放疗计划具有可行性和可重复性。结论：NOVA标记物在多模态成像中均能清晰显影，且比金锚或碳基标记物产生更小的剂量扰动。该标记物能有效促进MRI/CT图像融合及感兴趣区域的识别。

原文链接：

A Novel Polymer-Encapsulated Multi-Imaging Modality Fiducial Marker with Positive Signal Contrast for Image-Guided Radiation Therapy