TraceIT Gel as a Fiducial Marker for Image-Guided Radiation Therapy in Bladder Cancer: A feasibility pilot study

Congress:

2018 ASM

Poster Number:

R-0094

Type:

Scientific Exhibit

Keywords:

Pelvis, CT, Localisation, Image guided radiotherapy

Authors:

C. Wilson, M. Chao, F. Foroudi, D. Lim Joon, D. Bolton, A. Tan, N. Lawrentshuck, H. Ho, S. Spencer; VIC/AU

DOI:

10.1594/ranzcr2018/R-0094

DOI-Link:

https://dx.doi.org/10.1594/ranzcr2018/R-0094

Fig. 1: TraceIT® injection 1cm from tumour using cystoscopic injection needle

Fig. 2: TraceIT blebs (outlined in red) on CT images

Fig. 3: TraceIT® blebs (red contours) clearly visible on CBCT images

Purpose

96 800x600 To assess the visibility and stability of injecting Trace IT gel for use as a fiducial marker for image guided radiotherapy boost to the primary tumour in muscle invasive bladder cancer. To assess the variation in patient shift between bone and fiducial matching.

Methods and materials

96 800x600 Partial bladder irradiation is aimed at reducing treatment volumes by delivering radiotherapy only to the bladder tumour, sparing the remaining normal bladder. This can been delivered either as a single phase of treatment or as a boost phase alone, following lower dose irradiation of the entire bladder (1-4). This technique however is limited by both reliable target delineation on CT imaging as well as organ motion and subsequent variations in tumour position (5). Strategies have subsequently been developed to better delineate the location...

Results

96 800x600 From September 2015 to July 2017, four patients with muscle invasive bladder carcinoma were included in the study. No complications were reported following injection with TraceIT. The volume of Trace IT geldid notsignificantly diminish over the course of partial bladder radiotherapy with a mean volume on day 1 of 0.38mL, compared to a mean volume of 0.31mL on day 7 (p=0.14). The visibility of the fiducialalso remainedstable over the treatment course with a mean Hounsfield Unit of 1069.75 on Day 1, compared to...

Conclusion

96 800x600 This study demonstrates that Trace IT gel is a suitable fiducial marker for delivery of partial bladder radiotherapy. Despite a reduction in volume, the visibility of the marker on CBCT remained stable over the course of partial bladder radiotherapy. Use of fiducial markers increases accuracy of radiotherapy delivery in partial bladder radiotherapy.

Personal information

Dr Craig Wilson Clinical Research Fellow - Austin Health

References

1. Piet AH, Hulshof MC, Pieters BR, Pos FJ, de Reijke TM, Koning CC. Clinical results of a concomitant boost radiotherapy technique for muscle-invasive bladder cancer. Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft [et al]. 2008;184(6):313-8. 2. Yavuz AA, Yavuz MN, Ozgur GK, Colak F, Ozyavuz R, Cimsitoglu E, et al. Accelerated superfractionated radiotherapy with concomitant boost for invasive bladder cancer. International journal of radiation oncology, biology, physics. 2003;56(3):734-45. 3. Cowan RA, McBain CA, Ryder WD, Wylie JP, Logue JP, Turner SL, et al....