Fiducial migration following small peripheral lung tumor image-guided CyberKnife stereotactic radiosurgery

Konrad L. Strulik, Min H. Cho, Brian T. Collins, Noureen Khan, Filip Banovac, Rebecca Slack, Kevin Cleary


To track respiratory motion during CyberKnife stereotactic radiosurgery in the lung, several (three to five) cylindrical gold fiducials are implanted near the planned target volume (PTV). Since these fiducials remain in the human body after treatment, we hypothesize that tracking fiducial movement over time may correlate with the tumor response to treatment and pulmonary fibrosis, thereby serving as an indicator of treatment success. In this paper, we investigate fiducial migration in 24 patients through examination of computed tomography (CT) volume images at four time points: pre-treatment, three, six, and twelve month post-treatment. We developed a MATLAB based GUI environment to display the images, identify the fiducials, and compute our performance measure. After we semi-automatically segmented and detected fiducial locations in CT images of the same patient over time, we identified them according to their configuration and introduced a relative performance measure (ACD: average center distance) to detect their migration. We found that the migration tended to result in a movement towards the fiducial center of the radiated tissue area (indicating tumor regression) and may potentially be linked to the patient prognosis.

Original languageEnglish
Title of host publicationMedical Imaging 2008: Visualization, Image-Guided Procedures, and Modeling
Number of pages9
Publication date18.06.2008
Article number69181A
ISBN (Print)978-081947102-4
Publication statusPublished - 18.06.2008
Externally publishedYes
EventMedical Imaging 2008 - Visualization, Image-Guided Procedures, and Modeling - San Diego, United States
Duration: 16.02.200821.02.2008
Conference number: 72207


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