Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer
Purpose To evaluate Lipiodol as a liquid, radio-opaque fiducial marker for image-guided radiation therapy (IGRT) for bladder cancer.Materials and Methods Between 2011 and 2012, 5 clinical T2a-T3b N0 M0 stage II-III bladder cancer patients were treated with maximal transurethral resection of a bladde...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Urologia
2014-04-01
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| Series: | International Brazilian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000200190&lng=en&tlng=en |
| _version_ | 1811308957884481536 |
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| author | Jessica M. Freilich Philippe E. Spiess Matthew C. Biagioli Daniel C. Fernandez Ellen J. Shi Dylan C. Hunt Shilpa Gupta Richard B. Wilder |
| author_facet | Jessica M. Freilich Philippe E. Spiess Matthew C. Biagioli Daniel C. Fernandez Ellen J. Shi Dylan C. Hunt Shilpa Gupta Richard B. Wilder |
| author_sort | Jessica M. Freilich |
| collection | DOAJ |
| description | Purpose To evaluate Lipiodol as a liquid, radio-opaque fiducial marker for image-guided radiation therapy (IGRT) for bladder cancer.Materials and Methods Between 2011 and 2012, 5 clinical T2a-T3b N0 M0 stage II-III bladder cancer patients were treated with maximal transurethral resection of a bladder tumor (TURBT) and image-guided radiation therapy (IGRT) to 64.8 Gy in 36 fractions ± concurrent weekly cisplatin-based or gemcitabine chemotherapy. Ten to 15mL Lipiodol, using 0.5mL per injection, was injected into bladder submucosa circumferentially around the entire periphery of the tumor bed immediately following maximal TURBT. The authors looked at inter-observer variability regarding the size and location of the tumor bed (CTVboost) on computed tomography scans with versus without Lipiodol.Results Median follow-up was 18 months. Lipiodol was visible on every orthogonal two-dimensional kV portal image throughout the entire, 7-week course of IGRT. There was a trend towards improved inter-observer agreement on the CTVboost with Lipiodol (p = 0.06). In 2 of 5 patients, the tumor bed based upon Lipiodol extended outside a planning target volume that would have been treated with a radiation boost based upon a cystoscopy report and an enhanced computed tomography (CT) scan for staging. There was no toxicity attributable to Lipiodol.Conclusions Lipiodol constitutes a safe and effective fiducial marker that an urologist can use to demarcate a tumor bed immediately following maximal TURBT. Lipiodol decreases inter-observer variability in the definition of the extent and location of a tumor bed on a treatment planning CT scan for a radiation boost. |
| first_indexed | 2024-04-13T09:32:41Z |
| format | Article |
| id | doaj.art-d05cbe736c3142a59024ab60214de318 |
| institution | Directory Open Access Journal |
| issn | 1677-6119 |
| language | English |
| last_indexed | 2024-04-13T09:32:41Z |
| publishDate | 2014-04-01 |
| publisher | Sociedade Brasileira de Urologia |
| record_format | Article |
| series | International Brazilian Journal of Urology |
| spelling | doaj.art-d05cbe736c3142a59024ab60214de3182022-12-22T02:52:12ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-61192014-04-0140219019710.1590/S1677-5538.IBJU.2014.02.08S1677-55382014000200190Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder CancerJessica M. FreilichPhilippe E. SpiessMatthew C. BiagioliDaniel C. FernandezEllen J. ShiDylan C. HuntShilpa GuptaRichard B. WilderPurpose To evaluate Lipiodol as a liquid, radio-opaque fiducial marker for image-guided radiation therapy (IGRT) for bladder cancer.Materials and Methods Between 2011 and 2012, 5 clinical T2a-T3b N0 M0 stage II-III bladder cancer patients were treated with maximal transurethral resection of a bladder tumor (TURBT) and image-guided radiation therapy (IGRT) to 64.8 Gy in 36 fractions ± concurrent weekly cisplatin-based or gemcitabine chemotherapy. Ten to 15mL Lipiodol, using 0.5mL per injection, was injected into bladder submucosa circumferentially around the entire periphery of the tumor bed immediately following maximal TURBT. The authors looked at inter-observer variability regarding the size and location of the tumor bed (CTVboost) on computed tomography scans with versus without Lipiodol.Results Median follow-up was 18 months. Lipiodol was visible on every orthogonal two-dimensional kV portal image throughout the entire, 7-week course of IGRT. There was a trend towards improved inter-observer agreement on the CTVboost with Lipiodol (p = 0.06). In 2 of 5 patients, the tumor bed based upon Lipiodol extended outside a planning target volume that would have been treated with a radiation boost based upon a cystoscopy report and an enhanced computed tomography (CT) scan for staging. There was no toxicity attributable to Lipiodol.Conclusions Lipiodol constitutes a safe and effective fiducial marker that an urologist can use to demarcate a tumor bed immediately following maximal TURBT. Lipiodol decreases inter-observer variability in the definition of the extent and location of a tumor bed on a treatment planning CT scan for a radiation boost.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000200190&lng=en&tlng=enEthiodized OilRadiotherapyUrinary Bladder |
| spellingShingle | Jessica M. Freilich Philippe E. Spiess Matthew C. Biagioli Daniel C. Fernandez Ellen J. Shi Dylan C. Hunt Shilpa Gupta Richard B. Wilder Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer International Brazilian Journal of Urology Ethiodized Oil Radiotherapy Urinary Bladder |
| title | Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer |
| title_full | Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer |
| title_fullStr | Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer |
| title_full_unstemmed | Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer |
| title_short | Lipiodol as a Fiducial Marker for Image-Guided Radiation Therapy for Bladder Cancer |
| title_sort | lipiodol as a fiducial marker for image guided radiation therapy for bladder cancer |
| topic | Ethiodized Oil Radiotherapy Urinary Bladder |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382014000200190&lng=en&tlng=en |
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