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Fiducial markers and their impact on ablation outcome for patients treated with MR-guided transurethral ablation (TULSA): a retrospective technical analysis

Blanco Sequeiros Roberto; Anttinen Mikael; Boström Peter J; Wright Cameron; Sainio Teija; Mäkelä Pietari

dc.contributor.authorBlanco Sequeiros Roberto
dc.contributor.authorAnttinen Mikael
dc.contributor.authorBoström Peter J
dc.contributor.authorWright Cameron
dc.contributor.authorSainio Teija
dc.contributor.authorMäkelä Pietari
dc.date.accessioned2022-10-28T13:45:22Z
dc.date.available2022-10-28T13:45:22Z
dc.identifier.urihttps://www.utupub.fi/handle/10024/167193
dc.description.abstract<p><strong>Objectives: </strong>Fiducial markers improve accuracy in external beam radiation therapy (EBRT) for treatment of prostate cancer (PCa). However, many patients recur after EBRT necessitating additional treatment, such as MR-guided transurethral ultrasound ablation (TULSA). Residual markers may compromise TULSA through ultrasound field distortions and generation of local susceptibility artifacts. The objective was to investigate how markers affect the ablation outcome during clinical TULSA treatments.</p><p><strong>Subjects and methods: </strong>A retrospective analysis was performed on nine patients with radiorecurrent PCa and residual markers who received TULSA. The MR susceptibility artifact was quantified as a function of marker type, size and orientation, in particular for thermometry. The spatial distribution of markers inside the prostate was recorded, and the resulting impact on the thermal dose was measured. The thermal dose measurements were directly compared to the residual enhancing prostatic tissue observed on the immediate and control post-TULSA contrast enhanced (CE) image.</p><p><strong>Results: </strong>Successful thermal dose accumulation to the target boundary occurred for 14/20 (70%) of markers, confirmed with CE imaging. Gold markers situated simultaneously close to the urethra (≤12 mm) and far from the target boundary (≥13 mm) reduced the ultrasound depth of heating. Nitinol markers produced large, hypointense artifacts that disrupted thermometry and compromised treatment. Artifacts from gold markers were less pronounced, but when located near the target boundary, also affected treatment.</p><p><strong>Conclusion: </strong>Marker composition, orientation and location inside the prostate can all potentially impact treatment outcome. Proper patient selection through detailed MRI screening is critical to ensure successful radiorecurrent PCa treatment outcomes with TULSA.</p>
dc.language.isoen
dc.titleFiducial markers and their impact on ablation outcome for patients treated with MR-guided transurethral ablation (TULSA): a retrospective technical analysis
dc.identifier.urnURN:NBN:fi-fe2022012710916
dc.relation.volume38
dc.contributor.organizationfi=kirurgia|en=Surgery|
dc.contributor.organizationfi=tyks, vsshp|en=tyks, vsshp|
dc.contributor.organizationfi=kliinisen laitoksen yhteiset|en=Department of Clinical Medicine|
dc.contributor.organizationfi=diagnostinen radiologia|en=Diagnostic Radiology|
dc.contributor.organization-code2607303
dc.contributor.organization-code2607300
dc.contributor.organization-code2607309
dc.converis.publication-id68179635
dc.converis.urlhttps://research.utu.fi/converis/portal/Publication/68179635
dc.format.pagerange1684
dc.format.pagerange1677
dc.identifier.eissn1464-5157
dc.identifier.jour-issn0265-6736
dc.okm.affiliatedauthorBoström, Peter
dc.okm.affiliatedauthorSainio, Teija
dc.okm.affiliatedauthorDataimport, tyks, vsshp
dc.okm.affiliatedauthorBlanco Sequeiros, Roberto
dc.okm.affiliatedauthorWright, Cameron
dc.okm.affiliatedauthorAnttinen, Mikael
dc.okm.affiliatedauthorMäkelä, Pietari
dc.okm.discipline3126 Kirurgia, anestesiologia, tehohoito, radiologiafi_FI
dc.okm.discipline3126 Surgery, anesthesiology, intensive care, radiologyen_GB
dc.okm.internationalcopublicationnot an international co-publication
dc.okm.internationalityInternational publication
dc.okm.typeJournal article
dc.publisher.countryBritanniafi_FI
dc.publisher.countryUnited Kingdomen_GB
dc.publisher.country-codeGB
dc.relation.doi10.1080/02656736.2021.2008519
dc.relation.ispartofjournalInternational Journal of Hyperthermia
dc.relation.issue1
dc.year.issued2021


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