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dc.contributor.authorDuncan, Catriona-
dc.contributor.authorJoon, Daryl Lim-
dc.contributor.authorLawrentschuk, Nathan-
dc.contributor.authorJenkins, Trish-
dc.contributor.authorSchneider, Michal-
dc.contributor.authorKhoo, Vincent-
dc.contributor.authorChao, Michael-
dc.contributor.authorLawlor, Marita-
dc.contributor.authorO'Meara, Rachel-
dc.contributor.authorBerry, Colleen-
dc.contributor.authorViotto, Angela-
dc.contributor.authorBrown, Kerryn-
dc.contributor.authorWada, Morikatsu-
dc.contributor.authorForoudi, Farshad-
dc.contributor.authorSengupta, Shomik-
dc.identifier.citationWorld Journal of Urology 2019; 37(7): 1281-1287en_US
dc.description.abstractRadiotherapy to the bladder has a risk of toxicity to pelvic structures, which can be reduced by using fiducial markers for targeting. Injectable contrast offers an alternative marker to gold seeds, which may fall out or exacerbate scarring. Combining contrast agents with tissue glue can minimize dispersion through tissue, enhancing its utility. We evaluated combinations of contrast agents and tissue glue using porcine bladder, for feasibility and utility as fiducial markers to aid image-guided radiotherapy. Different contrast agents (Lipiodol ultra or Urografin) were combined with different tissue glues (Histoacryl, Tisseal or Glubran2). The mixtures were endoscopically injected into porcine bladder submucosa to identify the area of interest with multiple fiducial markers. The porcine bladders were imaged within a phantom porcine pelvis using standard radiation therapy imaging modalities. The feasibility as an injectable fiducial marker and visibility of each fiducial marker on imaging were scored as binary outcomes by two proceduralists and two radiation therapists, respectively. Lipiodol-glue combinations were successfully administered as multiple fiducials that were evident on CT and CBCT. Lipiodol with Histoacryl or Glubran2 was visible on kV imaging. The Lipiodol Glubran2 combination was deemed subjectively easiest to use at delivery, and a better fiducial on KV imaging. This study demonstrates the feasibility of mixing contrast medium Lipiodol with Histoacryl or Glubran2 tissue glue, which, injected endoscopically, provides discrete and visible fiducial markers to aid image-guided radiotherapy. Although promising, further study is required to assess the durability of these markers through a course of radiotherapy.en_US
dc.subjectBladder canceren_US
dc.subjectCone beam computed tomographyen_US
dc.subjectFiducial markersen_US
dc.subjectImage-guided radiotherapyen_US
dc.subjectIodized oilen_US
dc.subjectProstate canceren_US
dc.subjectTissue glueen_US
dc.titleFiducial markers: can the urologist do better?en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitleWorld Journal of Urologyen_US
dc.identifier.affiliationEastern Health Clinical School, Monash University, Level 2, 5 Arnold Street, Box Hill, VIC, 3128, Australiaen_US
dc.identifier.affiliationRoyal Marsden NHS Foundation Trust, London, UKen_US
dc.identifier.affiliationSurgery (University of Melbourne)en_US
dc.identifier.affiliationOlivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australiaen_US
dc.identifier.affiliationThe Peter MacCallum Cancer Centre, Melbourne, Victoria, Australiaen_US
dc.identifier.affiliationRadiation Oncologyen_US
dc.identifier.affiliationOlivia Newton-John Cancer Wellness and Research Centreen_US
dc.type.austinJournal Article-
dc.type.austinReview-, Colleen
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristype Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Oncology- Newton-John Cancer Wellness and Research Centre- Newton-John Cancer Wellness and Research Centre- Oncology-
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