Lori Anthony, PA1
1JFK Medical Center, Lake Worth, FL.
Currently, no reliable techniques are available to accurately identify a lumpectomy cavity volume, creating difficulty for radiation oncologists in targeting the cavity volume as part of a treatment regimen. As such, oncologists must expand the planned target volume using a larger area or volume of radiation, which exposes a greater volume of normal tissue and makes it unclear if the postoperative tumor bed cavity has been treated with the intended goal.
Materials and Methods
A metallic marker woven inside a dissolvable suture was positioned in the lumpectomy cavity at time of surgery by the operating surgeon for pinpoint accuracy. After removal of the tumor, 4 to 6 sutures were placed in the wall of the cavity (superior, inferior, medial, lateral, anterior, and posterior).
During the 6- to 8-week period following surgery, weekly orthogonal kilovoltage images were acquired using the Varian Onboard Imager system and compared with orthogonal digitally reconstructed radiographs generated from the simulation CT. The matched image sets were then overlaid for verification of fiducial position relative to the surgical cavity by the radiation oncologist.
During clinical trials, all safety and performance end points of the human study were met as intended, as follows:
Use of a 3D Fiducial Marker will allow accurate visualization and delineation of the cavity volume with high degree of consistency and reliability. The Accusyte 3D Fiducial Marker system has eliminated the localization problem. The markers offer a precise, stable target for postoperative radiation. They are more effective than loose markers, clips, or other competitive products.