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Cancers
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MRI-Assisted Radiosurgery (MARS)
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MRI-Assisted Radiosurgery (MARS)

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 1968

Special Issue Editor

Dr. Pavel Vítek

E-Mail Website
Guest Editor
Proton Therapy Center Czech, 180 00 Prague, Czech Republic
Interests: oncology in clinical practice; proton therapy; radiation oncology

Special Issue Information

Dear Colleagues,

MRI-assisted radiosurgery (MARS) is a novel technology in prostate LDR brachytherapy (LDR-BT). As monotherapy for low- and intermediate-risk prostate cancer, LDR provides excellent oncologic results and favourable cost-effectiveness. However, a very accurate technology of imaging and planning is required to achieve high conformity and to preclude substantial side effects including urinary incontinence. The toxicity is related to doses in very fine structures—membranous urethra (MUL) and external urinary sphincter (EUS).  Only MRI imaging is able to achieve a sufficient resolution of these structures' geometry and provide a sufficient basis for dose calculation, planning and delivery of permanent prostate seeds in the integral process of MARS. It has been employed since the previous decade and several encouraging results have been referred. Dose constraints for MUL and EUS have been introduced in relation to both acute and chronic urinary toxicity including incontinence and obstructive urinary symptoms. Compared to ultrasonography and CT-based planning, the lower constraints in MUL and EUS are achievable. Quality assurance measures for various sources I-125, Pd-103 and Cs-131 have been established. The objective urinary toxicity rate is lower for MARS and QOL outcomes are encouraging. Moreover, the cost-effectiveness analysis shows improved long-term costs of treatment. MARS as a technically more advanced and accurate method of brachytherapy desires prospective validation now.

Dr. Pavel Vítek
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • prostate cancer
  • LDR brachytherapy
  • MRI-based planning
  • membranous urethra
  • external urinary sphincter
  • incontinence
  • obstructive symptoms
  • dose constraints
  • quality of life
  • cost-effectiveness

Published Papers (2 papers)

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Research

13 pages, 2622 KiB  
Article
A Novel Positive-Contrast Magnetic Resonance Imaging Line Marker for High-Dose-Rate (HDR) MRI-Assisted Radiosurgery (MARS)
by Li Wang, Yao Ding, Teresa L. Bruno, R. Jason Stafford, Eric Lin, Tharakeswara K. Bathala, Jeremiah W. Sanders, Matthew S. Ning, Jingfei Ma, Ann H. Klopp, Aradhana Venkatesan, Jihong Wang, Karen S. Martirosyan and Steven J. Frank
Cancers 2024, 16(10), 1922; https://doi.org/10.3390/cancers16101922 - 18 May 2024
Viewed by 344
Abstract
Magnetic resonance imaging (MRI) can facilitate accurate organ delineation and optimal dose distributions in high-dose-rate (HDR) MRI-Assisted Radiosurgery (MARS). Its use for this purpose has been limited by the lack of positive-contrast MRI markers that can clearly delineate the lumen of the HDR [...] Read more.
Magnetic resonance imaging (MRI) can facilitate accurate organ delineation and optimal dose distributions in high-dose-rate (HDR) MRI-Assisted Radiosurgery (MARS). Its use for this purpose has been limited by the lack of positive-contrast MRI markers that can clearly delineate the lumen of the HDR applicator and precisely show the path of the HDR source on T1- and T2-weighted MRI sequences. We investigated a novel MRI positive-contrast HDR brachytherapy or interventional radiotherapy line marker, C4:S, consisting of C4 (visible on T1-weighted images) complexed with saline. Longitudinal relaxation time (T1) and transverse relaxation time (T2) for C4:S were measured on a 1.5 T MRI scanner. High-density polyethylene (HDPE) tubing filled with C4:S as an HDR brachytherapy line marker was tested for visibility on T1- and T2-weighted MRI sequences in a tissue-equivalent female ultrasound training pelvis phantom. Relaxivity measurements indicated that C4:S solution had good T1-weighted contrast (relative to oil [fat] signal intensity) and good T2-weighted contrast (relative to water signal intensity) at both room temperature (relaxivity ratio > 1; r2/r1 = 1.43) and body temperature (relaxivity ratio > 1; r2/r1 = 1.38). These measurements were verified by the positive visualization of the C4:S (C4/saline 50:50) HDPE tube HDR brachytherapy line marker on both T1- and T2-weighted MRI sequences. Orientation did not affect the relaxivity of the C4:S contrast solution. C4:S encapsulated in HDPE tubing can be visualized as a positive line marker on both T1- and T2-weighted MRI sequences. MRI-guided HDR planning may be possible with these novel line markers for HDR MARS for several types of cancer. Full article
(This article belongs to the Special Issue MRI-Assisted Radiosurgery (MARS))
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16 pages, 6299 KiB  
Article
A Novel Polymer-Encapsulated Multi-Imaging Modality Fiducial Marker with Positive Signal Contrast for Image-Guided Radiation Therapy
by Li Wang, Jeremiah Sanders, John F. Ward, Stephen R. Lee, Falk Poenisch, David Michael Swanson, Narayan Sahoo, Xiaorong Ronald Zhu, Jingfei Ma, Rajat J. Kudchadker, Seungtaek L. Choi, Quynh-Nhu Nguyen, Lauren L. Mayo, Shalin J. Shah and Steven J. Frank
Cancers 2024, 16(3), 625; https://doi.org/10.3390/cancers16030625 - 31 Jan 2024
Viewed by 891
Abstract
Background: Current fiducial markers (FMs) in external-beam radiotherapy (EBRT) for prostate cancer (PCa) cannot be positively visualized on magnetic resonance imaging (MRI) and create dose perturbation and significant imaging artifacts on computed tomography (CT) and MRI. We report our initial experience with clinical [...] Read more.
Background: Current fiducial markers (FMs) in external-beam radiotherapy (EBRT) for prostate cancer (PCa) cannot be positively visualized on magnetic resonance imaging (MRI) and create dose perturbation and significant imaging artifacts on computed tomography (CT) and MRI. We report our initial experience with clinical imaging of a novel multimodality FM, NOVA. Methods: We tested Gold Anchor [G-FM], BiomarC [carbon, C-FM], and NOVA FMs in phantoms imaged with kilovoltage (kV) X-rays, transrectal ultrasound (TRUS), CT, and MRI. Artifacts of the FMs on CT were quantified by the relative streak artifacts level (rSAL) metric. Proton dose perturbations (PDPs) were measured with Gafchromic EBT3 film, with FMs oriented either perpendicular to or parallel with the beam axis. We also tested the performance of NOVA-FMs in a patient. Results: NOVA-FMs were positively visualized on all 4 imaging modalities tested. The rSAL on CT was 0.750 ± 0.335 for 2-mm reconstructed slices. In F-tests, PDP was associated with marker type and depth of measurement (p < 10−6); at 5-mm depth, PDP was significantly greater for the G-FM (12.9%, p = 10−6) and C-FM (6.0%, p = 0.011) than NOVA (4.5%). EBRT planning with MRI/CT image co-registration and daily alignments using NOVA-FMs in a patient was feasible and reproducible. Conclusions: NOVA-FMs were positively visible and produced less PDP than G-FMs or C-FMs. NOVA-FMs facilitated MRI/CT fusion and identification of regions of interest. Full article
(This article belongs to the Special Issue MRI-Assisted Radiosurgery (MARS))
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