title: Implantation of fiducial markers in the liver for stereotactic body radiation therapy: Feasibility and results.
abstract: OBJECTIVE
  Robotic stereotactic body radiation therapy (SBRT) for the treatment of hepatocellular carcinoma requires the perilesional implant of gold fiducial markers for detection by scopy. The purpose of this study is to determine whether the implant of gold fiducial markers is still possible and, if so, with which imaging technique and with what results.
  
  
  METHODS
  This is a prospective study based on the implant of fiducial markers in the liver in our department for a treatment by SBRT for a hepatocellular carcinoma in 38 patients (49 lesions to treat) over a period of one year. As the first choice, it consisted of sonographic guidance and, if not possible, CT-scan guidance was used.
  
  
  RESULTS
  The mean number of fiducial markers implanted per procedure was 2.68(±0.61) with almost exclusive sonographic guidance (36 out of 38 patients or 95% of the patients). The mean distance between the markers and the lesion was 32mm (±11mm) and that between the markers was 17mm (±7mm).
  
  
  CONCLUSIONS
  SBRT is being evaluated for the treatment of liver lesions. The radiologist has an important role to play since the implant of fiducial markers in the liver is indispensable. It is almost always possible with sonographic guidance, including for lesions not accessible to microbiopsies, a treatment by radiofrequency or for lesions poorly individualisable by sonography or CT-scan.
authors.affiliation: Service de radiologie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France. Electronic address: g.oldrini@nancy.unicancer.fr.
authors.forename: G
authors.initials: G
authors.lastname: Oldrini
authors.affiliation: Service de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: H
authors.initials: H
authors.lastname: Taste-George
authors.affiliation: Service de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Renard-Oldrini
authors.affiliation: Service de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: A-S
authors.initials: AS
authors.lastname: Baumann
authors.affiliation: Service de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: V
authors.initials: V
authors.lastname: Marchesi
authors.affiliation: Service de radiologie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Troufléau
authors.affiliation: Service de radiothérapie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Peiffert
authors.affiliation: Service de radiologie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Didot-Moisei
authors.affiliation: Service de radiologie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: B
authors.initials: B
authors.lastname: Boyer
authors.affiliation: Service d'imagerie Guilloz, CHU de Nancy, avenue de Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: B
authors.initials: B
authors.lastname: Grignon
authors.affiliation: Service de radiologie, institut de cancérologie de Lorraine, 6, avenue de Bourgogne, CS 30519, 54519 Vandœuvre-lès-Nancy cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: Henrot
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D057918:Fiducial Markers; D006046:Gold; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D061089:Radiotherapy, Image-Guided; D014057:Tomography, X-Ray Computed; D014916:Whole-Body Irradiation
chemical_list: D006046:Gold
keywords: Gold fiducial markers; Hepatocellular carcinoma; Stereotactic body radiation therapy