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Liquid fiducial marker performance during radiotherapy of locally advanced non small cell lung cancer

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Background and purpose

We analysed the positional and structural stability of a long-term biodegradable liquid fiducial marker (BioXmark) for radiotherapy in patients with locally advanced lung cancer.

Material and methods

Markers were injected via endoscopic- or endobronchial ultrasound in lymph nodes and reachable primary tumours. Marker volume and Hounsfield Units (HU) changing rates were estimated using breath-hold CBCT. Inter-fraction variation in marker position relative to gross tumour volume (GTV) position was established, as well as the inter-fraction variation in mediastinal marker registration relative to a carina registration through the treatment.


Fifteen patients were included and 29 markers analysed. All markers that were in situ at planning were visible through the treatment. Mean HU was 902 ± 165 HU for lymph node and 991 ± 219 HU for tumour markers. Volume degradation rates were −5% in lymph nodes and −23% in primary tumours. Three-dimensional inter-fraction variation for marker position relative to the GTV position was −0.1 ± 0.7 mm in lymph nodes and −1.5 ± 2.3 mm in primary tumours. Inter-fraction variations in marker registration relative to carina registration were −0.4 ± 1.2 mm in left–right, 0.2 ± 2.0 mm in anterior–posterior and −0.5 ± 2.0 mm in cranio-caudal directions.


The liquid fiducial markers were visible and stable in size and position throughout the treatment course.
TidsskriftRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Udgave nummer1
Sider (fra-til)64-69
Antal sider6
StatusUdgivet - 18 jul. 2016

ID: 48318210