Had Fiducials or Transponders inserted in Prostate Bed
Yes - 12.5% - 3 votes
No - 87.5% - 21 votes
Posted 9/24/2016 2:18 PM (GMT -6)
When you had post operative radiation did you have Fiducials or Transponders in your prostate bed?
Also, please provide the year of your radiation and equipment used (i.e. Varian TrueBeam, Varian Edge, Vero, etc.)
Note: This is only for post operative radiology treatment, not initial treatment.
Posted 9/24/2016 3:23 PM (GMT -6)
I had 3 little tattoos, one on each hip and one center pubic area. They are about the size of the period at the end of this sentence. They are used for rough positioning of my body while laying on the gantry of the linear accelerator. Then using the cone beam CT (CBCT) they image my anatomy each time prior to the start of radiotherapy for precise alignment. Each time the radiation technicians (which were fantastic) would make minor position alignments to compensate for bladder or rectal volumes.
Entire process took less than 7 minutes.
Posted 9/25/2016 7:34 AM (GMT -6)
Hello Fellow Healingwellers --
Adjuvant and Salvage radiation guy's please respond to my poll--
My RO has indicated he will not need to use Fiducials or Transponders in doing my SRT.
Tall Allen, has indicated that he probably should be using one of the above.
Before I give a green light to the SRT I would like a consensus of how other Salvage or Adjuvant Radiation men were treated.
So far I have only two votes, both indicating there were no fiducials or transponders used.
Posted 9/25/2016 7:58 AM (GMT -6)
Only had 3 tattoos, same as Lapilot. Varian Arc machine.
Posted 9/25/2016 8:17 AM (GMT -6)
For SRT to prostate bed I had tattoos . For SRT to pelvic lymph nodes I had tattoos , quick CT scan and a device taped to my abdomen which allowed a laser to measure when I was exhaling at which point the LINAC beam was initiated . This was to minimize movement of target(s) caused by breathing . This is part of the DART process used by Dattoli Cancer Center.
Posted 9/25/2016 9:19 AM (GMT -6)
Three or four tiny tattoos, a Varian Rapid-Arc LINAC. 78 Gy in 40 fractions. (full pelvic) . The last 5 or 6 fractions were called "Boost" and were focused on my prostate bed. Aiming for this boost procedure was critical and my RO was in the control room when they were performed..The hoped for cure was not achieved..
Posted 9/25/2016 11:38 AM (GMT -6)
Posted 9/25/2016 12:03 PM (GMT -6)
I got 3 tattoos, same as Lapilot. The hospital used the Varian Arc machine. Had 33 sessions, went 5 times a week. Radiated the prostate bed and lymph nodes. Half the time each session was spent making sure I was in the correct position,
Posted 9/25/2016 3:10 PM (GMT -6)
I have 3 tattos, same as LaPilot & Ravineman430. I'm at 29 of 36 sessions for 64.8gy. Machine is Varian VMAT. Problems include trying to get bladder full as I have had moderate incontinence since Radical open in 2012. Using a Dribblestop clamp. Bowel movements are painful.
Posted 9/25/2016 4:41 PM (GMT -6)
I want to thank the 9 HW members who voted in this poll.
It allows me to go forward with SRT feeling more comfortable with the fact that my RO will not use Fiducials.
Posted 9/25/2016 5:36 PM (GMT -6)
The newer LINACS have a built-in CAT scanner that checks position just before the beam is energized.. Any problem with position or target location and the machine shuts down..
Posted 9/25/2016 8:06 PM (GMT -6)
Posted 9/25/2016 10:37 PM (GMT -6)
I had my SRT done in 2011.
A few tiny tatoos.
Varian Rapid Arc.
Posted 9/26/2016 12:18 AM (GMT -6)
SRT in 2008. Had 3 tiny tattoos.
Posted 9/26/2016 8:36 AM (GMT -6)
Varian, don't remember model. Year 2009, had 39 zaps, total of 72 gys all in prostate bed, small tattoos. Lot's of alignment issues on machine, each zap took 15 minutes on low side, to nearly an hour on bad days. Burning began on zap 4, all zaps conducted on empty bladder.
Posted 9/26/2016 11:55 AM (GMT -6)
SRT done in 2007. Just the little tattoos. I think it was a Varian. I don't know the model, but it had an 8-track and ashtrays. (jk)
Worked out fine. Had a minor side effect that went away on its own.
Posted 9/26/2016 1:36 PM (GMT -6)
SRT in 2010. Three small ink marks and used a Varian rapid arc.
Posted 9/27/2016 10:13 AM (GMT -6)
My IGRT is documented in the thread linked from my sig.
Short answer, yes, 3 markers, Calypso IGRT, 2010
Posted 9/27/2016 9:22 PM (GMT -6)
I had fiducials implanted and 3 small tattoos. This was done at UCSF in San Francisco. It's really hard to imagine how they could do a good job positioning a patient without either of those. It was a varian machine, I forget the particular model The protocol involved checking the position once before each of 40-odd sessions. the latest machines do what's called "intra-fraction" positioning, i.e. it tests the positioning multiple time during each individual session. I asked by Radiologist about this and he said that it is overkill; things average out over the large number of treatments. Hypofractionation would of course be a different story.
Again, I'd be suspicious of how they could do this right without either tatoos or fiducials.
Posted Yesterday 2:21 PM (GMT -6)
I talked to my RO about this. He was very aware of the UCSF study showing a 5 mm error. But, he has now stopped using fiducials for SRT. The reason was the fiducials he used (and I know there are some different brands) often didn't stay where they were put. Fiducials have little ridges to embed themselves in tissue, and they hold firm in the prostate, but they didn't hold firm when placed in the prostate bed. He found he had to site the soft tissue anyway because of that. Perhaps UCSF has a different method of placement or uses a different brand. And I don't know if any of this applies to Calypso transponders like 142 had placed.
He stressed the importance of 3 measures:
(1) Check for adequate bladder filling every time
(2) Use cone beam CT to position soft tissue (not bones, and not just tattoos) at the start of each session.
(3) Check for bowel distension every time. If it is distended, cancel the session.
(He also uses a fast machine, and CT/MRI fused images based on soft tissue landmarks)
It would be interesting to hear what UCSF says about this -- did you contact them?
I would also add the importance of adequate dosing. He gave a presentation at last week's ASTRO meeting demonstrating that 70 Gy is still on the steep part of the dose-response curve.
Posted Yesterday 2:58 PM (GMT -6)
3 tattoos. Varian but like Galileo said.... Had an 8 track player. As a matter of fact, I was one of the last patients treated on it before it was decommissioned and replaced with a more modern machine.
Posted Yesterday 4:02 PM (GMT -6)
Igrt salvage. 42 gys to lymph nodes. 62 gys to prostate bed.
3 tattoos took about 5 to 10 min once treatment started.
Posted Yesterday 4:13 PM (GMT -6)
IMRT-38 sessions. 68.4 gy
Almost halfway through...
Posted Yesterday 5:17 PM (GMT -6)
The poll results give me a lot of comfort in knowing a large majority of men did not use fiducials. Also, Allen has confirmed his RO does not use fiducials anymore.