In ultrasound/computed tomography (CT) fusion images, ultrasound allows visualization of the target in real time. CT provides a navigation for ultrasound scanning and improves the overview in areas of limited visualization with ultrasound. This study was performed to investigate the feasibility of ultrasound/CT fusion based on an electromagnetic tracking technique using external fiducial markers for canine ocular and periocular regions. In 7 Beagle dogs, contrast-enhanced CT images of the head were obtained with placing external fiducial markers over the frontal region and both sides of the forepaws of the dog. Ultrasonography was performed under a magnetic field by installing a position sensor in the linear probe, without changing the dog's position. The positions of the external fiducial markers were adjusted and matched, based on the CT images. The execution time of co-registration and the distance between the regions of interest and the co-registration points, the frontal bone, cornea, retina, and optic nerve, were estimated. Approximately 60% of external fiducial markers were properly recognized in all dogs. After adjustment, all external fiducial markers were precisely matched. The co-registration execution time was less than 1 min. The distances between the regions of interest and co-registration points were less than 3 mm in all dogs. The electromagnetic tracking technique using external fiducial markers was a simple and applicable method for fusion imaging of a canine head using real-time ultrasonography and CT. This technique can be useful for interventional procedures of retrobulbar and periorbital lesions.
Animals ; Cornea ; Dogs ; Fiducial Markers ; Frontal Bone ; Head ; Magnetic Fields ; Magnets ; Methods ; Optic Nerve ; Retina ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: The aim of this retrospective study was to investigate the use of a radiopaque tissue fiducial marker (TFM) in the treatment of prostate cancer patients who undergo post-prostatectomy radiotherapy (PPRT). TFM safety, its role and benefit in quantifying the set-up uncertainties in patients undergoing PPRT image-guided radiotherapy were assessed. MATERIALS AND METHODS: A total of 45 consecutive PPRT patients underwent transperineal implantation of TFM at the level of vesicourethral anastomosis in the retrovesical tissue prior to intensity-modulated radiotherapy. Prostate bed motion was calculated by measuring the position of the TFM relative to the pelvic bony anatomy on daily cone-beam computed tomography. The stability and visibility of the TFM were assessed in the initial 10 patients. RESULTS: No postoperative complications were recorded. A total of 3,500 images were analysed. The calculated prostate bed motion for bony landmark matching relative to TFM were 2.25 mm in the left-right, 5.89 mm in the superior-inferior, and 6.59 mm in the anterior-posterior directions. A significant 36% reduction in the mean volume of rectum receiving 70 Gy (rV₇₀) was achieved for a uniform planning target volume (PTV) margin of 7 mm compared with the Australian and New Zealand Faculty of Radiation Oncology Genito-Urinary Group recommended PTV margin of 10 mm. CONCLUSION: The use of TFM was safe and can potentially eliminate set-up errors associated with bony landmark matching, thereby allowing for tighter PTV margins and a consequent favourable reduction in dose delivered to the bladder and rectum, with potential improvements in toxicities.
Clothing ; Cone-Beam Computed Tomography ; Fiducial Markers ; Humans ; New Zealand ; Postoperative Complications ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Radiation Oncology ; Radiotherapy ; Radiotherapy, Image-Guided ; Radiotherapy, Intensity-Modulated ; Rectum ; Retrospective Studies ; Urinary Bladder

OBJECTIVE: Biplanar imaging systems allow for simultaneous acquisition of lateral and frontal cephalograms. The purpose of this study was to compare measurements recorded on three-dimensional (3D) cephalograms constructed from two-dimensional conventional radiographs and biplanar radiographs generated using a new biplanar imaging system with those recorded on cone-beam computed tomography (CBCT)-generated cephalograms in order to evaluate the accuracy of the 3D cephalograms generated using the biplanar imaging system. METHODS: Three sets of lateral and frontal radiographs of 15 human dry skulls with prominent facial asymmetry were obtained using conventional radiography, the biplanar imaging system, and CBCT. To minimize errors in the construction of 3D cephalograms, fiducial markers were attached to anatomical landmarks prior to the acquisition of radiographs. Using the 3D Ceph™ program, 3D cephalograms were constructed from the images obtained using the biplanar imaging system (3D cephbiplanar), conventional radiography (3D cephconv), and CBCT (3D cephcbct). A total of 34 measurements were obtained compared among the three image sets using paired t-tests and Bland–Altman plotting. RESULTS: There were no statistically significant differences between the 3D cephbiplanar and 3D cephcbct measurements. In addition, with the exception of one measurement, there were no significant differences between the 3D cephcbct and 3D cephconv measurements. However, the values obtained from 3D cephconv showed larger deviations than those obtained from 3D cephbiplanar. CONCLUSIONS: The results of this study suggest that the new biplanar imaging system enables the construction of accurate 3D cephalograms and could be a useful alternative to conventional radiography.
Cephalometry ; Cone-Beam Computed Tomography ; Facial Asymmetry ; Fiducial Markers ; Humans ; Radiography ; Skull

OBJECTIVES: The objective of this study was to develop mobile phone application for image-based dietary assessment and evaluate satisfaction regarding respondent's use of the mobile phone application. METHODS: We developed a mobile phone application to assess dietary intakes using 24 hour dietary recall. After initial development, application was reviewed by ten adults and revised based on their comments. We recruited 192 volunteers (92 males, 100 females) to use the mobile phone application and to respond to a satisfaction survey. Participants were instructed to use the mobile phone application with fiducial marker five centimeter in width, length and two centimeter height at each eating occasion during designated 4 days, capturing 45° angle and 90° angle images of all food and beverage items before and after consumption. After using the mobile phone application for 4 days, participants were asked to complete an online questionnaire on the satisfaction of the mobile phone app. User satisfaction items composed of 12 questions of application user interface, 8 questions of emotional response, 9 questions of eating behavior in 5 likert scale. Participants were also asked to provide additional open-ended comments on the use of mobile phone application. Statistical analysis was performed by using the SPSS 23.0 (Statistical Package for the Social Science). RESULTS: The average user interface score was 2.82 ± 1.08, which was close to the ‘normal’ response. Responses for emotion and eating behavior also were borderline to the ‘normal’. CONCLUSIONS: This study found that the mobile phone application using 24-hour recall was acceptable to be used to assess dietary intakes for several days. However, there should be a need for such technology to be user-oriented instead of researcher-oriented. Easy and cost-effective new technology is needed for estimating the amounts of food eaten automatically when the photos are taken.
Adult ; Beverages ; Cell Phones* ; Eating ; Feeding Behavior ; Fiducial Markers ; Humans ; Male ; Mobile Applications ; Volunteers

Development and use of linear-array echoendoscope and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) have made endoscopic ultrasound (EUS) more of an interventional procedure than a purely diagnostic procedure. This is a literature review of previously published clinical studies on EUS-guided direct intervention for solid pancreatic tumors, including EUS-guided fine needle injection (EUS-FNI) of antitumor agents, EUS-guided fiducial marker placement, EUS-guided brachytherapy and EUS-guided tumor ablation.
Antineoplastic Agents ; Brachytherapy ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Endosonography ; Fiducial Markers ; Needles ; Pancreatic Neoplasms ; Ultrasonography

BACKGROUND: There have been few reports on altered kinematics of the shoulder after reverse total shoulder arthroplasty (RTSA). We investigated differences in 3-dimensional (3D) scapular motions assessed using an optical tracking system between RTSA treated shoulders and asymptomatic contralateral shoulders during arm motion. METHODS: Thirteen patients who underwent RTSA were assessed for active arm elevation in 2 distinct elevation planes (sagittal plane flexion and scapular plane abduction). Their mean age was 72 years (range, 69 to 79 years) and the mean follow-up was 24.4 months (range, 13 to 48 months). The dominant side was the right side in all the 13 patients, and it was also the side treated with RTSA. Scapular kinematics was recorded with an optical tracking system. The scapular kinematics and the scapulohumeral rhythm (SHR) of the RTSA shoulders and asymptomatic contralateral shoulders were recorded and analyzed during arm elevation. RESULTS: There were no significant differences in internal/external rotation and anterior/posterior tilting of the scapula between shoulders during arm motion (p > 0.05). However, upward rotation of the scapula differed significantly during arm motion (p = 0.035 for sagittal plane flexion; p = 0.046 for scapular plane abduction). There were significant differences in the SHR between the two shoulders (p = 0.016 for sagittal plane flexion; p = 0.021 for scapular plane abduction). CONCLUSIONS: The shoulder kinematics after RTSA showed significant differences from the contralateral asymptomatic shoulders. Increased upward rotation and decreased SHR after RTSA indicate that RTSA shoulders use more scapulothoracic motion and less glenohumeral motion to elevate the arm.
Aged ; Arm/physiology ; Arthroplasty, Replacement, Shoulder/*methods ; Biomechanical Phenomena ; Cohort Studies ; Female ; Fiducial Markers ; Humans ; Imaging, Three-Dimensional/*methods ; Male ; Range of Motion, Articular/*physiology ; Scapula/*physiology ; Shoulder Joint/*physiology

Technological advances have rapidly expanded the therapeutic potential of endoscopic ultrasound (EUS). Innovations in stent technology; directed adjunctive therapy for pancreatic tumors, including radiofrequency ablation and fiducial marker placement; advanced imaging modalities, including needle-based confocal laser endomicroscopy; and new echoendoscopes, such as the forward-viewing linear echoendoscope, are emerging as safe and effective tools and devices for providing a broad range of treatments and therapies previously not thought possible. In this review, we summarize and discuss the new echoendoscopes, accessories, and stents for interventional EUS and highlight the recent literature on technical and therapeutic efficacy. The therapeutic role and indications for EUS are rapidly evolving well beyond its current limits as new EUS-specific designed tools are designed, and ultimately, should help achieve the goal of improving patient outcomes.
Catheter Ablation ; Endosonography ; Fiducial Markers ; Humans ; Microscopy ; Stents* ; Ultrasonography*

BACKGROUND: The purpose of this study was to evaluate the screw-home movement at the tibiofemoral joint during normal gait by utilizing the 3-dimensional motion capture technique. METHODS: Fifteen young males and fifteen young females (total 60 knee joints) who had no history of musculoskeletal disease or a particular gait problem were included in this study. Two more markers were attached to the subject in addition to the Helen-Hayes marker set. Thus, two virtual planes, femoral coronal plane (P(f)) and tibial coronal plane (P(t)), were created by Skeletal Builder software. This study measured the 3-dimensional knee joint movement in the sagittal, coronal, and transverse planes of these two virtual planes (P(f) and P(t)) during normal gait. RESULTS: With respect to kinematics and kinetics, both males and females showed normal adult gait patterns, and the mean difference in the temporal gait parameters was not statistically significant (p > 0.05). In the transverse plane, the screw-home movement occurred as expected during the pre-swing phase and the late-swing phase at an angle of about 17degrees. However, the tibia rotated externally with respect to the femur, rather than internally, while the knee joint started to flex during the loading response (paradoxical screw-home movement), and the angle was 6degrees. CONCLUSIONS: Paradoxical screw-home movement may be an important mechanism that provides stability to the knee joint during the remaining stance phase. Obtaining the kinematic values of the knee joint during gait can be useful in diagnosing and treating the pathological knee joints.
Adolescent ; Adult ; Biomechanical Phenomena/physiology ; Female ; Fiducial Markers ; Gait/*physiology ; Humans ; Imaging, Three-Dimensional ; Knee Joint/*physiology ; Male ; Range of Motion, Articular/*physiology ; Sex Factors ; Walking/physiology ; Young Adult

OBJECTIVE: To present our experience with placing endovascular coils in pulmonary arteries used as a fiducial marker for CyberKnife therapy and to describe the technical details and complications of the procedure. MATERIALS AND METHODS: Between June 2005 and September 2013, 163 patients with primary or secondary lung malignancies, referred for fiducial placement for stereotactic radiosurgery, were retrospectively reviewed. Fourteen patients (9 men, 5 women; mean age, 70 years) with a history of pneumonectomy (n = 3), lobectomy (n = 3) or with severe cardiopulmonary co-morbidity (n = 8) underwent coil (fiducial marker) placement. Pushable or detachable platinum micro coils (n = 49) 2-3 mm in size were inserted through coaxial microcatheters into a small distal pulmonary artery in the vicinity of the tumor under biplane angiography/fluoroscopy guidance. RESULTS: Forty nine coils with a median number of 3 coils per tumor were placed with a mean tumor-coil distance of 2.7 cm. Forty three (87.7%) of 49 coils were successfully used as fiducial markers. Two coils could not be used due to a larger tumor-coil distance (> 50 mm). Four coils were in an acceptable position but their non-coiling shape precluded tumor tracking for CyberKnife treatment. No major complications needing further medication other than nominal therapy, hospitalization more than one night or permanent adverse sequale were observed. CONCLUSION: Endovascular placement of coil as a fiducial marker is safe and feasible during CyberKnife therapy, and might be an option for the patients in which percutaneous transthoracic fiducial placement might be risky.
Adult ; Aged ; Aged, 80 and over ; Female ; *Fiducial Markers ; Humans ; Lung/surgery ; Lung Neoplasms/*surgery ; Male ; Middle Aged ; Platinum ; Pneumonectomy ; *Pulmonary Artery ; Radiosurgery/*methods ; Retrospective Studies

PURPOSE: To evaluate the treatment results in early stage non-small cell lung cancer patients who have undergone fiducial-less CyberKnife radiosurgery (CKRS). MATERIALS AND METHODS: From June 2011 to November 2013, 58 patients underwent CKRS at Asan Medical Center for stage I lung cancer. After excluding 14 patients, we retrospectively reviewed the records of the remaining 44 patients. All analyses were performed using SPSS ver. 21. RESULTS: The median age at diagnosis was 75 years. Most patients had inoperable primary lung cancer with a poor pulmonary function test with comorbidity or old age. The clinical stage was IA in 30 patients (68.2%), IB in 14 (31.8%). The mean tumor size was 2.6 cm (range, 1.2 to 4.8 cm), and the tumor was smaller than 2 cm in 12 patients (27.3%). The radiation dose given was 48-60 Gy in 3-4 fractions. In a median follow-up of 23.1 months, local recurrence occurred in three patients (2-year local recurrence-free survival rate, 90.4%) and distant metastasis occurred in 13 patients. All patients tolerated the radiosurgery well, only two patients developing grade 3 dyspnea. The most common complications were radiation-induced fibrosis and pneumonitis. Eight patients died due to cancer progression. CONCLUSION: The results showed that fiducial-less CKRS shows comparable local tumor control and survival rates to those of LINAC-based SABR or CKRS with a fiducial marker. Thus, fiducial-less CKRS using Xsight lung tracking system can be effectively and safely performed for patients with medically inoperable stage I non-small cell lung cancer without any risk of procedure-related complication.
Carcinoma, Non-Small-Cell Lung* ; Chungcheongnam-do ; Comorbidity ; Diagnosis ; Dyspnea ; Fibrosis ; Fiducial Markers ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Pneumonia ; Radiosurgery* ; Recurrence ; Respiratory Function Tests ; Retrospective Studies ; Survival Rate