Utilization of Iodinated SpaceOAR Vue™ During Robotic Prostate Stereotactic Body Radiation Therapy (SBRT) to Identify the Rectal-Prostate Interface and Spare the Rectum: A Case Report

Overview

Journal Front Oncol

Specialty Oncology

Date 2021 Jan 25

PMID 33489918

Citations 8

Authors

Dylan Conroy

Kelly Becht

Matthew Forsthoefel

Abigail N Pepin

Siyuan Lei

Abdul Rashid

Brian Timothy Collins

Jonathan W Lischalk

Simeng Suy

Nima Aghdam

Ryan Andrew Hankins

Sean P Collins

Affiliations

Soon will be listed here.

Abstract

We describe the utilization of SpaceOAR Vue™, a new iodinated rectal spacer, during Robotic Stereotactic Body Radiation Therapy (SBRT) for a Prostate Cancer Patient with a contraindication to Magnetic Resonance Imaging. A 69-year-old Caucasian male presented with unfavorable intermediate risk prostate cancer and elected to undergo SBRT. His medical history was significant for atrial fibrillation on Rivaroxaban with a pacemaker. He was felt to be at increased risk of radiation proctitis following SBRT due to the inability to accurately contour the anterior rectal wall at the prostate apex without a treatment planning MRI and an increased risk of late rectal bleeding due to prescribed anticoagulants. In this case report, we discuss the technical aspects of appropriate placement and treatment planning for utilizing SpaceOAR Vue™ with Robotic SBRT.

Citing Articles

Preventive efficacy of hydrocortisone enema for radiation proctitis in rectal cancer patients undergoing short-course radiotherapy: a phase II randomized placebo-controlled clinical trial.

Mohammadianpanah M, Tazang M, Nguyen N, Ahmadloo N, Omidvari S, Mosalaei A Ann Coloproctol. 2024; 40(5):506-514.

PMID: 39434555 PMC: 11532378. DOI: 10.3393/ac.2024.00192.0027.

Distinguishing Physiological Ureter Uptake From an Involved Lymph Node in Staging Prostate-Specific Membrane Antigen (PSMA) Scans: Implications for Radiation Planning.

Ching L, Bourne M, Kearney T, Choudhury K, Zwart A, Danner M Cureus. 2024; 16(6):e63105.

PMID: 39055460 PMC: 11271162. DOI: 10.7759/cureus.63105.

XIOSIS: An X-Ray-Based Intra-Operative Image-Guided Platform for Oncology Smart Material Delivery.

Hooshangnejad H, China D, Huang Y, Zbijewski W, Uneri A, McNutt T IEEE Trans Med Imaging. 2024; 43(9):3176-3187.

PMID: 38602853 PMC: 11418373. DOI: 10.1109/TMI.2024.3387830.

Application of Hydrogel Spacer SpaceOAR Vue for Prostate Radiotherapy.

Hadigal S, Gupta A Tomography. 2022; 8(6):2648-2661.

PMID: 36412680 PMC: 9680261. DOI: 10.3390/tomography8060221.

Systematic study of the iodinated rectal hydrogel spacer material discrepancy on accuracy of proton dosimetry.

Hooshangnejad H, Han D, Feng Z, Dong L, Sun E, Du K J Appl Clin Med Phys. 2022; 23(10):e13774.

PMID: 36106986 PMC: 9588264. DOI: 10.1002/acm2.13774.

References

Boersma M, Swanson G, Baacke D, Eng T . Anatomic-based three-dimensional planning precludes use of catheter-delivered contrast for treatment of prostate cancer. Int J Radiat Oncol Biol Phys. 2008; 71(1):51-7. DOI: 10.1016/j.ijrobp.2007.09.041. View

Montoya J, Gross E, Karsh L . How I Do It: Hydrogel spacer placement in men scheduled to undergo prostate radiotherapy. Can J Urol. 2018; 25(2):9288-9293. View

Odrazka K, Dolezel M, Vanasek J, Vaculikova M, Zouhar M, Sefrova J . Time course of late rectal toxicity after radiation therapy for prostate cancer. Prostate Cancer Prostatic Dis. 2009; 13(2):138-43. DOI: 10.1038/pcan.2009.56. View

Xie Y, Djajaputra D, King C, Hossain S, Ma L, Xing L . Intrafractional motion of the prostate during hypofractionated radiotherapy. Int J Radiat Oncol Biol Phys. 2008; 72(1):236-46. PMC: 2725181. DOI: 10.1016/j.ijrobp.2008.04.051. View

Hamstra D, Mariados N, Sylvester J, Shah D, Karsh L, Hudes R . Continued Benefit to Rectal Separation for Prostate Radiation Therapy: Final Results of a Phase III Trial. Int J Radiat Oncol Biol Phys. 2017; 97(5):976-985. DOI: 10.1016/j.ijrobp.2016.12.024. View

Hwang M, Mayeda M, Liz M, Goode-Marshall B, Gonzalez L, Elliston C . Stereotactic body radiotherapy with periprostatic hydrogel spacer for localized prostate cancer: toxicity profile and early oncologic outcomes. Radiat Oncol. 2019; 14(1):136. PMC: 6679492. DOI: 10.1186/s13014-019-1346-5. View

Choe K, Jani A, Liauw S . External beam radiotherapy for prostate cancer patients on anticoagulation therapy: how significant is the bleeding toxicity?. Int J Radiat Oncol Biol Phys. 2009; 76(3):755-60. DOI: 10.1016/j.ijrobp.2009.02.026. View

Pouliot J, Aubin M, Langen K, Liu Y, Pickett B, Shinohara K . (Non)-migration of radiopaque markers used for on-line localization of the prostate with an electronic portal imaging device. Int J Radiat Oncol Biol Phys. 2003; 56(3):862-6. DOI: 10.1016/s0360-3016(03)00267-0. View

Dewey M, Schink T, Dewey C . Frequency of referral of patients with safety-related contraindications to magnetic resonance imaging. Eur J Radiol. 2007; 63(1):124-7. DOI: 10.1016/j.ejrad.2007.01.025. View

10.

Chow G, Nazarian S . MRI for patients with cardiac implantable electrical devices. Cardiol Clin. 2014; 32(2):299-304. PMC: 4010944. DOI: 10.1016/j.ccl.2013.12.002. View

11.

McLaughlin P, Evans C, Feng M, Narayana V . Radiographic and anatomic basis for prostate contouring errors and methods to improve prostate contouring accuracy. Int J Radiat Oncol Biol Phys. 2009; 76(2):369-78. DOI: 10.1016/j.ijrobp.2009.02.019. View

12.

Zelefsky M, Kollmeier M, McBride S, Varghese M, Mychalczak B, Gewanter R . Five-Year Outcomes of a Phase 1 Dose-Escalation Study Using Stereotactic Body Radiosurgery for Patients With Low-Risk and Intermediate-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys. 2019; 104(1):42-49. PMC: 7525798. DOI: 10.1016/j.ijrobp.2018.12.045. View

13.

Mariados N, Sylvester J, Shah D, Karsh L, Hudes R, Beyer D . Hydrogel Spacer Prospective Multicenter Randomized Controlled Pivotal Trial: Dosimetric and Clinical Effects of Perirectal Spacer Application in Men Undergoing Prostate Image Guided Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys. 2015; 92(5):971-977. DOI: 10.1016/j.ijrobp.2015.04.030. View

14.

Feagins L, Kim J, Chandrakumaran A, Gandle C, Naik K, Cipher D . Rates of Adverse IBD-Related Outcomes for Patients With IBD and Concomitant Prostate Cancer Treated With Radiation Therapy. Inflamm Bowel Dis. 2019; 26(5):728-733. DOI: 10.1093/ibd/izz175. View

15.

Joh D, Chen L, Porter G, Bhagat A, Sood S, Kim J . Proctitis following stereotactic body radiation therapy for prostate cancer. Radiat Oncol. 2014; 9:277. PMC: 4272823. DOI: 10.1186/s13014-014-0277-4. View

16.

Fischer-Valuck B, Chundury A, Gay H, Bosch W, Michalski J . Hydrogel spacer distribution within the perirectal space in patients undergoing radiotherapy for prostate cancer: Impact of spacer symmetry on rectal dose reduction and the clinical consequences of hydrogel infiltration into the rectal wall. Pract Radiat Oncol. 2017; 7(3):195-202. DOI: 10.1016/j.prro.2016.10.004. View

17.

Poggi M, Gant D, Sewchand W, Warlick W . Marker seed migration in prostate localization. Int J Radiat Oncol Biol Phys. 2003; 56(5):1248-51. DOI: 10.1016/s0360-3016(03)00328-6. View

18.

Karsh L, Gross E, Pieczonka C, Aliotta P, Skomra C, Ponsky L . Absorbable Hydrogel Spacer Use in Prostate Radiotherapy: A Comprehensive Review of Phase 3 Clinical Trial Published Data. Urology. 2017; 115:39-44. DOI: 10.1016/j.urology.2017.11.016. View

19.

Oermann E, Slack R, Hanscom H, Lei S, Suy S, Park H . A pilot study of intensity modulated radiation therapy with hypofractionated stereotactic body radiation therapy (SBRT) boost in the treatment of intermediate- to high-risk prostate cancer. Technol Cancer Res Treat. 2010; 9(5):453-62. DOI: 10.1177/153303461000900503. View

20.

Chen L, Suy S, Uhm S, Oermann E, Ju A, Chen V . Stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience. Radiat Oncol. 2013; 8:58. PMC: 3610192. DOI: 10.1186/1748-717X-8-58. View