A Comparison of In-Room Computerized Tomography Options for Detection of Fiducial Markers in Prostate Cancer Radiotherapy

Identification of FMs on volumetric or planar images was found to be not equivalent (±3 mm) using either linear accelerator. Intrafraction prostate motion, interpretation of FM location, and spatial properties of images are contributing factors. Although in-room CT has superior image quality, the process of realigning the treatment couch to acquire a CT introduces an error, highlighting the benefits of a single isocentric system.