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Table 1.

Patients’ characteristics.

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Fig 1.

The SuperLock nitinol coil fiducial marker.

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Fig 2.

SuperLock nitinol coil fiducials deployed into the left lower lobe of the lung through electromagnetic navigation bronchoscopy.

Five fiducials were deployed, four in or within 1–2 cm of the tumor, and one further away as visualized during the placement procedure (panel A), and at a post-procedure chest radiograph (panel B). The fiducials were centered around the tumor, which is not well-visualized in the kV images.

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Fig 3.

Breath-hold CT and CBCT (spotlight) matching with three fiducial markers in the left lower lobe of the lung, just prior to SBRT treatment.

Panel A shows CBCT completely overlaid onto the planning CT images. Panel B-C shows the two-way sliding window matching between CBCT and planning CT images.

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Fig 4.

Position of three SuperLock nitinol coil fiducials used in two dimensional (2D) marker matching just prior to SBRT treatment for a left lower lobe lung tumor as visualized using on-board kV imaging (panel A: anterior-posterior image; panel B: lateral image).

Three green crosses showed locations of the fiducials identified from the planning CT. The background images were 2D kV-kV pair images acquired prior to treatment.

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Fig 5.

CBCT images of 4 fiducials placed in or near a tumor in the right upper lobe treated with SBRT in (A) axial, (B) frontal, and (C) sagittal views.

The four green squares indicated the four fiducials identified on the planning CT.

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Fig 5 Expand

Fig 6.

Fiducial group migration with respect to the GTV for all 16 targets.

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Fig 6 Expand

Fig 7.

Fiducial averaged individual migration with respect to the planning CT for all 16 targets.

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Fig 8.

Residual shifts after the first imaging prior to the SBRT treatment for all 16 targets.

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Table 2.

Maximum, mean, and standard deviation for fiducial individual and group migration.

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Table 2 Expand