Usage in organs

Prostate

Provides target coverage while protecting nearby sensitive organs

Prostate cancer is the second most common cancer diagnosed in males worldwide. Fiducial markers are often used to guide external beam radiotherapy for prostate to provide target coverage while protecting nearby sensitive organs. The fiducial markers can be used for the treatment planning, daily patient setup and for intrafraction motion management during treatment. Using fiducial markers for prostate radiotherapy have proven to increase accuracy, reduce side effects and improve treatment outcome.

Traditional markers are, however, implanted with relatively thick needles that can cause infections and bleeding. Traditional markers can also move in the needle tract some days after implantation because the markers have a smaller diameter than the needle tract. Medical teams therefore typically choose to wait 1-3 weeks for the markers to “settle in” before continuing with CT/MR for dose planning.

Gold Anchor’s industry leading thin needles and unique anchoring marker design makes it possible to proceed with CT/MR for dose planning on the same day as implantation.

Reduce implantation time

Gold Anchor implantation offers two methods: transrectal and transperineal. Transrectal implantation is a low-risk, quick procedure that typically takes under five minutes and does not require anesthesia. For transperineal implantation, anesthesia can also be avoided by using an anesthetic patch or cream prior to the procedure, facilitated by the thin Gold Anchor needle.

Transrectal

With Gold Anchor transrectal implantation is a low-risk procedure that does not require anesthesia. Three Gold Anchors can typically be implanted by the doctor in less than five minutes.

Transperineal

If you prefer to implant markers transperineally you can also avoid anesthesia – using an anaesthetic patch or cream before implantation is enough with the thin Gold Anchor needle.

Reduce patient discomfort

Intensity of pain during transrectal implantation in prostate (not showing those answering “no pain”).

Source (17G): Igdem S, Akpinar H, Alço G et al. Implantation of fiducial markers for image guidance in prostate radiotherapy: patient-reported toxicity. Br Radiol 2009;82:941-945.

Source (18G; 1×5 mm): S Gill, J Li, J Thomas, et al. Patient-reported complications from fiducial marker implantation for prostate image-guided radiotherapy. Br J Radiol. 2012 Jul;85(1015):1011-7.

Source (22G): Wioletta Mista, Leszek Miszczyk. An evaluation of side effects after gold markers (Gold Anchor™) implantation to prostate gland in patients with prostate cancer. Onkologia Info 2011;8;2:110-111.

For statistics on 22G needle, see article
Reduce complications from implantation, showing chart of results.

Reduce complications from implantation

Gold Anchors can be implanted transrectally in prostate with a very low risk of infection vs. other transrectal procedures, see graph.

These results from Karolinska suggest that the thin Gold Anchor needles reduce the risk of UTI despite the use of only a single dose of non-broadspectrum antibiotics as prophylaxis.

About low infection rate

“The application process for Gold Anchor is much easier than for other fiducial markers. With Gold Anchor we do not have to use local anesthesia – giving local anesthesia would be more painful than implanting the fine needle marker.

We have between 5-8 patients per week and have had almost no infections since we started using Gold Anchors in 2009 [see graph above].” 

Oncologist Enrique Castellanos

MD, PhD, Department of Oncology, Karolinska University Hospital, Sweden

Save lead time
and travel

With Gold Anchor there is no need to wait the usual 7-21 day before dose planning. The thin Gold Anchor needle, that causes minimal bleeding and swelling, in combination with the strong tissue attachment of the marker, makes it possible to proceed with CT and/or MR for dose plan on the same day as implantation.

Note: Most centers that use traditional markers send their patient home for 7-21 days after implantation to allow the traditional markers to “settle in”, i.e. to allow the potential bleeding and swelling subside to reduce the risk that the traditional markers migrate in the tissue.

“We use two Gold Anchors per patient – one with line shape and one with ball shape. We have never seen any events of infection.

When we use these very thin needles we have stopped to give local anaesthesia – the tiny needles are usually tolerated very well by the patient. Instead we use a small numbing patch.

We do the CT planning on the same day as the gold marker implantation.”

Bengt Johansson

MD, PhD, Dept. of Oncology, Örebro University Hospital, Sweden

Great visibility for prostate

Thin marker in unique material

Gold Anchor is made of an alloy of pure gold and 0.5% pure iron for improved MR visibility. The marker is only 0.28 or 0.40 mm thick, wich improves the surface-to-volume ratio. 

Read more about great visibility

Benefits

  • Reduce CT artifacts
  • Easily register CT and MR images
  • Clearly visible on kV and ultrasound
  • Ideal for Proton therapy