The advantage of iron-containing fiducial markers placed with a thin needle for radiotherapy of liver cancer in terms of visualization on MRI: an initial experience of Gold Anchor

Radiotherapy for liver malignancy is increasing due to advances in radiotherapy technique. Visualization of the tumor as well as fiducial markers is essential. To see if improved visibility exists on computed tomography (CT) and magnetic resonance imaging (MRI), we evaluated an iron-containing fiducial marker. A patient with hepatocellular carcinoma and a patient with cholangiocarcinoma were enrolled. Pain caused by placement of marker and the best MRI sequence for visualization of both the fiducial marker as well as the liver tumor on MRI was evaluated. CT was obtained in 2.5-mm thickness, and MRIs were obtained in eight sequences (ie, T2-weighted image). 22G preloaded needles were used for marker placement in both patients; this caused little pain during placement under local anesthesia with xylocaine. No complication occurred in either patient. Both markers and tumors were well visualized by the same MRI sequence. The iron-containing fiducial marker is safe and useful for detecting fiducial markers in the liver and for registration using CT and MRI.