Dr. Nadim Nasr

So that's what convinced me to start using it really routinely.

So that's what convinced me to start using it really routinely.

So that's what convinced me to start using it really routinely.

Honestly, on the spacer, I feel like once it's in that perirectal space, it's going to go sometimes where it wants to go. And as long as I've got some separation, that's really all I need. I'm much more particular about the fiducial or marker placement, especially for CyberKnife SBRT, since the imaging for that is really based on 45 degree plane films of the pelvis.

Honestly, on the spacer, I feel like once it's in that perirectal space, it's going to go sometimes where it wants to go. And as long as I've got some separation, that's really all I need. I'm much more particular about the fiducial or marker placement, especially for CyberKnife SBRT, since the imaging for that is really based on 45 degree plane films of the pelvis.

Honestly, on the spacer, I feel like once it's in that perirectal space, it's going to go sometimes where it wants to go. And as long as I've got some separation, that's really all I need. I'm much more particular about the fiducial or marker placement, especially for CyberKnife SBRT, since the imaging for that is really based on 45 degree plane films of the pelvis.

So you really want to have those four markers separated in two separate planes, actually really three separate planes. So we do four fiducials now for everyone, just because we end up with the two markers in each needle that are tethered together. So you get a lot less migration of the markers and you can really separate them in terms of their planes.

So you really want to have those four markers separated in two separate planes, actually really three separate planes. So we do four fiducials now for everyone, just because we end up with the two markers in each needle that are tethered together. So you get a lot less migration of the markers and you can really separate them in terms of their planes.

So you really want to have those four markers separated in two separate planes, actually really three separate planes. So we do four fiducials now for everyone, just because we end up with the two markers in each needle that are tethered together. So you get a lot less migration of the markers and you can really separate them in terms of their planes.

But I'm much more particular about the fiducial placement than the actual spacer placement. With the spacer, I'm just happy if I get any separation.

But I'm much more particular about the fiducial placement than the actual spacer placement. With the spacer, I'm just happy if I get any separation.

But I'm much more particular about the fiducial placement than the actual spacer placement. With the spacer, I'm just happy if I get any separation.

So for the fiducial markers, you really want to put them in in separate planes so that no marker is blocking another one. If you can imagine taking 45 degree x-rays to the pelvis. And so you want one set that's a little bit deeper than the other if you're looking from a transperineal standpoint. And you want one set that's a little bit more anterior, another one that's a little bit more posterior.

So for the fiducial markers, you really want to put them in in separate planes so that no marker is blocking another one. If you can imagine taking 45 degree x-rays to the pelvis. And so you want one set that's a little bit deeper than the other if you're looking from a transperineal standpoint. And you want one set that's a little bit more anterior, another one that's a little bit more posterior.

So for the fiducial markers, you really want to put them in in separate planes so that no marker is blocking another one. If you can imagine taking 45 degree x-rays to the pelvis. And so you want one set that's a little bit deeper than the other if you're looking from a transperineal standpoint. And you want one set that's a little bit more anterior, another one that's a little bit more posterior.

And as long as you do that, you are going to see four separate markers. Now, we only need three to track. And so the other one is thought of as our spare. So in case you have any shadowing of one marker versus the other, or one marker is really just out of bounds because of distance, you can just turn it off and track based on the other three.

And as long as you do that, you are going to see four separate markers. Now, we only need three to track. And so the other one is thought of as our spare. So in case you have any shadowing of one marker versus the other, or one marker is really just out of bounds because of distance, you can just turn it off and track based on the other three.

And as long as you do that, you are going to see four separate markers. Now, we only need three to track. And so the other one is thought of as our spare. So in case you have any shadowing of one marker versus the other, or one marker is really just out of bounds because of distance, you can just turn it off and track based on the other three.

And I leave any, anything you want to add? Yeah, no, I mean, I think we are lucky in the sense that we do have the capability of getting anesthesia down for some light sedation. And I always lead it off with my patients and asking them how they had their biopsy done and how they specifically did with the biopsy.

And I leave any, anything you want to add? Yeah, no, I mean, I think we are lucky in the sense that we do have the capability of getting anesthesia down for some light sedation. And I always lead it off with my patients and asking them how they had their biopsy done and how they specifically did with the biopsy.