{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T21:59:20Z","timestamp":1779919160682,"version":"3.53.1"},"reference-count":33,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:00:00Z","timestamp":1693180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>In this technical development report, we present the strategic placement of fiducial markers within the prostate under the guidance of computed tomography (CT) and electromagnetic navigation (EMN) for the delivery of ultra-hypofractionated cyberknife (CK) therapy in a patient with localized prostate cancer (PCa) who had previously undergone chemo-radiotherapy for rectal cancer and subsequent abdominoperineal resection due to local recurrence. The patient was positioned in a prone position with a pillow under the pelvis to facilitate access, and an electromagnetic fiducial marker was placed on the patient\u2019s skin to establish a stable position. CT scans were performed to plan the procedure, mark virtual points, and simulate the needle trajectory using the navigation system. Local anesthesia was administered, and a 21G needle was used to place the fiducial markers according to the navigation system information. A confirmatory CT scan was obtained to ensure proper positioning. The implantation procedure was safe, without any acute side effects such as pain, hematuria, dysuria, or hematospermia. Our report highlights the ability to use EMN systems to virtually navigate within a pre-acquired imaging dataset in the interventional room, allowing for non-conventional approaches and potentially revolutionizing fiducial marker positioning, offering new perspectives for PCa treatment in selected cases.<\/jats:p>","DOI":"10.3390\/curroncol30090576","type":"journal-article","created":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T06:57:35Z","timestamp":1693205855000},"page":"7926-7935","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cyberknife Radiosurgery for Prostate Cancer after Abdominoperineal Resection (CYRANO): The Combined Computer Tomography and Electromagnetic Navigation Guided Transperineal Fiducial Markers Implantation Technique"],"prefix":"10.3390","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7965-7966","authenticated-orcid":false,"given":"Andrea","family":"Vavassori","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4726-2692","authenticated-orcid":false,"given":"Giovanni","family":"Mauri","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0865-0134","authenticated-orcid":false,"given":"Giovanni Carlo","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6580-6767","authenticated-orcid":false,"given":"Federico","family":"Mastroleo","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Translational Medicine, University of Piemonte Orientale (UPO), 20188 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Bonomo","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2905-5947","authenticated-orcid":false,"given":"Stefano","family":"Durante","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Zerini","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5339-8038","authenticated-orcid":false,"given":"Giulia","family":"Marvaso","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5757-6073","authenticated-orcid":false,"given":"Giulia","family":"Corrao","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elettra Dorotea","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Rondi","sequence":"additional","affiliation":[{"name":"Unit of Medical Physics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Vigorito","sequence":"additional","affiliation":[{"name":"Unit of Medical Physics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Cattani","sequence":"additional","affiliation":[{"name":"Unit of Medical Physics, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7330-0499","authenticated-orcid":false,"given":"Franco","family":"Orsi","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara Alicja","family":"Jereczek-Fossa","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, IEO European Institute of Oncology 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