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Seed migration in prostate brachytherapy: a re-implant case report

IRCCS S. Raffaele, Departments of ¹ Radiochemotherapy, ² Medical Physics and ⁴ Urology, Via Olgettina 60-20132 Milano and ³ Casa di Cura Ville Turro, Department of Urology, Via Stamira d'Ancona 20-20127 Milano, Italy

View larger version (87K): [in a new window]   Figure 1. MRI-imaged axial slice of the prostate gland. (a) Post-implant dosimetry reveals a cold area in the transitional, subcapsular zone; (b) post-implant dosimetry after the re-implant confirms the optimal dosimetric coverage of the anterior part.

View larger version (37K): [in a new window]   Figure 2. Sagittal, longitudinal section of a "pear-shaped" prostate, with needles in the correct positions to release seeds in the pre-planned anterior subcapsular zone. When a longitudinal ultrasound "real-time" control is not performed, seeds could be misplaced in the venous plexus due to: 1) 0.0 plane definition at fluoroscopy or transverse ultrasound control can be doubtful; 2) too rapid retraction of the needles can drag seeds.