Reduction of radioactive seed embolization to the lung following prostate brachytherapy

Tapen, E; Blasko, John C.; Grimm, Peter; Ragde, Haakon; Luse, Ray W.; Clifford, Stephanie; Sylvester, John; Griffin, Thomas W.

doi:10.1016/s0360-3016(98)00353-8

Cited by 125 publications

(77 citation statements)

References 18 publications

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“…It is likely that this migration occurs as a result of seed placement within the large lumens of the periprostatic venous plexus (17). In this study, the migration of seeds was detected only after one or two months of follow-up and there was a concern to implant the least possible number of periprostatic seeds to minimize their displacement.…”

Section: Commentsmentioning

confidence: 61%

“…Reed et al (16) showed that patients with stranded seeds have 23% risk of seeds loss, compared to 47% incidence in patients receiving loose seeds. Tapen et al (17) reported that the use of linked seeds in the peripheral needles reduced the incidence of seed migration to 0.7% compared with the use of free seeds (11%). Ankem et al (18) showed that seeds migration may be influenced by the number of implanted seeds alone, whatever the type of seeds used.…”

Section: Commentsmentioning

confidence: 99%

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Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

et al. 2009

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Objectives: To assess the incidence and clinical parameters that could influence migration of seeds in localized prostate cancer patients treated by stranded versus loose sources by Iodine-125 brachytherapy. Materials and Methods: 100 patients were treated from January/1998 until December/2006. Age, PSA, clinical stage, Gleason, prostate volume, number of seeds, activity of radioactive seeds, and dosimetric parameters, such as V 100 , V 150 and D 90 were evaluated. Results: Mean follow-up was 79 months (18 -120. CI 95%: 72 -85). Overall, 6 of 100 patients experienced seed migration. Seed migration was found in 4/50 (8%) patients using loose seeds and in 2/50 (4%) treated by stranded seeds. Mean value dosimetric parameters for stranded seeds were greater than those for loose seeds (V 100 (

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Section: Commentsmentioning

confidence: 61%

Section: Commentsmentioning

confidence: 99%

Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

et al. 2009

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“…Two possible consequences of seed migration are inadequate dose coverage of the prostate [15] and potential effects of tissue irradiation at the site of migration. Although stranded seeds embedded in vicrylsutures migrate less (about 1%) than loose seeds (about 10%) [17]- [19], to accurately deliver the linked seeds is quite challenging. Therefore, the actual delivered dose may significantly deviate from the planned dose.…”

Section: Introductionmentioning

confidence: 99%

Radioactive seed immobilization techniques for interstitial brachytherapy

et al. 2008

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Let us know how access to this document benefits you Methods: We first analyze the possible causes for seed movement, and propose three potential techniques for seed immobilization: (1) surgical glue, (2) laser coagulation and (3) diathermy coagulation. The feasibility of each method is explored. Experiments were carried out using fresh bovine livers to investigate the efficacy of seed immobilization using surgical glue. Results:Results have shown that the surgical glue can effectively immobilize the seeds.Evaluation of the radiation dose distribution revealed that the non-immobilized seed movement would change the planned isodose distribution considerably; while by using surgical glue method to immobilize the seeds, the changes were negligible.Conclusions: Prostate brachytherapy seed immobilization is necessary and three alternative mechanisms are promising for addressing this issue. Experiments for exploring the efficacy of the other two proposed methods are ongoing. Devices compatible with the brachytherapy procedure will be designed in future.

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“…The periprostatic venous plexus flanks the prostate gland laterally and anteriorly and theoretically serves as a ready access for radioactive seed emboli. This venous complex drains into the iliac vessels, then into the inferior vena cava, and eventually into the right side of the heart and to the lungs (1). Migration potentially could alter the implant dosimetry and produce unwanted seed-related sequelae.…”

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confidence: 99%

Scintigraphic Detection of ¹²⁵I Seeds After Permanent Brachytherapy for Prostate Cancer

Kono

Kubota²,

Mitsumoto³

et al. 2008

J Nucl Med

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The purpose of this investigation was to monitor the localization and migration of 125 I seeds after permanent brachytherapy for prostate cancer using a new scintigraphic technique that may overcome the drawbacks of conventional x-ray methods. Methods: 125 I seeds emit g-rays with an average energy peak of 28 keV. We used a g-camera equipped with low-energy high-resolution collimators that were tuned to an energy level of 35 keV with a 70% window width. Sixteen patients with prostate cancer were examined after 125 I seed insertion. The number of seeds remaining in the prostate was confirmed using pelvic CT for postoperative dose planning; however, seeds that had migrated outside the prostate could not be detected. Furthermore, the migrated seeds were not completely traceable using chest or abdominal radiography. Thus, we adopted a scintigraphic technique to perform this task. The evaluation of radiography and scintigraphy findings was masked, and the rates of migrated seed detection were statistically examined using the McNemar test. To localize the migrated seeds, we fused the scintigraphic images of the migrated seeds and the patients' contours. Results: Scintigraphy was successfully used to detect 20 migrated seeds of a total of 1,182 implanted seeds, whereas radiography was successfully used to detect 7. The sensitivity of the scintigraphy results was 20 of 20 (100%), whereas that of the radiography results was 7 of 20 (35%). Seed migration was detected in 11 of 16 patients (69%) using scintigraphy, whereas seed migration was detected in only 4 patients (25%) using radiography; this difference was statistically significant (P 5 0.016). Conclusion: Scintigraphy is more effective for detecting seed migration and monitoring the localization of 125 I seeds than radiography. The precise anatomic location of migrated seeds can be pinpointed using fusion images. Scintigraphy may become a standard procedure for monitoring seed migration during 125 I brachytherapy in patients with prostate cancer.

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Reduction of radioactive seed embolization to the lung following prostate brachytherapy

Cited by 125 publications

References 18 publications

Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

Radioactive seed immobilization techniques for interstitial brachytherapy

Scintigraphic Detection of ¹²⁵I Seeds After Permanent Brachytherapy for Prostate Cancer

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Reduction of radioactive seed embolization to the lung following prostate brachytherapy

Cited by 125 publications

References 18 publications

Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds

Radioactive seed immobilization techniques for interstitial brachytherapy

Scintigraphic Detection of 125I Seeds After Permanent Brachytherapy for Prostate Cancer

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Scintigraphic Detection of ¹²⁵I Seeds After Permanent Brachytherapy for Prostate Cancer