Sequential Comparison of Seed Loss and Prostate Dosimetry of Stranded Seeds With Loose Seeds in 125I Permanent Implant for Low-Risk Prostate Cancer

Saibishkumar, Elantholi P.; Borg, Jette; Yeung, Ivan; Cummins-Holder, Cheryl; Landon, Angela; Crook, Juanita

doi:10.1016/j.ijrobp.2008.04.009

Cited by 55 publications

(28 citation statements)

References 25 publications

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“…Crook's group at Princess Margaret Hospital[25] applied CT/MRI fusion on days 0, 7, and 30 to study the movement of loose and stranded seeds (Biocompatibles VariStrand) and the impact on dosimetry for N = 40 patients. Seed losses of 1.1% and 0.6% were observed in the stranded and loose seed cohorts, respectively; the urinary tract was identified as the primary site of loss.…”

Section: Resultsmentioning

confidence: 99%

Impact of edema and seed movement on the dosimetry of prostate seed implants

et al. 2012

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This article summarizes current knowledge concerning the characterization of prostatic edema and intra-prostatic seed movement as these relate to dosimetry of permanent prostate implants, and reports the initial application to clinical data of a new edema model used in calculating pre- and post-implant dose distributions. Published edema magnitude and half-life parameters span a broad range depending on implant technique and measurement uncertainty, hence clinically applicable values should be determined locally. Observed intra-prostatic seed movements appear to be associated with particular aspects of implant technique and could be minimized by technique modification. Using an extended AAPM TG-43 formalism incorporating the new edema model, relative dose error RE associated with neglecting edema was calculated for three I-125 seed implants (18.9 cc, 37.6 cc, 60.2 cc) performed at our center. Pre- and post-plan RE average values and ranges in a 50 × 50 × 50 mm3 calculation volume were similar at ~2% and ~0–3.5%, respectively, for all three implants; however, the spatial distribution of RE varied for different seed configurations. Post-plan values of D90 and V100 for prostate were reduced by ~2% and ~1%, respectively. In cases where RE is not clinically negligible as a consequence of large edema magnitude and / or use of Pd-103 seeds, the dose calculation method demonstrated here can be applied to account for edema explicitly and there by improve the accuracy of clinical dose estimates.

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Section: Resultsmentioning

confidence: 99%

Impact of edema and seed movement on the dosimetry of prostate seed implants

et al. 2012

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“…The American Brachytherapy Society has advised that a chest radiograph should be undertaken at the first follow-up visit to scan the lungs for embolized seeds [6]. Consequently, the incidence of seed migration to the chest has been well reported [1,2,4,5,7-19]. However, documentation of the incidence of seed migration to the abdomen and pelvis is rare.…”

Section: Introductionmentioning

confidence: 99%

Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

et al. 2011

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BackgroundThe aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds.MethodsWe reviewed the records of 267 patients who underwent prostate brachytherapy with loose 125I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration.ResultsA total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration.ConclusionWe showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90.

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“…One series using SS reported no cases of pulmonary seed embolisation 5. Although early loss of SS through the urinary tract has been reported, the use of SS seems to have eliminated venous seed migration 7. To the best of our knowledge, venous migration of a whole strand of seeds has not been previously reported.…”

Section: Introductionmentioning

confidence: 95%

Migration of a strand of four seeds in low-dose-rate brachytherapy

Dedic-Hagan

Teh²,

Liang

et al. 2014

BMJ Case Reports

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SUMMARYWe report a case of stranded-seed migration (one strand of four seeds), via the prostatic venous plexus to the internal pudendal vein, in low-dose-rate (LDR) prostate brachytherapy. A 70-year-old man with low-risk prostate adenocarcinoma underwent transperineal permanent seed implantation. A total of 93 iodine-125 seeds were implanted (91 stranded seeds and 2 loose seeds). Immediate postimplantation fluoroscopic image and day 1 postimplantation CT scan indicated all implanted seeds to be within the vicinity of the prostate as planned. Day 30 pelvic X-ray and CT scan revealed migration of a strand of four seeds to the right pelvis (adjacent to ischial spine). At 2 years postimplantation, the patient continues to have good disease control with prostate specific antigen level of 0.69 μg/L, and asymptomatic. To the best of our knowledge, this is the first report of migration of an entire strand of seeds following LDR prostate brachytherapy. BACKGROUND

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Sequential Comparison of Seed Loss and Prostate Dosimetry of Stranded Seeds With Loose Seeds in 125I Permanent Implant for Low-Risk Prostate Cancer

Cited by 55 publications

References 25 publications

Impact of edema and seed movement on the dosimetry of prostate seed implants

Impact of edema and seed movement on the dosimetry of prostate seed implants

Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose 125I seeds

Migration of a strand of four seeds in low-dose-rate brachytherapy

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