Technical improvement in permanent seed implantation: a two-stage brachytherapy system. Description and comparison with current technique
Permanent seed implantation by available techniques has modest limitations. A new, two-stage needle design and technique is described and evaluated in comparison to a conventional permanent seed technique. The technique involves placing a stylet and sleeve initially into the all target coordinates p...
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| Veröffentlicht in: | Brachytherapy 2004, Vol.3 (1), p.34-40 |
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| creator | Grimm, Peter D Blasko, John C Sylvester, John E Heaney, Charles Gasparich, James Quackenbush, Jeffrey Gottesman, Jim Downey, Jim Grier, Doug Roddy, Tim Nellans, Roger Sood, Narender Wahl, David |
| description | Permanent seed implantation by available techniques has modest limitations. A new, two-stage needle design and technique is described and evaluated in comparison to a conventional permanent seed technique.
The technique involves placing a stylet and sleeve initially into the all target coordinates prior to seed placement similar to temporary seed technique. The second stage involves consecutively removing the stylet from each sleeve and inserting a clear, plastic needle containing preloaded seeds into the sleeve and implanting the seeds. Fifty-six
125I patients were treated with the two-stage technique. Comparisons were made with a cohort of 71 patients implanted using a conventional technique at the Seattle Prostate Institute. Prostate movement, surgical time, catheterization rate, and DVH postop dosimetry were analyzed.
After an initial learning curve, the two-stage technique had surgical times similar to conventional techniques. Cephalad movement of 3–10 mm was noted in 4 (8%) patients vs. 71 (100%) patients with our conventional technique. Of the 6 (10%) patients who required Foley catheterization, 3 (5%) did so for 1 day and 3 (5%) did so for less than 3 weeks. Day 1 CT scan based dosimetry was calculated on all patients. The V100 ranged from 80–100% with a median of 92.5%. For primary cases, the V100 ( |
| doi_str_mv | 10.1016/j.brachy.2003.07.001 |
| format | Article |
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The technique involves placing a stylet and sleeve initially into the all target coordinates prior to seed placement similar to temporary seed technique. The second stage involves consecutively removing the stylet from each sleeve and inserting a clear, plastic needle containing preloaded seeds into the sleeve and implanting the seeds. Fifty-six
125I patients were treated with the two-stage technique. Comparisons were made with a cohort of 71 patients implanted using a conventional technique at the Seattle Prostate Institute. Prostate movement, surgical time, catheterization rate, and DVH postop dosimetry were analyzed.
After an initial learning curve, the two-stage technique had surgical times similar to conventional techniques. Cephalad movement of 3–10 mm was noted in 4 (8%) patients vs. 71 (100%) patients with our conventional technique. Of the 6 (10%) patients who required Foley catheterization, 3 (5%) did so for 1 day and 3 (5%) did so for less than 3 weeks. Day 1 CT scan based dosimetry was calculated on all patients. The V100 ranged from 80–100% with a median of 92.5%. For primary cases, the V100 (<85%) was 14% for the conventional vs. 7% for the two-stage technique. No two-stage patient had a V100 <80%. The V100 values for the two-stage and conventional techniques demonstrated a possible advantage with the two-stage technique (mean V100 92.6% vs. 90.7%, [
p
=
0.051]). The D90 for the two-stage technique ranged from 123–190 Gy with a median of 151.5 Gy for implant only and a median of 127 Gy for boost cases. The D90 values for the two-stage patients were slightly but not statistically better than the conventional technique (
p
=
0.232). Thirty-one percent of conventional technique patients had a D90 <140 Gy vs. 22% for two-stage technique.
This new two-stage brachytherapy technique may offer some advantages over conventional techniques including: simple and improved needle loading verification, less complicated and better visualization of needle placement, improved stabilization of the gland, and more consistent postoperative dosimetry.</description><identifier>ISSN: 1538-4721</identifier><identifier>EISSN: 1873-1449</identifier><identifier>DOI: 10.1016/j.brachy.2003.07.001</identifier><identifier>PMID: 15110312</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Brachytherapy ; Brachytherapy - instrumentation ; Brachytherapy - methods ; Cohort Studies ; Equipment Design ; Humans ; Iodine Radioisotopes ; Male ; Needles ; Prostate Cancer ; Prostatic Neoplasms - radiotherapy ; Radiometry ; Technique ; Two-stage ; Urinary Catheterization</subject><ispartof>Brachytherapy, 2004, Vol.3 (1), p.34-40</ispartof><rights>2004 American Brachytherapy Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c275t-d27c622b7f482141f349ed2a936ea9877a9c3ff7bc02c1abc0b2e832cbe0d9323</citedby><cites>FETCH-LOGICAL-c275t-d27c622b7f482141f349ed2a936ea9877a9c3ff7bc02c1abc0b2e832cbe0d9323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.brachy.2003.07.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15110312$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Grimm, Peter D</creatorcontrib><creatorcontrib>Blasko, John C</creatorcontrib><creatorcontrib>Sylvester, John E</creatorcontrib><creatorcontrib>Heaney, Charles</creatorcontrib><creatorcontrib>Gasparich, James</creatorcontrib><creatorcontrib>Quackenbush, Jeffrey</creatorcontrib><creatorcontrib>Gottesman, Jim</creatorcontrib><creatorcontrib>Downey, Jim</creatorcontrib><creatorcontrib>Grier, Doug</creatorcontrib><creatorcontrib>Roddy, Tim</creatorcontrib><creatorcontrib>Nellans, Roger</creatorcontrib><creatorcontrib>Sood, Narender</creatorcontrib><creatorcontrib>Wahl, David</creatorcontrib><title>Technical improvement in permanent seed implantation: a two-stage brachytherapy system. Description and comparison with current technique</title><title>Brachytherapy</title><addtitle>Brachytherapy</addtitle><description>Permanent seed implantation by available techniques has modest limitations. A new, two-stage needle design and technique is described and evaluated in comparison to a conventional permanent seed technique.
The technique involves placing a stylet and sleeve initially into the all target coordinates prior to seed placement similar to temporary seed technique. The second stage involves consecutively removing the stylet from each sleeve and inserting a clear, plastic needle containing preloaded seeds into the sleeve and implanting the seeds. Fifty-six
125I patients were treated with the two-stage technique. Comparisons were made with a cohort of 71 patients implanted using a conventional technique at the Seattle Prostate Institute. Prostate movement, surgical time, catheterization rate, and DVH postop dosimetry were analyzed.
After an initial learning curve, the two-stage technique had surgical times similar to conventional techniques. Cephalad movement of 3–10 mm was noted in 4 (8%) patients vs. 71 (100%) patients with our conventional technique. Of the 6 (10%) patients who required Foley catheterization, 3 (5%) did so for 1 day and 3 (5%) did so for less than 3 weeks. Day 1 CT scan based dosimetry was calculated on all patients. The V100 ranged from 80–100% with a median of 92.5%. For primary cases, the V100 (<85%) was 14% for the conventional vs. 7% for the two-stage technique. No two-stage patient had a V100 <80%. The V100 values for the two-stage and conventional techniques demonstrated a possible advantage with the two-stage technique (mean V100 92.6% vs. 90.7%, [
p
=
0.051]). The D90 for the two-stage technique ranged from 123–190 Gy with a median of 151.5 Gy for implant only and a median of 127 Gy for boost cases. The D90 values for the two-stage patients were slightly but not statistically better than the conventional technique (
p
=
0.232). Thirty-one percent of conventional technique patients had a D90 <140 Gy vs. 22% for two-stage technique.
This new two-stage brachytherapy technique may offer some advantages over conventional techniques including: simple and improved needle loading verification, less complicated and better visualization of needle placement, improved stabilization of the gland, and more consistent postoperative dosimetry.</description><subject>Brachytherapy</subject><subject>Brachytherapy - instrumentation</subject><subject>Brachytherapy - methods</subject><subject>Cohort Studies</subject><subject>Equipment Design</subject><subject>Humans</subject><subject>Iodine Radioisotopes</subject><subject>Male</subject><subject>Needles</subject><subject>Prostate Cancer</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiometry</subject><subject>Technique</subject><subject>Two-stage</subject><subject>Urinary Catheterization</subject><issn>1538-4721</issn><issn>1873-1449</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kclOxDAMhiMEYn8DhHLi1pKl07QckNCwSkhc4BylrstkNF1IMqB5BN6alI7EjZNj5bN__zYhZ5ylnPH8cplWzsBikwrGZMpUyhjfIYe8UDLhWVbuxvdMFkmmBD8gR94vI5CXUu6TAz7jnEkuDsn3K8Kis2BW1LaD6z-xxS5Q29EBXWu6MfGI9fi7Ml0wwfbdFTU0fPWJD-Yd6TRGWKAzw4b6jQ_YpvQWPTg7jDg1XU2hbwfjrI_plw0LCmvnxubhV_9jjSdkrzErj6fbeEze7u9e54_J88vD0_zmOQGhZiGphYJciEo1WSF4xhuZlVgLU8ocTVkoZUqQTaMqYAK4iaESWEgBFbK6lEIek4upb3QbZX3QrfWAq-gO-7XXihd5rqSKYDaB4HrvHTZ6cLY1bqM50-MJ9FJP3vV4As2UjhuOZefb_uuqxfqvaLvzCFxPAEaXnxad9mCxA6ytQwi67u3_Cj-ni52P</recordid><startdate>2004</startdate><enddate>2004</enddate><creator>Grimm, Peter D</creator><creator>Blasko, John C</creator><creator>Sylvester, John E</creator><creator>Heaney, Charles</creator><creator>Gasparich, James</creator><creator>Quackenbush, Jeffrey</creator><creator>Gottesman, Jim</creator><creator>Downey, Jim</creator><creator>Grier, Doug</creator><creator>Roddy, Tim</creator><creator>Nellans, Roger</creator><creator>Sood, Narender</creator><creator>Wahl, David</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2004</creationdate><title>Technical improvement in permanent seed implantation: a two-stage brachytherapy system. Description and comparison with current technique</title><author>Grimm, Peter D ; Blasko, John C ; Sylvester, John E ; Heaney, Charles ; Gasparich, James ; Quackenbush, Jeffrey ; Gottesman, Jim ; Downey, Jim ; Grier, Doug ; Roddy, Tim ; Nellans, Roger ; Sood, Narender ; Wahl, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c275t-d27c622b7f482141f349ed2a936ea9877a9c3ff7bc02c1abc0b2e832cbe0d9323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Brachytherapy</topic><topic>Brachytherapy - instrumentation</topic><topic>Brachytherapy - methods</topic><topic>Cohort Studies</topic><topic>Equipment Design</topic><topic>Humans</topic><topic>Iodine Radioisotopes</topic><topic>Male</topic><topic>Needles</topic><topic>Prostate Cancer</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiometry</topic><topic>Technique</topic><topic>Two-stage</topic><topic>Urinary Catheterization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Grimm, Peter D</creatorcontrib><creatorcontrib>Blasko, John C</creatorcontrib><creatorcontrib>Sylvester, John E</creatorcontrib><creatorcontrib>Heaney, Charles</creatorcontrib><creatorcontrib>Gasparich, James</creatorcontrib><creatorcontrib>Quackenbush, Jeffrey</creatorcontrib><creatorcontrib>Gottesman, Jim</creatorcontrib><creatorcontrib>Downey, Jim</creatorcontrib><creatorcontrib>Grier, Doug</creatorcontrib><creatorcontrib>Roddy, Tim</creatorcontrib><creatorcontrib>Nellans, Roger</creatorcontrib><creatorcontrib>Sood, Narender</creatorcontrib><creatorcontrib>Wahl, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Brachytherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Grimm, Peter D</au><au>Blasko, John C</au><au>Sylvester, John E</au><au>Heaney, Charles</au><au>Gasparich, James</au><au>Quackenbush, Jeffrey</au><au>Gottesman, Jim</au><au>Downey, Jim</au><au>Grier, Doug</au><au>Roddy, Tim</au><au>Nellans, Roger</au><au>Sood, Narender</au><au>Wahl, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Technical improvement in permanent seed implantation: a two-stage brachytherapy system. Description and comparison with current technique</atitle><jtitle>Brachytherapy</jtitle><addtitle>Brachytherapy</addtitle><date>2004</date><risdate>2004</risdate><volume>3</volume><issue>1</issue><spage>34</spage><epage>40</epage><pages>34-40</pages><issn>1538-4721</issn><eissn>1873-1449</eissn><abstract>Permanent seed implantation by available techniques has modest limitations. A new, two-stage needle design and technique is described and evaluated in comparison to a conventional permanent seed technique.
The technique involves placing a stylet and sleeve initially into the all target coordinates prior to seed placement similar to temporary seed technique. The second stage involves consecutively removing the stylet from each sleeve and inserting a clear, plastic needle containing preloaded seeds into the sleeve and implanting the seeds. Fifty-six
125I patients were treated with the two-stage technique. Comparisons were made with a cohort of 71 patients implanted using a conventional technique at the Seattle Prostate Institute. Prostate movement, surgical time, catheterization rate, and DVH postop dosimetry were analyzed.
After an initial learning curve, the two-stage technique had surgical times similar to conventional techniques. Cephalad movement of 3–10 mm was noted in 4 (8%) patients vs. 71 (100%) patients with our conventional technique. Of the 6 (10%) patients who required Foley catheterization, 3 (5%) did so for 1 day and 3 (5%) did so for less than 3 weeks. Day 1 CT scan based dosimetry was calculated on all patients. The V100 ranged from 80–100% with a median of 92.5%. For primary cases, the V100 (<85%) was 14% for the conventional vs. 7% for the two-stage technique. No two-stage patient had a V100 <80%. The V100 values for the two-stage and conventional techniques demonstrated a possible advantage with the two-stage technique (mean V100 92.6% vs. 90.7%, [
p
=
0.051]). The D90 for the two-stage technique ranged from 123–190 Gy with a median of 151.5 Gy for implant only and a median of 127 Gy for boost cases. The D90 values for the two-stage patients were slightly but not statistically better than the conventional technique (
p
=
0.232). Thirty-one percent of conventional technique patients had a D90 <140 Gy vs. 22% for two-stage technique.
This new two-stage brachytherapy technique may offer some advantages over conventional techniques including: simple and improved needle loading verification, less complicated and better visualization of needle placement, improved stabilization of the gland, and more consistent postoperative dosimetry.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15110312</pmid><doi>10.1016/j.brachy.2003.07.001</doi><tpages>7</tpages></addata></record> |
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| subjects | Brachytherapy Brachytherapy - instrumentation Brachytherapy - methods Cohort Studies Equipment Design Humans Iodine Radioisotopes Male Needles Prostate Cancer Prostatic Neoplasms - radiotherapy Radiometry Technique Two-stage Urinary Catheterization |
| title | Technical improvement in permanent seed implantation: a two-stage brachytherapy system. Description and comparison with current technique |
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