PURPOSE: Post-implant dosimetry following prostate seed implantation (PSI) occasionally reveals suboptimal dosimetric coverage of the gland. Published reports of re-implantation techniques have focused on earlier-generation techniques, including preplanned approaches and stranded seeds. The purpose of this case report is to describe a customizable approach to perform corrective re-implantation using loose seeds and intraoperative planning technique.
MATERIAL AND METHODS: This case report describes a 63-year-old male with favorable risk prostate adenocarcinoma receiving PSI. Thirty day post-implant dosimetric evaluation revealed suboptimal coverage of the base of the gland. Using guidance from post-implant CT-images and real-time planning, the patient received a corrective re-implantation with intraoperative planning.
RESULTS: Post-implant dosimetry after re-implantation procedure with intraoperative planning yielded improved target volume coverage that achieved standard dosimetric criteria.
CONCLUSIONS: Re-implantation as a salvage treatment technique after sub-optimal PSI is a valid treatment option performed with intraoperative real-time planning.
Recommended CitationDoyle, Laura; Hesney, Adam J; Chapman, Katherine L; Liu, Haisong; Weiner, Perry R; Dicker, Adam; Yu, Yan; and Showalter, Timothy, "Re-implantation of suboptimal prostate seed implantation: technique with intraoperative treatment planning." (2012). Department of Radiation Oncology Faculty Papers. Paper 32.