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Once the "target volume" has been determined, radiation physics personnel use specialized computer software to create a "dosimetry plan". This plan will specify the distribution, number & strength of seeds that will provide the proper dose of radiation to the prescribed area. (Figure 10) On average, approximately 100-110 seeds are used in a typical implant procedure. Performing the Implant: An implant is an outpatient procedure. At SPI, patients are in the hospital for a total of approximately 5 hours, less than an hour of which is spent in the OR. Patients are generally given spinal anesthesia so that they can be awake during the procedure- and recover more quickly afterwards.
Performing the Implant: An implant is an outpatient procedure. At SPI, patients are in the hospital for a total of approximately 5 hours, less than an hour of which is spent in the OR. Patients are generally given spinal anesthesia so that they can be awake during the procedure- and recover more quickly afterwards.
Since the volume study images form the basis of the seed (and needle) distribution scheme, the physician must replicate these images in the OR in order to carry out the procedure as planned. (Figure 11) These live images are then used to guide the insertion of the needles to the correct depths corresponding with each image (or "retraction plane") so that the seeds can be placed exactly where they belong. (Figure 12)
Post-Op Evaluation: On the day after the implant, a pelvic x-ray, chest x-ray, and a CT scan are taken. The pelvic x-ray (Figure 6) provides the implant team with general information about the implant and aids in counting the seeds. The chest x-ray is performed to determine if any seeds were deposited in the blood stream and carried to the lungs. (This occurs very rarely and does not appear to cause any harm to patients.) Finally, a series of CT scans is taken at the same intervals as the earlier ultrasound volume study images. (Figure 13) These two sets of images are then used by radiation physics staff to calculate the actual radiation dose received by the prostate and surrounding tissue.
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Post-Op Evaluation: On the day after the implant, a pelvic x-ray, chest x-ray, and a CT scan are taken. The pelvic x-ray (Figure 6) provides the implant team with general information about the implant and aids in counting the seeds. The chest x-ray is performed to determine if any seeds were deposited in the blood stream and carried to the lungs. (This occurs very rarely and does not appear to cause any harm to patients.) Finally, a series of CT scans is taken at the same intervals as the earlier ultrasound volume study images. (Figure 13) These two sets of images are then used by radiation physics staff to calculate the actual radiation dose received by the prostate and surrounding tissue.
