A nomogram to compensate for intraoperative prostate edema during transperineal brachytherapy Journal Article
| Authors: | Potters, L.; Wang, X. H.; Yamada, Y. |
| Article Title: | A nomogram to compensate for intraoperative prostate edema during transperineal brachytherapy |
| Abstract: | Purpose: Prostate edema during and following prostate brachytherapy may have a negative impact on implant dosimetry. The purpose of this study was to assess the magnitude of prostate edema during the operative procedure and to develop a nomogram of isotope activity required for compensation of such intraoperative prostate volume changes. Materials and Methods: Twenty-five consecutive patients with early-stage, localized adenocarcinoma of the prostate underwent ultrasound-guided transperineal interstitial permanent prostate brachytherapy with either iodine 125 or palladium 103. Transrectal ultrasound volume studies of the prostate were performed before and during the implant procedure. Computed tomography-based postimplant dosimetry was performed 3-4 weeks after surgery. Results: A median intraoperative prostate volume increase after insertion of applicator needles of 10.4% (range 1.2- 32.5%) was identified. A correlation of-0.55 (95% confidence interval -0.78 to -0.19) between the minimum dose covering 90% of the prostate volume (%D90) and the amount of edema was identified. An algorithm and nomogram was developed to calculate the extra isotope activity necessary to compensate for intraoperative edema. Conclusions: Prostate edema occurs at the time of transperineal needle placement. A negative correlation was found between the amount of edema and dose coverage of the prostate (%D90). Therefore, to cover the prostate volume adequately, additional isotope activity is required when preoperative treatment planning is performed. This nomogram can be used to compensate for such volume changes. |
| Keywords: | adult; clinical article; aged; middle aged; implant; treatment planning; neoplasm staging; prospective studies; adenocarcinoma; edema; computer assisted tomography; radiotherapy dosage; tomography, x-ray computed; algorithms; prostate cancer; prostatic neoplasms; iodine 125; iodine radioisotopes; algorithm; dosimetry; radiation injuries; brachytherapy; prostate adenocarcinoma; radioisotopes; organ size; nomogram; radioisotope therapy; palladium; endosonography; rectum; perineum; iodine; intraoperative complications; peroperative complication; humans; human; male; priority journal; article; prostate edema |
| Journal Title: | Techniques in Urology |
| Volume: | 6 |
| Issue: | 2 |
| ISSN: | 1079-3259 |
| Publisher: | Raven Press |
| Date Published: | 2000-01-01 |
| Start Page: | 99 |
| End Page: | 103 |
| Language: | English |
| PUBMED: | 10798808 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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