125I reimplantation in patients with poor initial dosimetry after prostate brachytherapy Mira Keyes, MD, Tom Pickles, MD, Alexander Agranovich, MD, Winkle.

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Presentation transcript:

125I reimplantation in patients with poor initial dosimetry after prostate brachytherapy Mira Keyes, MD, Tom Pickles, MD, Alexander Agranovich, MD, Winkle Kwan, MB, B.S., W.James Morris, MD International Journal of Radiation Oncology • Biology • Physics Volume 60, Issue 1, Pages 40-50 (September 2004) DOI: 10.1016/j.ijrobp.2004.02.011

Fig. 1 Patient 3. Axial CT images of initial postimplant dosimetry. Prostate, bladder and seminal vesicles were contoured. Isodose lines 145 Gy (100%) and 216 Gy (150%) as marked. Entire base was underdosed. “Day 30” CT postimplant dosimetry: V100 59% and D90 70 Gy. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)

Fig. 2 Patient 3. Two-dimensional reconstructed (a) sagittal and (b) coronal prostate images. Isodose lines 145 Gy (100%) and 216 Gy (150%) as marked. Entire base was underdosed. “Day 30” CT postimplant dosimetry: V100 59% and D90 70 Gy. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)

Fig. 3 Patient 3. Reimplant plan. Initial seeds given in white, additional seeds for reimplant in black. Plan displays 28 additional seeds. Patient was reimplanted with 32 additional seeds, all deposited at base. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)

Fig. 4 Patient 3. Axial CT images of reimplant. Isodose lines 145 Gy (100%) and 216 Gy (150%) as marked. “Day 0” CT postimplant dosimetry: V100 90% and D90 144 Gy. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)

Fig. 5 Patient 3. Two-dimensional reconstructed (a) sagittal and (b) coronal reimplant prostate images. Isodose lines 145 Gy (100%) and 216 Gy (150%) as marked. “Day 0” CT postimplant dosimetry: V100 90% and D90 144 Gy. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)

Fig. 6 International Prostate Symptom Score (IPSS) in all 7 reimplanted patients. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)

Fig. 7 Median International Prostate Symptom Score (IPSS) for 7 reimplant patients and median IPSS for 400 consecutive cohort patients. International Journal of Radiation Oncology • Biology • Physics 2004 60, 40-50DOI: (10.1016/j.ijrobp.2004.02.011)