Predicting Urinary Morbidity after Brachytherapy of Localized Prostate Cancer  Marcel J. Steggerda, Henk G. van der Poel, Luc M.F. Moonen  European Urology Supplements  Volume 7, Issue 12, Pages 723-731 (November 2008) DOI: 10.1016/j.eursup.2008.07.004 Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 1 International Prostate Symptom Score (IPSS) as a function of postimplant time interval published by different authors [4,10,15,18,21]. * Indicates a study with mean IPSS values. ** Indicates a study with median IPSS values. Note: 0 mo represents the situation before treatment. European Urology Supplements 2008 7, 723-731DOI: (10.1016/j.eursup.2008.07.004) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 2 Transversal ultrasound image through the midgland. (a) “Peripheral” loading of the seeds to spare the urethra; dose at the center of the urethra is 197Gy. (b) “Uniform” loading of the seeds; the needle at D3.5 is likely to puncture the urethra; dose at the center of the urethra is 330Gy. Legend: White line, prostate contour; orange line, 145Gy isodose; light green line, 290Gy isodose; blue line, 72.5Gy isodose; dark green line, urethra contour; orange dots, I-125 seed sources. European Urology Supplements 2008 7, 723-731DOI: (10.1016/j.eursup.2008.07.004) Copyright © 2008 European Association of Urology Terms and Conditions

Fig. 3 Dose build-up implant with I-125 sources and Pd-103 sources. Because of the shorter half-value time of Pd-103 (17 d) compared with I-125 (60 d), the dose builds up much faster in prostates implanted with Pd-103; consequently, the radiation dose is expected to take effect earlier. Greater biologic effectiveness requires a lower total dose when applying Pd-103 (usually 125Gy) than when applying I-125 (usually 145Gy). European Urology Supplements 2008 7, 723-731DOI: (10.1016/j.eursup.2008.07.004) Copyright © 2008 European Association of Urology Terms and Conditions