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Journal of Contemporary Brachytherapy
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vol. 10
Original paper

A cold spot compensation technique using a combination of trans-rectal ultrasonography and intraoperative computed tomography for interstitial permanent prostate brachytherapy: a single-arm prospective trial

Hiromichi Ishiyama, Hideyasu Tsumura, Shogo Kawakami, Takefumi Satoh, Akane Sekiguchi, Ken-ichi Tabata, Masatsugu Iwamura, Kazushige Hayakawa

J Contemp Brachytherapy 2018; 10, 1: 10–16
Online publish date: 2018/02/28
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To evaluate the efficacy of a cold spot compensation technique using a combination of trans-rectal ultrasonography (TRUS) and computed tomography (CT) for permanent interstitial prostate brachytherapy.

Material and methods
Sixty-five patients were treated with the cold spot compensation technique using TRUS-CT fusion. The prescribed dose was set at 145 Gy. The dose to 90% of prostate volume (D90) was planned to be within 195 Gy (134%) and 205 Gy (141%). After implantation using the conventional technique, additional seeds were implanted if cold spots were detected on TRUS-CT fusion images.

Cold spots were detected in 32 of 65 patients (49%) and were compensated by additional seeds. Median number of additional seeds was 3 (range, 1-5). A CT scan 1 month later revealed that the percentage of patients receiving an undesirably low D90 (160-180 Gy) was significantly reduced in the examination arm compared to historical controls. However, mean operation time was significantly longer in the examination arm (64 min) than in historical controls (49 min, p < 0.001). With median follow-up of 18 months (range, 9-24 months), no grade 3 or worse toxicity was encountered.

The cold spot compensation technique using TRUS-CT fusion appears effective for patients receiving permanent interstitial prostate brachytherapy.


brachytherapy, low-dose-rate, intraoperative CT, O-arm system, prostate cancer

Polo A, Salembier C, Venselaar J et al. Review of intraoperative imaging and planning techniques in permanent seed prostate brachytherapy. Radiother Oncol 2010; 94: 12-23.
Nag S, Bice W, DeWyngaert K et al. The American Bra­chy­therapy Society recommendations for permanent prostate brachytherapy postimplant dosimetric analysis. Int J Radiat Oncol Biol Phys 2000; 46: 221-230.
Davis BJ, Horwitz EM, Lee WR et al. American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy. Brachytherapy 2012; 11: 6-19.
Ishiyama H, Sekiguchi A, Satoh T et al. Dosimetry of permanent interstitial prostate brachytherapy for an interoperative procedure, using O-arm based CT and TRUS. J Contemp Brachytherapy 2016; 8: 7-16.
Zauls AJ, Ashenafi MS, Onicescu G et al. Comparison of intraoperatively built custom linked seeds versus loose seed gun applicator technique using real-time intraoperative planning for permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 2011; 81: 1010-1016.
Ishiyama H, Satoh T, Kawakami S et al. A prospective quasi-randomized comparison of intraoperatively built custom-linked seeds versus loose seeds for prostate brachytherapy. Int J Radiat Oncol Biol Phys 2014; 90: 134-139.
Westendorp H, Hoekstra CJ, van’t Riet A et al. Intraoperative adaptive brachytherapy of iodine-125 prostate implants guided by C-arm cone-beam computed tomography-based dosimetry. Brachytherapy 2007; 6: 231-237.
Westendorp H, Hoekstra CJ, Immerzeel JJ et al. Cone-beam CT-based adaptive planning improves permanent prostate brachytherapy dosimetry: An analysis of 1,266 patients. Med Phys 2017; 44: 1257-1267.
Peters M, Smit Duijzentkunst DA, Westendorp H et al. Adap­tive cone-beam CT planning improves long-term bioche­mical disease-free survival for 125 I prostate brachytherapy. Brachytherapy 2017; 16: 282-290.
Zelefsky MJ, Worman M, Cohen GN et al. Real-time intraoperative computed tomography assessment of quality of permanent interstitial seed implantation for prostate cancer. Urology 2010; 76: 1138-1142.
Kaplan ID, Meskell P, Oldenburg NE et al. Real-time comput­ed tomography dosimetry during ultrasound-guided bra­chy­therapy for prostate cancer. Brachytherapy 2006; 5: 147-151.
Ishiyama H, Kitano M, Satoh T et al. Difference in rectal dosimetry between pre-plan and post-implant analysis in transperineal interstitial brachytherapy for prostate cancer. Radiother Oncol 2006; 78: 194-198.
Seppenwoolde Y, Kolkman-Deurloo IK, Sipkema D et al. HDR prostate monotherapy: dosimetric effects of implant deformation due to posture change between TRUS- and CT-imaging. Radiother Oncol 2008; 86: 114-119.
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