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Journal of Contemporary Brachytherapy
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ABS 2015
vol. 10
Original paper

Predicting pubic arch interference in permanent prostate brachytherapy based on the specific parameters derived from nuclear magnetic resonance imaging

Yupeng Zheng, Jixiang Wu, Shan Chen, Yuexin Liu, Guangyin Zhang

J Contemp Brachytherapy 2018; 10, 5: 405–410
Online publish date: 2018/10/25
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The aim of this study was to establish a more reliable method to predict pubic arch interference (PAI) before permanent prostate brachytherapy.

Material and methods
We retrospectively analyzed the nuclear magnetic resonance imaging (MRI) results of forty patients with prostate cancer, who were treated with permanent implantation of 125I seeds (permanent brachytherapy). We measured and calculated six parameters based on the MRI results: 1. The prostate volume (PV); 2. The angle of the pubic arch (AoPA); 3. The angle of PAI (AoPAI, pubic symphysis level); 4. The height of PAI (hPAI, pubic symphysis level); 5. The maximum angle of PAI (AoPAIMax); 6. The maximum height of PAI (hPAIMax). We then tested which parameters could accurately predict PAI through receiver operating characteristic (ROC) curve analysis.

The results of this study demonstrated that AoPAI, hPAI, hPAIMax, and AoPAIMax could predict PAI. Out of forty cases in our research, 10 cases were with PAI and 30 cases without PAI during the operation. The areas under the ROC curve for PV, AoPA, AoPAI (pubic symphysis level), hPAI (pubic symphysis level), AoPAIMax, and hPAIMax were 0.592, 0.567, 0.957, 0.940, 0.927, and 0.877, respectively. The AoPAI (pubic symphysis level), hPAI (pubic symphysis level), AoPAIMax, and hPAIMax were statistically correlated with PAI. The boundary values were 26.32°, 1.13 cm, 28.37°, and 1.51 cm, respectively.

This new method derived from MRI has predictive value, as AoPAI, hPAI, hPAIMax, and AoPAIMax could predict PAI. Taking other factors into consideration, we suggest the use of AoPAI as a novel and very reliable predictor of PAI.


brachytherapy, nuclear magnetic resonance imaging (MRI), prostate cancer, pubic arch interference (PAI), seed implantation

Taira AV, Merrick GS, Butler WM et al. Long-term outcome for clinically localized prostate cancer treated with permanent interstitial brachytherapy. Int J Radiat Oncol Biol Phys 2011; 79: 1336-1342.
Hayashi N, Izumi K, Sano F et al. Ten-year outcomes of I-125 low-dose-rate brachytherapy for clinically localized prostate cancer: a single-institution experience in Japan. World J Urol 2015; 33: 1519-1526.
Stish BJ, Davis BJ, Mynderse LA et al. Brachytherapy in the management of prostate cancer. Surg Oncol Clin N Am 2017; 26: 491-513.
Bellon J, Wallner K, Ellis W et al. Use of pelvic CT scanning to evaluate pubic arch interference of transperineal prostate brachytherapy. Int J Radiat Oncol Biol Phys 1999; 43: 579-581.
Nguyen PL, Alibhai SM, Basaria S et al. Adverse effects of androgen deprivation therapy and strategies to mitigate them. Eur Urol 2015; 67: 825-836.
Henderson A, Laing RW, Langley SE. Identification of pubic arch interference in prostate brachytherapy: Simplifying the transrectal ultrasound technique. Brachytherapy 2003; 2: 240-245.
Fukada J, Shigematsu N, Nakashima J et al. Predicting pubic arch interference in prostate brachytherapy on transrectal ultrasonography-computed tomography fusion images. J Radiat Res 2012; 53: 753-759.
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.
Ryu B, Bax J, Edirisinge C et al. Prostate brachytherapy with oblique needles to treat large glands and overcome pubic arch interference. Int J Radiat Oncol Biol Phys 2012; 83: 1463-1472.
Blanchard P, Menard C, Frank SJ et al. Clinical use of magnetic resonance imaging across the prostate brachytherapy workflow. Brachytherapy 2017; 16: 728-733.
Tincher SA, Kim RY, Ezekiel MP et al. Effects of pelvic rotation and needle angle on pubic arch interference during transperineal prostate implants. Int J Radiat Oncol Biol Phys 2000; 47: 361-363.
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