PURPOSE: A large number of men are diagnosed with early-stage prostate cancer as a result of prostate-specific antigen (PSA) screening. For many of these men, prostatectomy results in long-term freedom from biochemical and clinical failure. Despite limited follow-up data, ultrasound-guided prostate brachytherapy has gained acceptance as a treatment for early-stage prostate cancer, in part due to its favorable side effect profile and brief recovery period. We report on the use of three-dimensional real-time magnetic resonance (MR) guidance, which has several advantages compared with biplanar ultrasound guidance for prostate brachytherapy, including enhanced geometric and dosimetric feedback during the procedure. MATERIALS AND METHODS: Median clinical target volume coverage of 96% was achieved using MR guidance. The ability to define more precisely the clinical target volume with MR and the use of real-time assessment of dose distribution resulted in an excellent acute side effect profile. Only 19% of patients required oral alpha1 blockers for postimplant urethritis and 9% required temporary reinsertion of the Foley catheter due to acute urinary obstruction. CONCLUSIONS: These results compare favorably to those of ultrasound-guided brachytherapy. Further follow-up is needed to ascertain the impact this technique will have on cancer control and long-term quality of life.
PURPOSE: A large number of men are diagnosed with early-stage prostate cancer as a result of prostate-specific antigen (PSA) screening. For many of these men, prostatectomy results in long-term freedom from biochemical and clinical failure. Despite limited follow-up data, ultrasound-guided prostate brachytherapy has gained acceptance as a treatment for early-stage prostate cancer, in part due to its favorable side effect profile and brief recovery period. We report on the use of three-dimensional real-time magnetic resonance (MR) guidance, which has several advantages compared with biplanar ultrasound guidance for prostate brachytherapy, including enhanced geometric and dosimetric feedback during the procedure. MATERIALS AND METHODS: Median clinical target volume coverage of 96% was achieved using MR guidance. The ability to define more precisely the clinical target volume with MR and the use of real-time assessment of dose distribution resulted in an excellent acute side effect profile. Only 19% of patients required oral alpha1 blockers for postimplant urethritis and 9% required temporary reinsertion of the Foley catheter due to acute urinary obstruction. CONCLUSIONS: These results compare favorably to those of ultrasound-guided brachytherapy. Further follow-up is needed to ascertain the impact this technique will have on cancer control and long-term quality of life.
Authors: A Jain; A Deguet; I Iordachita; G Chintalapani; S Vikal; J Blevins; Y Le; E Armour; C Burdette; D Song; G Fichtinger Journal: Med Image Anal Date: 2010-08-14 Impact factor: 8.545
Authors: Paul L Nguyen; Ming-Hui Chen; Yuanye Zhang; Clare M Tempany; Robert A Cormack; Clair J Beard; Mark D Hurwitz; W Warren Suh; Anthony V D'Amico Journal: J Urol Date: 2012-08-15 Impact factor: 7.450
Authors: Cynthia Ménard; Robert C Susil; Peter Choyke; Gary S Gustafson; William Kammerer; Holly Ning; Robert W Miller; Karen L Ullman; Nancy Sears Crouse; Sharon Smith; Etienne Lessard; Jean Pouliot; Victor Wright; Elliot McVeigh; C Norman Coleman; Kevin Camphausen Journal: Int J Radiat Oncol Biol Phys Date: 2004-08-01 Impact factor: 7.038