CT-based optimized planning for transperineal prostate implant with customized template.

A computerized planning procedure has been developed for CT-guided transperineal prostate implants. The segment for custom planning of perineal needle orientations allows placement of I-125 seeds in the entire prostate gland while avoiding the pubic bones. Least-squares optimization (LSO) is used to obtain the seed-loading pattern along the needles. The optimized seed distribution produces a better fit between treatment and target volumes than that obtained from our previous manual technique. Also, the present semi-automatic technique reduces planning time by about a factor of 10 compared to that of the manual approach.