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Overcoming pubic arch interference with free-hand needle placement in men undergoing prostate brachytherapy
Erin P Gibbons1, Ryan P Smith, Sushil Beriwal
1Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Purpose:
The present study evaluates the postimplant dosimetry when free-hand needles were placed to overcome interference from the pubic arch.
Methods And Materials:
A review of all patients who underwent prostate brachytherapy at our institution from 2001 to 2006 was performed. Postimplant dosimetry in men requiring free-hand needle placement was compared with postimplant dosimetry in men not requiring free-hand needle placement.
Results:
Of the 145 patients who underwent prostate brachytherapy, 8 patients required free-hand needle placement. The mean prostate volume in the free-hand needle cohort was 46.0cc with a mean of 3.4 free-hand needles placed. In the 137 patients not requiring free-hand needle placement, the mean volume was 39.7cc. The mean D(90), V(100), V(150), and rectal V(100) for the free-hand cohort was 129.5%, 96.3%, 81.6%, and 1.45cc, respectively. The mean D(90), V(100), V(150), and rectal V(100) in men not requiring free-hand needle placement was 126.8%, 97.1%, 78.7%, and 1.03cc, respectively.
Conclusion:
The present study finds that adequate postimplant dosimetry can be obtained if free-hand needles are required due to pubic arch interference.
