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Fluoroscopic visualization of the prostatic urethra to guide transperineal prostate implantation
1Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Purpose:
To describe a novel way to assure proper needle positioning within the prostate during transperineal implantation, using the urethra as the primary radiographic landmark.
Methods And Materials:
Preoperative computerized tomography (CT) images through the prostate are used to plan optimal transperineal needle-seed placement. When performing the procedure, a Foley catheter, with radio-opaque wire is used to visualize the prostatic urethra fluoroscopically in anterior-posterior and lateral projections. Proper needle placement is determined by their position relative to the urethra.
Results:
Sixty patients have been implanted with this method at Memorial Sloan-Kettering Cancer Center from 1990-1992.
Conclusion:
The method described here is an improvement over previously described CT-based techniques. It could be used to supplement or replace ultrasound imaging.