The history of interstitial brachytherapy of prostatic cancer

The history of interstitial brachytherapy of the prostate began in 1917 when Barringer inserted radium needles transperineally into the prostate, guided by a finger in the rectum. In 1952, Flocks et al. injected radioactive gold solution in prostatic cancer during open operation. In 1972, Whitmore et al. described retropubic Iodine-125 seed implantation through an open operation with pelvic lymph node dissection. The basis for ultrasound (US)-guided seed implantation was established in the late 1960s by Kratochwil's description of the first puncture transducer for one-dimensional US-guidance and Watanabe's pioneer work in prostatic screening. Our group performed the first punctures guided by static two-dimensional ultrasonic scanning (1969) and by dynamic ultrasound scanning (1974). During the 1970s, US-guided biopsies of almost all abdominal organs were performed and, in 1981, we introduced US-guided seed implantation of abdominal tumors and developed a technique for precise needle placement in the prostate guided by transrectal ultrasound. This was followed in 1983 by a technique for seed implantation guided by transrectal (transverse) ultrasonic scanning. That same year, Fornage described prostatic biopsy guided by transrectal longitudinal scanning. In 1990, we developed the seed implantation technique further by combining transverse and longitudinal scannings. In the late 1980s, Ragde from Seattle transferred the technique to the U.S., and since then, Ragde, Blasko, and others have treated numerous patients, refined the technique, taught many courses, and published extensively. They have obtained very promising prostate-specific antigen (PSA)-based results which compare favorably with radical prostatectomy and external beam radiation in the treatment of prostatic cancer.