Prostatic brachytherapy: ultrasound and CT findings

Case contributed by Dr Chris O'Donnell

Presentation

Prostatic cancer treated with radioactive seeds 5 years ago. Now difficulty passing urine.

Patient Data

Age: 65
Gender: Male

Multiple metallic seeds located in the peripheral zone of the prostate bilaterally

Multiple echogenic foci in the periphery of the prostate representing the seeds. Large residual bladder volume of >350 ml post micturition.

Case Discussion

Low dose-rate (LDR) brachytherapy to the prostate involves transperineal insertion of multiple (50-150) radioactive seeds

  • Iodine-125 (t1/2: 59.4 days), or
  • Palladium-103 (t1/2: 17 days)

These are inserted into the gland, especially the peripheral zone where cancers usually arise, with concentration at the site of tumour based on biopsy or MRI. Side effects of incontinence, erectile dysfunction, diarrhoea and urinary obstruction are usually short term, but bladder neck stricture can occur over the long term and cause difficulties in micturition, leading to a large residual bladder volume, as in this case.

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Case information

rID: 37560
Case created: 13th Jun 2015
Last edited: 21st Jun 2017
System: Urogenital
Inclusion in quiz mode: Included

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