FLUOROSCOPIC VISUALIZATION OF THE PROSTATIC URETHRA TO GUIDE TRANSPERINEAL PROSTATE IMPLANTATION

Purpose: To decribe 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.