title: Overcoming pubic arch interference with free-hand needle placement in men undergoing prostate brachytherapy.
abstract: OBJECTIVE
  The present study evaluates the postimplant dosimetry when free-hand needles were placed to overcome interference from the pubic arch.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The present study finds that adequate postimplant dosimetry can be obtained if free-hand needles are required due to pubic arch interference.
authors.affiliation: Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Erin P
authors.initials: EP
authors.lastname: Gibbons
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Smith
authors.forename: Sushil
authors.initials: S
authors.lastname: Beriwal
authors.forename: Komanduri
authors.initials: K
authors.lastname: Krishna
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Benoit
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage; D008297:Male; D009929:Organ Size; D011467:Prostate / Q000473:pathology / Q000528:radiation effects*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011630:Pubic Bone / Q000000981:diagnostic imaging; D011859:Radiography
chemical_list: D007457:Iodine Radioisotopes