title: Migration of a strand of four seeds in low-dose-rate brachytherapy.
abstract: We report a case of stranded-seed migration (one strand of four seeds), via the prostatic venous plexus to the internal pudendal vein, in low-dose-rate (LDR) prostate brachytherapy. A 70-year-old man with low-risk prostate adenocarcinoma underwent transperineal permanent seed implantation. A total of 93 iodine-125 seeds were implanted (91 stranded seeds and 2 loose seeds). Immediate postimplantation fluoroscopic image and day 1 postimplantation CT scan indicated all implanted seeds to be within the vicinity of the prostate as planned. Day 30 pelvic X-ray and CT scan revealed migration of a strand of four seeds to the right pelvis (adjacent to ischial spine). At 2 years postimplantation, the patient continues to have good disease control with prostate specific antigen level of 0.69 μg/L, and asymptomatic. To the best of our knowledge, this is the first report of migration of an entire strand of seeds following LDR prostate brachytherapy.
authors.affiliation: Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jasmina
authors.initials: J
authors.lastname: Dedic-Hagan
authors.affiliation: Radiation Oncology Institute, Sydney, New South Wales, Australia.
authors.forename: Amy Y M
authors.initials: AY
authors.lastname: Teh
authors.affiliation: Department of Radiology, Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Eisen
authors.initials: E
authors.lastname: Liang
authors.affiliation: Radiation Oncology Institute, Sydney, New South Wales, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Collett
authors.affiliation: Sydney Adventist Hospital Clinical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Henry H
authors.initials: HH
authors.lastname: Woo
mesh_terms: D000230:Adenocarcinoma / Q000532:radiotherapy; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D005471:Fluoroscopy; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D010388:Pelvis; D011471:Prostatic Neoplasms / Q000532:radiotherapy