Intracardiac Embolized Prostate Brachytherapy Seeds: Imaging Features in Patients Undergoing Electrocardiogram-Gated Cardiac Computed Tomography.
OBJECTIVE
This study aims to provide the first description of the computed tomographic (CT) appearances of intracardiac embolized brachytherapy seeds in patients undergoing electrocardiogram (ECG)-gated cardiac CT.


METHODS
The institutional Picture Archive and Communication System was searched for male patients who underwent enhanced ECG-gated cardiac CT, and reports were searched for the key words "metallic," "prostate," "brachytherapy," "radiation," "embolized," and "radioactive." Each study was identified and examined for an intracardiac metallic object conforming to the size of a prostate seed.


RESULTS
Between January 01, 2005, and June 30, 2014, a total of 3206 male patients underwent ECG-gated cardiac CT. Five patients (0.15%) had a history of prostate cancer and an intracardiac metallic object with CT imaging characteristics consistent with an embolized prostate seed. In all 5 patients, the seeds were embedded in the trabeculations of the inferior aspect of the basal right ventricular free wall.


CONCLUSIONS
Intracardiac embolized brachytherapy seeds appear as small objects with surrounding metallic artifact characteristically embedded in the inferior aspect of the basal right ventricular free wall.
From the *Department of Radiology, Memorial Sloan Kettering Cancer Center; and †Department of Radiology, Cardiac Imaging Section, NYU Langone Medical Center, New York, NY.
Darragh F
DF
Halpenny
Larry
L
Latson
Derek
D
Mason
Robert
R
Donnino
Jeffrey
J
Alpert
Jill E
JE
Jacobs
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging* / Q000209:etiology; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D019736:Prostheses and Implants / Q000009:adverse effects; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*