Comparative Studies on Permanent Prostate Brachytherapy Pre-Plan and Real-Time Transrectal Ultrasound Guided Iodine-125 Seed Implants at Korle-Bu Teaching Hospital, Ghana

Abstract

This research was carried out to investigate and compare the real-time and pre-plan implant at the Radiotherapy Department of the Korle-Bu Teaching Hospital, Ghana. Prowess Panther 4.5 treatment planning system and Variseed 7.2 software were used for pre-plan and real-time implant respectively. The study was conducted for eighty -three (83) patients treated for prostate cancer through real-time implant brachytherapy between September, 2008 to April, 2013. Thirty one patients (31) whose Ultrasound images were available were selected for the pre-plan study. The slices of ultrasound images were re-drawn on transparent A-4 sheets and later on scanned, contoured and registered in the treatment planning system (Prowess 4.5) .After planning, the volume to be implanted, total number of needles, seeds and the total activity of the source were displayed. Comparison was done with the pre-plan and real-time implant. In both cases the variation was below 5% as recommended in dosimetry. About 30-40% of the imported seeds were left un-used due to over-estimation of seeds ordered from the manufacturer (BARD Company-USA) .Hence this work (pre-plan) aims to solve this problem. The comparison for dosimetric parameters was assessed for prostate, urethra and rectum as (V95%, V100%,V150%, D90Gy, D90%) , (D90Gy, D90%, D30Gy , D30%) and ( V100% , D30Gy and D30%) respectively and the variation were within the limit of ± 5%. Comparison of dosimetric values for this work were done with other institutions, like Karolinska university hospital, Sweden, The institute of Curie / hospital Cochin Group Paris-France and European recommendations. The values reported at Korle-Bu teaching hospital (this work) were in good agreement with the international guidelines.