Ch. 14 Extra part 3

post implant assessment

An important step in any permanent implant is the _________ _________ to verify the seeds were placed correctly and that the patent receives an adequate treatment

external beam

Cervical cancer is usually treated with a combination of _________ ______ and intracavitary brachytherapy

urinary bladder and rectum while maximizing dose to the cervix

Classic Intracavitary applicators have small shields placed anterior and posterior to the sources. This was done to protect the?

give a high dose to vaginal lesions without delivering an excessive dose to the urinary bladder or rectum

Customized multichannel cylinder applicators are designed to?

3 fractions about a week apart (treatment is usually prescribed 5 mm from applicator surface)

Endometrial treatments are typically administered in?

ultrasound, CT

HDR prostate implants: Planning can be done intraoperatively by using ________ alone or posteriorly by using ____ or MRI

balloon-based

In the US, the _______ ______ approach has gained popularity for its simplicity, favorable cosmetic results, and patient comfort

1. to treat parametrial disease and pelvic lymph nodes that cannot be treated with brachytherapy 2. to reduce tumor volume, thereby reducing the treatment volume and toxicity associated with the brachytherapy treatment that follows

Intracavitary Implants: External beam servers two purposes

CT

Most commonly used imaging modality for HDR prostate implant treatment?

Iodine-125 and Palladium-103

Most commonly used isotopes for permanent implants are?

prophylactic

One other common GYN brachytherapy application is the _________ treatment of posthysterectomy endometrial cancer

internal or external

PEG hydrogel or SpaceOAR is widely used today for both ________ or _______ radiation procedures in treating prostate cancer

external beam and brachytherapy

Partial breast radiation therapy include both:

microscopic

Permanent Implants: In the simplest application, seeds embedded in suture or polyglactin 910 (vicril) mesh can be placed onto a surgically exposed area to treat ________ disease after resection of a tumor. (used in neck, lung and brain)

CT images obtained after insertion

Positioning of the balloon applicator within the cavity as well as its proximity to critical structures is assessed by using?

CT

Postimplant evaluations are typically done by using _____ imaging, although MRI evaluations have been conducted for improved delineation of the prostate gland

intraoperative technique

Seeds can be preloaded by the manufacturer according to a plan prepared a week or two before procedure, or built in the operating room in what is referred to as......

single channel cylinder

Standard cylinder for GYN is

Permanent Implants

TRUS first approach: Needles are preloaded with seeds prepared according to standard protocol or patient specific treatment plan, are used to place seeds in target volume.

intraoperative technique

TRUS first method: includes the .....

Mick applicator

TRUS second approach: a gunlike applicator is used for seed placement according to the treatment plan. Either preoperative plans or intraoperative plans may be used. This device is known as the

TRUS (transrectal ultrasound)

The introduction of _______ revolutionized prostate brachytherapy because it enabled visualization of the prostate, critical organs (urethra, rectum, and bladder) as well as needles inserted.

TRUS

The spacer material, using ________ guidance, is injected through the perineum into the tissue space posterior to prostate and anterior to rectum, forming a soft gel in 10 seconds

balloons or retractors

Vaginal packing can be substituted by specialized _______ or _______

MRI (they are able to ensure gross tumor volumes are treated)

What is the imaging modality of choice for GYN implants?

45 Gy LDR implant

When temporary implants are used as a primary treatment, patients are treated to the equivalent of a ....