Completion of intra-operative planning
10. Completion of dose planning
- The dose planning is completed using the dose constrains below. At this time assess where the bulk of the cancer is situated and ensure, if possible this is covered by the 150% isodose. Theatre Intra-operative tolerances
Technical note: Planning the central needles.
- When using loose seeds, have two seeds at the base for the anterior two needles, in case one inadvertently passes into the bladder.
- When using loose seeds try and avoid planning with three or more seeds together as small misplacements of the initial two seeds will lead to the last seed/s being significantly out of position. This is less of an issue using stranded seeds created by the Isoloader).
11. Realignment of prostate position
- The antero-posterior position of the prostate needs to be realigned. In the transverse views, identify the base plane with the ultrasound probe and planning computer, then scroll the probe into the middle of the gland and adjust the position of the prostate on the planning computer to align with the gland on the ultrasound.
- The central needle positions are then transferred from the planning computer to the ultrasound screen.