4D Brachytherapy implant

2. Patient set up

  • Legs flexed to 100 degrees, to minimise arch interference. Ensure pelvis and spine are straight.
  • Ensure rectum is empty and insert diclofenac suppository, if to be used, high in the rectum.
  • Ensure the absence of air bubbles in balloon and optimise the acoustic contact between the probe and inner aspect of balloon, outer aspect of balloon and condom, and condom and rectal wall – assessed on ultrasound images. Do not proceed until this is optimised.
  • Assess for pubic arch interference in transverse plane and adjust leg position and probe angle from starting position of 6odown to flat or 6o up, if required.
  • Position 16G foley catheter into bladder with balloon deflated.
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