The specialised team in charge of this procedure uses an integrated technological support that includes transrectal ultrasonography, computerised dosimetry and a support and transperineal guide system.

STUDY OF PROSTATIC VOLUME

It is done out-patiently by transrectal ultrasonography in the position of a lithotomy and under the same conditions as the day of the implant. It is regarded as a critical first to achieve a satisfactory implant. Its objective is to provide the dosimetric planning team with an ecographic model of prostatic images.
	The quality and exactness of the implant is based on the ecographic model of prostate.

DOSIMETRIC PLANNING

A tridimensional ideal model of the prostate is built from the ecographic model. The seeds are distributed and verified and the isodosis curves are adjusted in order to ensure an efficient treatment and minimise high dosis on the four critical structures: bladder, urethra, rectum and nerves.

All the points of a curve have the same dosis. The ones of the deepest curve have a dosis three times as big as the ones of the most external.

THE IMPLANT

It is usually completed in a day in-patient stay, under epidural anaesthetic. In accordance with the co-ordinates and the depth of the planning we introduce between 18-24 needles charged with the seeds (between 80-140). Everything is controlled in real time by ultrasonography and radioscopy. At the end a cytoscopy ensures the non-presence of seeds in bladder and urethra. Some post-implant x-rays allow us to confirm the position of the seeds.

Image of the real position of the seeds once deposited in the implant.