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Case Reports
. 2016 Nov 12;12(1):34-38.
doi: 10.1016/j.radcr.2016.10.005. eCollection 2017 Mar.

Embolization of prostatic brachytherapy seeds to pulmonary arteries: a case study

Alexander D Calvert  1 , Andrew W Dyer  1 , Van A Montgomery  1
Affiliations
Case Reports

Embolization of prostatic brachytherapy seeds to pulmonary arteries: a case study

Alexander D Calvert et al. Radiol Case Rep. .

Abstract

Pulmonary seed embolization is a complication of prostatic brachytherapy with varying incidence rates. Key factors that reportedly influence the incidence of seed embolization include planning volume, quantity of seeds, seed placement, and type of seeds (stranded vs free). The clinical implications of seed migration are unclear because sequelae were not demonstrated in multiple short-term studies yet there have been several reports of long-term complications. We report a case of a 56-year-old patient who presented with dyspnea approximately 6 years after brachytherapy treatment for a very low-risk prostate cancer. Chest radiograph showed multiple linear densities overlying the right suprahilar lung. Computed tomography confirmed the location of the densities within the pulmonary arteries in the right upper lobe.

Keywords: Brachytherapy; Iodine-125; Prostatic neoplasms; Seed migration.

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Figures

Fig. 1
Fig. 1
A 56-year-old male with brachytherapy seeds in prostate. Technique: Fluoroscopy. Findings: Operative fluoroscopy was used for assistance in brachytherapy implantation seeds within the prostate. Approximate fluoroscopy time was greater than 1-hour standard.
Fig. 2
Fig. 2
A 56-year-old male with brachytherapy seeds in prostate. Technique: Axial computed tomography (CT) of pelvis without contrast. A 2.5-mm contiguous imaging was obtained. Findings: Multiple small densities within the prostate gland consistent with radiation implant seeds. Superior (A) and inferior view (B) provided.
Fig. 3
Fig. 3
A 56-year-old male with brachytherapy seed migration. Technique: Frontal (posterior to anterior technique) and lateral chest radiograph. Findings: Frontal chest radiograph demonstrates six migrated brachytherapy seeds in right suprahilar lung (A), which is better illustrated in a magnified view (B). Lateral chest radiograph demonstrates seven brachytherapy seeds located in right suprahilar lung suggestive of involvement in the ascending branches of the right upper pulmonary artery (C). Two seeds are adjacent to each other and best appreciated in a magnified view (yellow arrow in D).
Fig. 4
Fig. 4
A 56-year-old male with brachytherapy seed migration. Technique: Axial and coronal CT images of the thorax without contrast. Findings: Seven brachytherapy seeds (two of which are adjacent to one another in (B)) located within the pulmonary artery branches of the right upper lobe (red arrowheads). Moderate centrilobular emphysematous changes predominately in the upper lobes. Images oriented from superior (A) to inferior (D). Two brachytherapy seeds adjacent to one another within the pulmonary artery branches of the right upper lobe (E).
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References

    1. McAninch J.W., Lue T.F., Smith D.R. Smith and Tanagho's General Urology. McGraw-Hill Professional; New York: 2013. Radiotherapy of urologic tumors. 978–0071624978.
    1. Steinfeld A.D., Donahue B.R., Plaine L. Pulmonary embolization of iodine-125 seeds following prostate implantation. Urology. 1991;37(2):149–150. - PubMed
    1. Eshleman J.S., Davis B.J., Pisansky T.M., Wilson T.M., Haddock M.G., King B.F. Radioactive seed migration to the chest after transperineal interstitial prostate brachytherapy: extraprostatic seed placement correlates with migration. Int J Radiat Oncol Biol Phys. 2004;59(2):419–425. - PubMed
    1. Tapen E.M., Blasko J.C., Grimm P.D., Ragde H., Luse R., Clifford S. Reduction of radioactive seed embolization to the lung following prostate brachytherapy. Int J Radiat Oncol Biol Phys. 1998;42(5):1063–1067. - PubMed
    1. Merrick G.S., Butler W.M., Dorsey A.T., Lief J.H., Benson M.L. Seed fixity in the prostate/periprostatic region following brachytherapy. Int J Radiat Oncol Biol Phys. 2000;46(1):215–220. - PubMed

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