Fluoroscopic visualization of the prostatic urethra to guide transperineal prostate implantation.

Abstract

To describe a novel way to assure proper needle positioning within the prostate during transperineal implantation, using the urethra as the primary radiographic landmark. Preoperative computerized tomography (CT) images through the prostate are used to plan optimal transperineal needle-seed placement. When performing the procedure, a Foley catheter, with radio-opaque wire is used to visualize the prostatic urethra fluoroscopically in anterior-posterior and lateral projections. Proper needle placement is determined by their position relative to the urethra. Sixty patients have been implanted with this method at Memorial Sloan-Kettering Cancer Center from 1990-1992. The method described here is an improvement over previously described CT-based techniques. It could be used to supplement or replace ultrasound imaging.