Quality Assurance for Radioactive Seed Implantation
The Prostate Cancer Treatment Center performs numerous quality assurance processes to insure that each implant is performed safely. Each plan begins with a volume study; an outline of the area determined by your physician to be treated. The planning of the seed placement is a cooperative effort of a medical dosimetrist, a medical physicist, the attending physicians (always a Radiation Oncologist and often an Urologist too) and nurses involved in the case. We order seeds from only 2 sources Oncura, a GE company, and Bard.
These companies have demonstrated a high commitment to quality, consistency and a dedication to improving brachytherapy. Your individual plan is sent to the company as a custom seed order. Seeds are checked multiple times prior to leaving the company.
Upon arrival at our center, the seeds undergo additional testing prior to implantation. A test for radiation leakage called a wipe test is performed to assure the isotope is contained within the seed and no radiation leakage. We also independently verify the manufacturer's seed activity through a process called seed assay. This confirms that the seed activity we ordered is what was received for each patient. Both prior to arriving in the operating room and again in the operating room, the seeds are checked for accuracy by the OR team and your physician.
Post operatively, CT scans are performed to determine the precise location of the seeds within the gland. The dosimetrist will calculate the actual dose received by the gland. This calculation, referred to as post operative dosimetry, is then evaluated by the dosimetrist and Dr. Grimm. A post card will be sent to you in approximately 2-3 weeks regarding our findings. While it is possible that additional seeds may be required, it is exceedingly unusual.
Three to four times a year, the entire planning team, physicians and nurses conduct a formal review of all the implants performed in the time period. Dosimetry patterns side effects, complications, new studies, techniques and clinical care issues are discussed at that Quality Assurance meeting.