Brachytherapy Overview | Why Brachytherapy? | Procedure Step by Step | Quality Assurance | ProQura

Quality Assurance for Radioactive Seed Implantation

The Prostate Cancer Center of Seattle performs numerous quality assurance processes to insure that each implant is performed accurately and safely. Each plan begins with an MRI and a volume study. The MRI scan has greatly improved the ability to create a three dimensional model of the gland and view it in multiple angles. The contour from the ultrasound and MRI are used to determine the area requiring treatment. The planning of the seed placement at PCCS  is a cooperative effort of a your physician and a medical physicist.  as well as our 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.   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. Our team will calculate the actual dose received by the gland. This calculation, referred to as post operative dosimetry, is then evaluated by  Drs. Grimm or Hsi for quality . 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.