Advanced techniques

Brachytherapy, also known as seed therapy, is a common method of internal radiation and is considered an option for men who choose radiation therapy. The two main refinements of brachytherapy are MRI-guided brachytherapy and high-dose-rate brachytherapy.

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• MRI-guided brachytherapy: In a further refinement of the process, a technique using magnetic resonance imaging (MRI) to guide seed implantation has been developed. An MRI allows for a much more precise placement of the seeds than ultrasound, according to its developer. MRI-guided brachytherapy is not widely available because few oncologists have access to the necessary equipment.
• High-dose-rate brachytherapy: Another refinement to the brachytherapy procedure is high-dose-rate brachytherapy, in which the seeds are inserted into the prostate temporarily, rather than permanently. Ultrasound is used to guide the placement of approximately 25 tiny hollow plastic needles into the prostate. While the patient remains in the hospital, a single radioactive pellet is delivered through each needle several times over a 24- to 48-hour period. After each treatment, the pellet is removed. After the final treatment, the needles are removed as well and the patient is discharged.