Article ; Online: A more efficient, radiation-free alternative to systematic chest x-ray for the detection of embolized seeds to the lung.
International journal of radiation oncology, biology, physics
2010 Volume 78, Issue 4, Page(s) 1052–1056
Abstract: Purpose: To evaluate the efficacy of a seed-migration detector and to compare its performance to fluoroscopy and postoperative chest radiographs.: Methods and materials: A gamma scintillation survey meter was converted to a seed-migration detector by ...
| Abstract | Purpose: To evaluate the efficacy of a seed-migration detector and to compare its performance to fluoroscopy and postoperative chest radiographs. Methods and materials: A gamma scintillation survey meter was converted to a seed-migration detector by adding a shield on the probe detection window. The detector response to three (125)I seed activities was characterized for different source-to-detector distances in water. The detector was used to perform a chest evaluation on 737 patients at their first postoperative visit. When the detector showed positive activity, seed migration was confirmed by taking a chest radiograph and by looking at the region with fluoroscopy. Results: One hundred and three patients (14.0%) presented at least one embolized seed. This accounts for 123 of the 39,887 seeds. Eighty-seven, 12, and 4 patients had respectively one, two, and three seed embolization. Compared with the seed-migration detector, detection based on fluoroscopy would have led to 13 false-negative detections (of 103, or 12.6%), and the radiograph would have resulted in 31 or 30.1%. More important, standard chest X-ray would have required a survey and extra radiation dose to lung to 100% of the patients, rather than the 14% who required it. Conclusions: The usual recommendation to perform chest radiographs at the first follow-up visit to scan lungs for embolized seeds should be revised because of the high false-negative rate. Scintillator-based gamma counter detector provides superior detection sensitivity and should be adopted as a standard of practice. Chest X-ray could be limited to documenting cases of positive migration. |
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| MeSH term(s) | Brachytherapy/adverse effects ; Brachytherapy/instrumentation ; Calibration ; False Negative Reactions ; Fluoroscopy ; Foreign-Body Migration/complications ; Foreign-Body Migration/diagnostic imaging ; Gamma Cameras ; Humans ; Iodine Radioisotopes ; Lung ; Male ; Prospective Studies ; Prostatic Neoplasms/radiotherapy ; Pulmonary Embolism/diagnostic imaging ; Pulmonary Embolism/etiology ; Radionuclide Imaging |
| Chemical Substances | Iodine Radioisotopes |
| Language | English |
| Publishing date | 2010-11-15 |
| Publishing country | United States |
| Document type | Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 197614-x |
| ISSN | 1879-355X ; 0360-3016 |
| ISSN (online) | 1879-355X |
| ISSN | 0360-3016 |
| DOI | 10.1016/j.ijrobp.2009.09.012 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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