76965 Ultrasonic guidance for interstitial radioelement application

Name of the Procedure:

Ultrasonic Guidance for Interstitial Radioelement Application (also known as Ultrasound-Guided Brachytherapy or Interstitial Radiotherapy)

Summary

Ultrasonic guidance for interstitial radioelement application is a procedure where a doctor uses ultrasound imaging to accurately place small radioactive seeds or sources directly into or near a tumor. This technique helps in the local treatment of cancer by precisely targeting the tumor while sparing surrounding healthy tissue.

Purpose

The procedure is used to treat various types of cancer, including prostate, breast, and some gynecological cancers. The goal is to deliver high doses of radiation directly to the tumor to destroy cancer cells while minimizing exposure to surrounding healthy tissues.

Indications

• Localized tumors that are accessible via needles or small catheters
• Patients who require targeted radiation therapy
• Patients seeking an alternative to external beam radiation or surgery

Preparation

• Fasting may be required for several hours before the procedure.
• Medication adjustments as advised by the healthcare provider.
• Pre-procedure imaging studies such as MRI, CT scans, or previous ultrasounds to map out the treatment area.
• Blood tests to check for clotting ability and overall health status.

Procedure Description

1. The patient is positioned, and the area of interest is cleaned and sterilized.
2. Local anesthesia or conscious sedation is administered to minimize discomfort.
3. An ultrasound probe is used to visualize the tumor and guide the placement of needles.
4. Radioactive seeds are inserted through needles or catheters directly into or near the tumor, guided by real-time ultrasound imaging.
5. The needles or catheters are removed once the seeds are accurately placed.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and the number of seeds needed.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center equipped with specialized ultrasound and radiation equipment.

Personnel

• Interventional radiologist or radiation oncologist
• Ultrasound technician
• Nursing staff
• Anesthesiologist, if sedation is used

Risks and Complications

• Infection at the insertion site
• Bleeding or bruising
• Displacement of radioactive seeds
• Damage to surrounding tissues or organs
• Rare allergic reactions to anesthesia

Benefits

• Precise targeting of the tumor with minimal damage to healthy tissue
• Shorter treatment periods compared to external beam radiation therapy
• Rapid symptom relief and tumor shrinkage
• Outpatient nature reduces hospital stay

Recovery

• Patients may experience mild discomfort, bruising, or swelling at the insertion site.
• Pain management with over-the-counter pain relievers
• Normal activities can usually be resumed within a few days.
• Follow-up appointments to monitor treatment progress and manage any side effects

Alternatives

• External beam radiation therapy: Non-invasive but may affect surrounding tissues
• Surgery: Can be more invasive with a longer recovery period
• Chemotherapy: Systemic treatment with broader side effects
• Each alternative has different pros and cons and may be more suitable depending on the individual patient’s condition and overall health

Patient Experience

During the procedure, the patient might feel pressure or mild discomfort at the insertion site. Post-procedure, there may be soreness, which can be managed with pain medications. The healthcare team will take measures to keep the patient as comfortable as possible throughout the procedure and recovery period.