Interstitial radiation source application; intermediate
CPT4 code
Name of the Procedure:
Interstitial Radiation Source Application; Intermediate (also known as Intermediate Brachytherapy)
Summary
In interstitial radiation source application, also known as brachytherapy, small radioactive seeds or sources are placed directly into or near the tumor. This intermediate procedure means a moderate level of complexity. It is commonly used for cancers that are confined to localized areas, such as prostate or breast cancer, allowing for high doses of radiation to the tumor while sparing surrounding healthy tissue.
Purpose
Medical Condition
Treats localized cancers such as prostate cancer, breast cancer, and certain gynecological cancers.
Goals/Outcomes
Targeted destruction of cancer cells, minimizing damage to surrounding healthy tissues, potentially leading to reduced side effects compared to external radiation therapy.
Indications
Symptoms/Conditions
- Localized prostate cancer
- Early-stage breast cancer
- Certain cervical and uterine cancers ##### Patient Criteria
- Confirmed diagnosis of a localized tumor
- Suitable for localized radiation treatment based on size and location of the tumor
Preparation
Instructions
- Fasting for several hours before the procedure
- Adjustment or discontinuation of certain medications (e.g., blood thinners) ##### Diagnostic Tests
- Imaging studies (e.g., MRI, CT scan) to determine the exact location and size of the tumor
- Blood tests and thorough health evaluation
Procedure Description
- Anesthesia: The patient is given general or regional anesthesia to facilitate comfort.
- Insertion: Using imaging guidance, thin applicators (needles or tubes) are inserted into or near the tumor site.
- Placement: Radioactive seeds or sources are accurately placed through the applicators into the tumor.
- Verification: Imaging may be used to ensure correct placement of the seeds.
- Completion: The applicators are removed, leaving the seeds in place.
Tools & Technology
- Imaging equipment (ultrasound, CT, MRI)
- Applicators (needles or catheters)
- Radioactive seeds/sources
Duration
Typically lasts 1-2 hours, depending on the complexity and location of the tumor.
Setting
Performed in a hospital or specialized cancer treatment center.
Personnel
- Radiation oncologists
- Medical physicists
- Radiologists
- Nurses
- Anesthesiologists
Risks and Complications
Common
- Localized pain or discomfort
- Swelling or bruising at insertion sites ##### Rare
- Infection
- Radiation injury to nearby tissues
- Bleeding or damage to surrounding structures
Benefits
- High precision in targeting the tumor
- Minimizes exposure to surrounding healthy tissue
- Shorter treatment duration compared to external radiation
- Reduced side effects
Recovery
Post-procedure Care
- Monitoring for a few hours after the procedure
- Pain management
- Instructions on activity restrictions (e.g., avoiding heavy lifting) ##### Recovery Time Most patients can resume normal activities within a few days to a week. Follow-up appointments will monitor the effectiveness and manage any side effects.
Alternatives
- External Beam Radiation Therapy: Non-invasive but less targeted compared to brachytherapy.
- Surgery: May offer complete removal but involves more significant recovery and potential complications.
- Chemotherapy: Systemic treatment that affects the whole body, not just the localized tumor.
Patient Experience
During Procedure
- Under anesthesia to ensure comfort, so no sensation during the actual insertion. ##### After Procedure
- Some localized pain or discomfort manageable with over-the-counter pain relievers.
- Minor swelling or bruising at the insertion sites.
Pain management and comfort measures are focused on ensuring a smooth recovery with regular follow-up to assess treatment success and address any post-procedure concerns.