Targeted Biopsy With Reduced Number of Cores: Optimal Sampling Scheme in Patients Undergoing Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Prostate Biopsy.

The 3 Tesla (3T) magnetic resonance imaging (MRI) combined ultrasound (TRUS) targeted biopsy plus 12-core systematic biopsy (TBx + 12-SBx) was considered a reliable method for prostate cancer (PCa) diagnosis. To find another optimal sampling scheme with fewer cores and the same efficiency as TBx + 12-SBx for prostate biopsy, 113 patients who underwent five different hypothetical sampling schemes were analyzed and compared with TBx + 12-SBx. The detection rates of targeted biopsy plus 6-core lateral systematic biopsy (TBx + lateral 6-SBx) for PCa and clinically significant prostate cancer (csPCa) (99.1% and 96.4%, respectively) were higher than other schemes, and the area under the receiver operating characteristic curve of TBx + lateral 6-SBx for PCa and csPCa (0.991 and 0.990, respectively) were also significantly higher than other sampling schemes except TBx plus 6-core ipsilateral systematic biopsy (TBx + ipsilateral 6-SBx). Additionally, TBx + lateral 6-SBx had the lowest missed diagnosis rate. Thus, the TBx + lateral 6-SBx may be the optimal scheme for patients undergoing MRI/TRUS fusion prostate biopsy.

[Ultrasound guided implantation of radioactive (125)I seeds for treatment of recurrent head and neck carcinomas].

OBJECTIVE: To evaluate the efficacy and the technological feasibility of B-ultrasound guided implantation of (125)I seed for recurrent head and neck cancer. METHODS: In the study, 29 patients with local or regional recurrence of head and neck tumors after external beam radiotherapy alone, external beam radiotherapy combined neck dissection or chemotherapy were treated with (125)I seed implantation guided by ultrasound under local anesthesia. The median number of seeds was 27 (ranging from 3 to 61), and the radioactive activity ranged from 0.35-0.8 mCi(1.30×10(7) -2.96×10(7) Bq). Postoperative quality evaluations were routinely obtained for all the patients. RESULTS: The median follow-up was 8 months (ranging from 3 to 42 months). The 1-, 2- and 3-year local controls were 53.1%, 34.8%, and 17.4%, respectively. The 1-, 2- and 3-year survival rates were 54.1%, 27.5%, and 27.5%, respectively. CONCLUSION: Ultrasound guided implantation of (125)I seeds can play an important role in the salvage treatment of recurrence of head and neck cancer. This study shows B-ultrasound guided (125)I seed implantation is one of the most efficient brachytherapies, which is easy to operate, least invasive and safe for low morbidity.

Permanent implantation of iodine-125 seeds as a salvage therapy for recurrent head and neck carcinoma after radiotherapy.

Seventeen patients with head and neck recurrent carcinoma underwent (125)I seed implantation under CT or ultrasound guidance. The actuarial D90 of the (125)I seeds implanted was 90-160 Gy (median, 126 Gy). Median follow-up was 10 months (range, 3-48 months). The median local control time was 16 months; the 1- and 2-year local control rates were 66.5% and 49.9%, respectively. The 1- and 2-year survival rates were 51.3% and 38.5%, respectively (median, 16 months). None of the patients experienced grade 4 toxicity. (125)I seed implantation was a feasible and effective salvage treatment for patients with recurrent head and neck cancers.

Percutaneous computed tomography/ultrasonography-guided permanent iodine-125 implantation as salvage therapy for recurrent squamous cell cancers of head and neck.

OBJECTIVE: To assess the feasibility, efficacy, and morbidity of permanent percutaneous 125I seed implantation under computed tomography (CT)/ultrasonography guidance for recurrent squamous cell carcinomas of head and neck. METHODS: Twenty-five patients underwent 125I seed implantation under CT or ultrasonography guidance. Postoperative dosimetry was routinely performed for all the patients. The actuarial D90 of the implanted 125I seeds ranged from 90 Gy to 160 Gy (median: 130 Gy). The activity of 125I seed ranged from 0.35 mCi to 0.8 mCi (median: 0.6 mCi). The total number of seeds implanted ranged from 3 to 61 (median: 22). The follow-up period ranged from 3 to 40 months (median: 8 months). RESULTS: The median local disease-free progression was 12 months (95% CI, 4.8-19.2), and the 1- and 2-year local tumor control rates were 48.7% and 39.9%, respectively. The 1- and 2-year survival rates were 42.5% and 28.3%, respectively (median: 11 months) (95% CI, 8.2-13.8). Of the 25 patients, 6 (24%) died of local recurrence and 5 (20%) died of metastases; 2 patients showed recurrences at 3 and 8 months after seed implantation and subsequently died of pneumonia. One patient died of heart disease. One developed ulceration with tumor progression. Blood vessel damage and neuropathy were not observed. CONCLUSION: The high local tumor control rates, minimal invasion, and low morbidity suggest that percutaneous 125I seed implantation is a feasible and safe salvage for patients with recurrent squamous cell carcinomas of the head and neck.