Index. B Biologically effective dose (BED), 158

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1 Index B Biologically effective dose (BED), 158 C Catheter displacement, 113, 114 rectal probe, 114 self-anchoring catheters, 113 Catheter fixation, HDR, Catheter insertion, HDR sagittal ultrasound image, 106 transaxial image, seminal vesicles, 105, 106 Z-axis co-ordination, Clinical target volume (CTV) GEC-ESTRO guidelines, 107 seminal vesicles, 104 Comparative and fusion imaging, post-implant dosimetry CT-MRI fusion, 133 intra-and inter-observer variation, 133 MRI/TRUS, 131 Computed tomography (CT) C-arm-based cone-beam, 126 flat-panel cone-beam, 126 intra-observer and inter-observer variations, 125 neurovascular structures, 126 prostate base and apex, 123 software algorithms, 125 source position detection, 125 TRUS-derived volume, 124 urethra, 126 volumetric, 3D source cloud, 124, 125 CT-based treatment planning catheter fixation, 153 HDR prostate, 152 CTV. See Clinical target volume (CTV) D DCE-MRI. See Dynamic contrast-enhanced MRI (DCE-MRI) Diffusion-weighted imaging (DWI) ADC values, 46 artefacts, 47 correlation of, 47 description, 46 tumour aggressiveness, 46 Digital rectal examination (DRE), 64 Dose-response relationship discrepancies brachytherapy, clinical outcome, EBRT, implant prostate brachytherapy BED, bpfs, 173 high-risk population, 172 Dose-volume histograms (DVHs), 144 Dosimetry planning, permanent seeds DVHs, 144 dynamic dose calculation, geometrical optimisation, 143 interactive planning, 146 intraoperative planning, 146 inverse planning, 144 manual forward planning, 143 needle loading report, preplanning, TPS, 141 DRE. See Digital rectal examination (DRE) DVHs. See Dose-volume histograms (DVHs) DWI. See Diffusion-weighted imaging (DWI) Dynamic contrast-enhanced MRI (DCE-MRI) limitations, 45 perfusion map, 44 signal intensity change, 44 tumour angiogenesis, 43 T1-weighted sequences, 44 G. Kovács, P. Hoskin (eds.), Interstitial Prostate Brachytherapy, DOI / , Springer-Verlag Berlin Heidelberg

2 256 Index E EAU. See European Association of Urology (EAU) EBRT. See External beam radiation therapy (EBRT) Environmental factors, PCa alcohol consumption, 17 description, 16 dietary intake, 16 infection and prostate cancer, 18 obesity and physical activity, 17 smoking, 17 steroid hormones, vasectomy and sexual activity, 18 Epidemiology, PCa age-adjusted cancer death rates by site, 12, 13 CONCORD study, 9 differences among European countries, 9, 11 global differences incidence, 8, 9 mortality, 11, 12 incidence and mortality rates by site, race and ethnicity, 8 regional differences, 9, 10 incidence rates, 5 leading sites, cancer cases and deaths per gender, 5, 7 over-diagnosis/detection, indolent tumours, 12 PSA-based screening, mortality, European Association of Urology (EAU), 1 External beam radiation therapy (EBRT), 71, , F Focal prostate therapy brachytherapy planning, 59 CT scanning, 58 DWI and DCE-MRI, 58 functional MRI techniques, 59 index intraprostatic lesion, 57 intraprostatic failures, 58 PSA screening, 56 T2-MRI, DCE-MRI and intraoperative TRUS, 57 G Gleason sum score, 80 Gross tumour volume (GTV), 107 GTV. See Gross tumour volume (GTV) H HDR. See High-dose-rate (HDR) HDR prostate brachytherapy clinical team, equipment, 83 patient selection (see Patient selection, HDR) planning CT-based treatment planning, description, 149 dose calculation, DVHs, 154 implant needles, 150 target volume definitions, 150 ultrasound real-time planning, preimplant TRUS imaging, 80 prostate brachytherapy, 184 radiobiological considerations, 180 recording and reporting, toxicity, 183 treatments external beam radiation, 198 monotherapy, prostate cancer, 198 toxicities, 199 tumour control, 183 HDR techniques description, 103 equipment applicators, HDR, 104 local infiltration, perineum, 103 stepper unit, 104 template mount, 104 transperineal technique, anaesthesia, 103 transrectal ultrasound, 103 procedure catheter fixation, catheter insertion (see Catheter insertion, HDR) GEC-ESTRO guidelines, 107 patient setup, post-implant imaging, 107 quality assurance, tolerance dose, 108 treatment delivery, 109 High-dose external irradiation (HDRT), 170 High-dose-rate (HDR) alpha/beta effect, economic comparison, 185 monotherapy, 179 physical implant properties, RBE, 180 seed brachytherapy, 179

3 Index High-intensity focused ultrasound (HIFU) cancer control, 231 technique, 230 urethrorectal fistula, 231 Hormonal therapy, 233 I ICRP. See International Commission on Radiological Protection (ICRP) Imaging. See Post-implant dosimetry International Commission on Radiological Protection (ICRP), International Prostate Symptom Score (IPSS), 67, 80 IPSS. See International Prostate Symptom Score (IPSS) Isoflavones, 24 L LDR. See Low-dose-rate (LDR) LDR prostate brachytherapy children fathering, 248 cremation, 247 dose rate, abdomen surface, 244, 246 EBRT, expelled seeds, ICRP 98, 244 pelvic/abdominal surgery, 248 radiation detection monitors, 248 secondary cancers, Localised prostate carcinoma autopsy and early follow-up studies, 34 biopsy and biopsy-based Gleason score, 34 brachytherapy patients, 52 nomograms, 34 functional imaging, 35 glandular and nonglandular zones, identification, anatomic subregions, 35 imaging workup, aggressiveness, radiolabelled antibody imaging, 56 screening, PSA, 33 treatment-associated morbidity, 33 Low-dose-rate (LDR) prostate brachytherapy, 89 Lower urinary tract symptoms (LUTS) IPSS, individual questionnaire, 67 urodynamic studies, LUTS. See Lower urinary tract symptoms (LUTS) Lycopene, M Magnetic resonance imaging (MRI) localised prostate carcinoma anatomical T2-weighted MRI scans, 40 benign abnormalities, 41 haemorrhage, TRUS biopsy, 41 inter-and intraobserver variability, 42 invasion, seminal vesicles (T3b), 43 technologic developments, 43 T2 MRI and DWI-MRI, 41 post-implant dosimetry description, 126 fused image, CT-MRI, 127, 129 linked sources, prostate, 127, 129 prostate apex, 126, 127 Maximum intensity projection (MIP), 160 MIP. See Maximum intensity projection (MIP) mpmri. See Multiparametric MRI (mpmri) MRI. See Magnetic resonance imaging (MRI) MRS. See MR spectroscopy (MRS) MR spectroscopy (MRS) choline-to-citrate ratios, description, 47 in vivo imaging spectra, 48 MRI, combined, 49 sequences and acquisitions, three-dimensional, 49 spectral analysis, 47, 48 transitional zone cancer, 49 Multiparametric MRI (mpmri) clinical indications, 50 computer software programmes, 50 description, 49 localisation accuracy, DCE-MRI, 50 local staging accuracy, 50 P Patient selection, HDR curative combined HDR and EBRT, 81 focal therapy, 82 monotherapy, 81 salvage after failure of surgery/ebrt, 82 PCa. See Prostate cancer (PCa) PCI. See Prostatic capsular invasion (PCI) PCPT. See Prostate Cancer Prevention Trial (PCPT) PDR. See Pulsed-dose-rate (PDR) PDR brachytherapy beam radiotherapy, catheter displacement (see Catheter displacement, PDR) catheters/needles, 111

4 258 Index PDR brachytherapy (cont.) description, 203 dose distribution, 112, 113 dose schedule, erectile function, 205 outcomes, patient care, pretreatment plan, 112 target volume and dose, 204 time dose pattern, dose delivery, 112 Perineural invasion (PNI), 66 Permanent prostate brachytherapy acute urinary morbidity, 210 chronic urinary morbidity, clinical outcome, 188 combined therapy, 190 description, 63, 207 DRE, 64 erectile dysfunction, 211 external beam radiation boost after, 72 salvage after failure, 73 focal therapy, 73 functional outcome, 188 high-risk patients, outcomes, 192 history and clinical examination, implant procedure brachytherapy/general operating room, 92 dose planning, 93, 96 Foley catheter, 93 prostate, transversal and sagital direction, 93, 95 intermediate-risk localized prostate cancer patients, 72 intermediate-risk patients, low-risk patients, 188 active surveillance, EBRT, 71 exclusion criteria, family history, 70 men under 60 years of age, 70 posttreatment fertility, radical prostatectomy, 71 LUTS (see Lower urinary tract symptoms (LUTS)) outcomes and dose parameters, 191 preplanning disadvantages, 92 intraoperative planning, 92 patient set-up, lithotomy position, 90, 91 prostate, middle of template, 90, 91 TRUS, 90 urethra and rectal wall, pretreatment measures general/spinal/saddle block anaesthesia, patients, 92 locking needles, 92, 94 materials, 92, 94 support system, 92, 93 prognostic factors, radiation proctitis, rectal side effects ( see Rectal side effects) second primary tumours, 192 surgery, 193 volume and staging imaging assessment, large prostates and neoandrogen deprivation, 67 younger patients, outcomes, PET. See Positron emission tomography (PET) Physical implant properties dosimetry and dose delivery, HDR implant, 182 LDR seeds, 181 Planning target volume (PTV) prostate capsule, 107 PNI. See Perineural invasion (PNI) Polyphenols, 25 Positron emission tomography (PET) 18F-FDG, C acetate ( 11 C AC), 55 11C-methionine, 56 SUV, 54 multiple bone metastases, 18 F-FCH PET scan, 53, 55 radiotracers, Post-implant dosimetry comparative and fusion imaging, craniocaudal shift, 134 CT (see Computed tomography (CT)) CT-based, 120 day zero imaging, 134 dose calculation, 121 dose rate distribution, 133 edema resolution dynamics, 165 identification, implanted sources anatomy, 121 CT greyscale beam profiles, 121 seed detection rates, 121 limitations, 122 ultrasound signal intensity, 121

5 Index imaging MIP, 160 TRUS, implant-related morbidity, 134 intraoperative planning, 163 loose vs. stranded seeds, 164 MRI (see Magnetic resonance imaging (MRI)) plain radiography, 122 rectal bleeding, 135 reporting ESTRO/EAU/EORTC recommendations, 162 sexual dysfunction, 136 timing BED, 158 implant, 158 prostatic edema, 158 Post-implant imaging, 107 PPB. See Permanent prostate brachytherapy (PPB) Prevention, PCa 5a-reductase inhibitors, 21 carcinogenesis, 19 chemopreventive agents, 19 dietary nutrients and supplements, 19 effective chemoprevention, 19 epidemiologic, 19 PCPT, 20 SELECT (see Selenium and Vitamin E Cancer Prevention Trial (SELECT)) selenium, vitamin E, 22 Prostate biopsies Gleason score, 65 PCI, 66 percent positive, 65 PNI, 66 Prostate brachytherapy implantation HDR, history, PDR, 90 perineal implantation, permanent LDR, 89 PPB, 87 transperineal techniques (see Transperineal techniques) Prostate cancer (PCa) aggressiveness DCE-MRI, 51 functional imaging, Gleason scores, magnetic field strengths, MR elastography and optical imaging, 52 multifocal cancer, T2-MRI at 3 T, 51 T2-weighted MRI signal intensity, 51 historical facts, 3 5 hormonal therapy, 233 isoflavones, 24 lycopene, polyphenols, 25 prevention (see Prevention, PCa) resveratrol, risk factors age, 14 description, 14 familial aggregation, 15 genetic background, 16 heredity, 15 race/ethnicity, 15 salvage cryotherapy (see Salvage cryotherapy) statins, 26 Prostate Cancer Prevention Trial (PCPT), 20 Prostatic capsular invasion (PCI), 66 PSA density (PSAd), 65 PSA velocity (PSAv), PTV. See Planning target volume (PTV) Q QA. See Quality assurance (QA) Quality assurance (QA), R Radical prostatectomy, 71 Radiofrequency interstitial tumor ablation (RITA), 232 RBE. See Relative biological equivalence (RBE) Rectal side effects acute, 210 chronic, 210 incidence, Relative biological equivalence (RBE), 180 Resveratrol, PCa, RITA. See Radiofrequency interstitial tumor ablation (RITA) S Salvage cryotherapy complications, 230 focal cryotherapy, 230

6 260 Index Salvage cryotherapy (cont.) oncologic outcomes, 229 technique, Salvage open radical prostatectomy complications, 222 functional outcomes, oncological outcome, 220 radiotherapy, surgical outcome, Salvage photodynamic therapy, Salvage radiotherapy complications, 226 external beam radiotherapy and brachytherapy, functional outcomes, Salvage robot-assisted radical prostatectomy (srarp), SELECT. See Selenium and Vitamin E Cancer Prevention Trial (SELECT) Selenium and Vitamin E Cancer Prevention Trial (SELECT) description, 22 Single photon emission computed tomography (SPECT), 54 srarp. See Salvage robot-assisted radical prostatectomy (srarp) Statins, PCa, 26 Steroid hormones androgens, 18 estrogens, 19 leptins, peptides, 19 lower serum vitamin D levels, 19 and biopsy, 218 calcification within gland, D post-implant, 130, 131 intraoperative patient set-up, 130 localised prostate carcinoma biopsy guidance and image-guided treatments, 36 colour Doppler, 38 contrast-enhanced, 38 3D TRUS, T3a tumour, 37 HistoScanT, 38, 39 malignant prostate tissue, 39 tissue elasticity, 39 TURP, 40 prostate oedema and haemorrhage, 129 segmentation algorithms, Treatment planning software (TPS), 141 TRUS. See Transrectal ultrasound (TRUS) U Ultrasound real-time planning geometrical optimization, 152 isodose distribution, Urinary flow rate (Qmax), 80 Urinary morbidity acute, 210 chronic, Urodynamic studies, LUTS, V Vasectomy and sexual activity, 18 T TPS. See Treatment planning software (TPS) Transrectal ultrasound (TRUS)