Brachytherapy consists of placing radioactive sources into or adjacent to tumors, to deliver conformal radiation treatment. The technique is used for treatment of primary malignancies and for salvage in recurrent disease. Permanent prostate brachytherapy seeds are small metal implants containing radioactive sources of I-125, Pd-103, or Cs-131 encased in a titanium shell. They can embolize through the venous system to the lungs or heart and subsequently be detected by cardiovascular computed tomography. Cardiovascular imagers should be aware of the appearance of migrated seeds, as their presence in the chest is generally benign, so that unnecessary worry and testing are avoided. We report a case of a patient who underwent brachytherapy for prostate cancer and developed a therapeutic seeds embolus to the right ventricle.
Digital Object Identifier (DOI)
Supplementary data associated with this article can be found in the online version, at http://dx.doi.org/10.1016/j.radcr.2016.10.009.
Sachdeva, Shilpa; Udechukwu, Nneka S.; Elbelasi, Hossam; Landwehr, Kevin P.; St. Clair, William H.; and Winkler, Michael A., "Prostate Brachytherapy Seed Migration to the Heart Seen on Cardiovascular Computed Tomographic Angiography" (2017). Radiation Medicine Faculty Publications. 7.
Cine 1: Pseudoaxial thin maximal intensity projection shows foci of metal moving within the parenchyma of the anterior wall of the right ventricle throughout the cardiac cycle (for use in electronic version only).
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Cine 2: Simulation of brachytherapy seeds around prostate capsule (for use in electronic version only).
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Cine 3: Radial thick maximal intensity projection series derived from a CT urogram shows in situ prostate seeds (different patient; for use in electronic version only).