Migration of implanted free radioactive seeds for adenocarcinoma of the prostate using a Mick applicator

This study investigates the rate of free seed migration and associated seed-related sequelae after using a radioimmunoguided Mick applicator technique to place radioactive seeds within the prostate.Between December 1998 and September 2002, 120 patients diagnosed with prostate cancer underwent interstitial transperineal prostate brachytherapy with free ¹²⁵I or ¹⁰³Pd seeds positioned using a radioimmunoguided Mick applicator technique. Orthogonal pelvic and chest radiographs were obtained postimplant (Day 0) and at a second follow-up visit to determine the rate of radioactive seed embolization.On the day of implant (Day 0), 7 (6%) of the 120 men demonstrated single pulmonary seed emboli; none of these seeds migrated subsequently. During follow-up, 87 (72.5%) men had a total of 249 (2.0%) out of 12,524 seeds implanted migrate. Sixty-eight (0.55%) of the implanted seeds migrated to the lungs, an incidence common among brachytherapy techniques utilizing free or vicryl-laden radioactive seeds. No clinical symptoms or adverse sequelae from seed emboli have been reported.The rate of seed emboli to the pulmonary vessels or to other tissue localities resulting from a radioimmunoguided Mick applicator technique does not appear to be markedly different from the reported rate seen with other free seed techniques.