What is the Real-Time Seed Implant Technique and why is it so important?
To have optimal results from your prostate seed implant, it is vital that all areas of the prostate are adequately covered with seeds, and that no sensitive areas outside the prostate are implanted. Using the Real-Time Intra-Operative Technique, there is minimal risk of placement of needles or seeds too close to the bladder, rectum, urethra or nerves. Any motion of the prostate or change in its size or shape during the procedure can be immediately taken into account, ensuring good seed placement.


The Real-Time Technique differs greatly from the much older “pre-planned or Seattle technique.” That technique involves mapping out the prostate a few weeks in advance by ultrasound. Then, when the man goes to the operating room, the prior ultrasound is used to determine where to place the needles and seeds. The preplan technique unfortunately does NOT take into account any differences in the size, shape or position of the prostate at the actual time of surgery. It has been our experience that the prostate can be very different at the time of surgery. Subtle changes in leg position, the degree of bladder filling, the use of anesthesia, and the shape of your prostate after the needles are inserted can have profound effects, making a pre-plan virtually useless.

In contrast, using powerful computers and experience based on thousands of previous cases, the Real-Time Technique takes all of the above possible changes into effect. All of the needles and seeds are placed based on how the prostate looks at the time of the procedure, not how it looked weeks before. The doses of radiation to the various areas are calculated live, in real-time.

Currently, no other Radiation Oncology group in Florida is using this technique.


Intra-operative computer planning

Our physicians have helped pioneer the use of powerful computers during the implant procedure to instantly calculate the dose of radiation received by the prostate and surrounding areas. The computer can obtain and analyze live images of the prostate gland throughout the implant procedure to further ensure optimal seed distribution and placement. This is a major improvement over older techniques where the amount of radiation received by the prostate could not be determined until after all the seeds were implanted.

Dr. Mitchell Terk was among one of the first physicians in the world to perform this technique, which was originally developed at Mount Sinai Medical Center in New York City. Based on his vast experience of well over 1800 patients, he has been training centers throughout the world on this procedure. All physicians with the Florida Center for Prostate Care and the Florida Radiation Oncology Group use this technique