ABSTRACT
Prostate brachytherapy has gained widespread acceptance as an alternative to external beam radiotherapy or surgery for patients with localized prostate adenocarcinoma. As the technique has evolved, significant advances have refined the procedure. Early attempts at brachytherapy with permanent radioisotopes in the 1970s were marked by unsatisfactory results due to inadequate technology for proper treatment planning. The widespread availability of improved imaging modalities and planning software in the 1980s led to the development of prostate brachytherapy as it is widely practiced today, with a lowmorbidity transperineal approach that can be performed on an outpatient basis.1 Despite these advances, there is still no accepted technique to plan an implant procedure based on the distribution of tumor within the gland, rather than on the size and shape of the prostate itself. Theoretically, therapy designed to target specific foci of disease within the prostate would yield better local disease control with decreased morbidity.
