Prostate Seed Brachytherapy
Eckert & Ziegler BEBIG manufactures small, radioactive implants, so-called seeds, which are mainly used in LDR brachytherapy for the treatment of localized prostate cancer. The seeds take the form of little capsules containing a minuscule quantity of a radioactive isotope, I-125 (Iodine-125). They are implanted into the prostate, where they remain permanently and destroy the cancer cells. Permanent LDR prostate brachytherapy with seeds is highly effective, especially in the early stages of prostate cancer and causes relatively low side effects in comparison to alternative treatment options.
Loose Seeds for Prostate Cancer Treatment
IsoSeed I-125 for Prostate Cancer Treatment
These seeds are intended for the permanent treatment of localized prostate cancer. They are delivered as sterile loose IsoSeeds or loaded in Mick™ Magazines and are implanted using needles.
Implantation with the Mick™ TP/TPV Applicator
Each Mick™ Magazine has a capacity of 15 IsoSeeds. With the Mick™ TP/TPV Applicator, IsoSeed® can be implanted in any desired seed spacing distance, thus allowing a geometrically unrestricted seed distribution.
At Eckert & Ziegler BEBIG, the customer can choose between two different sealed source models for prostate cancer treatment: I25.S17plus and I25.S06. Both seed models are visible under X-ray, fluoroscopy, CT, MR and ultrasound.
- IsoSeed® I25.S17plus features a full-size silver marker and has been designed for visibility under X-ray and fluoroscopic imaging. In addition, it enables MR imaging and opens new perspectives for postoperative planning.
- IsoSeed® I25.S06 contains a thin gold marker within a ceramic carrier, diminishing artifacts and providing good visibility in CT Imaging.
Mick® TP/TPV Applicator System
Fast and Accurate Loose Seed Placement Capability
Mick® TP Applicator
The Mick TP Applicator uses Manchester source placement principles and allows for seed placement adjustments during the implant in order to adapt to changes in the prostate position and size. When attached to an implanted Mick TP Needle, the applicator allows for seeds to be inserted individually per pre-plan or real-time technique. Treatment modifications can be done on the spot and without interruptions. The design of the Mick System offers very good seed placement flexibility and a significant reduction in radiation exposure to staff and personnel.
Mick® TPV Applicator
Like the Mick TP Applicator, the Mick TPV Applicator enables very good seed placement adjustability. Additionally, the design of the Mick TPV Applicator allows for instantaneous seed spacing selections of 12 mm, 11 mm, 10 mm, 8 mm, 7.5 mm and a neutral position “N”. The neutral position disengages the clicking mechanism to prevent needle displacement while resetting the template ring.
Mick® Sterilization and Storage Cassette
The Mick Sterilization and Storage Cassette is an anodized, light weighted aluminium case for the Mick TP/TPV Applicator. It protects and prevents loss of delicate instrumentation by offering designated component placement and silk-screened component locators. The Mick® Sterilization and Storage Cassette are ideal for steam or ETO sterilization.
The Mick Magazines are designed to optimally shield staff and patient from excess radiation exposure before and during the implant procedure. When inserted in the Mick® TP/TPV Applicator, the exposure rate around the magazine nears background readings. The hexagonal magazine head is threaded for safe storage in the Loading V-Block or Seed Sterilizer and Carrier. Mick® Magazines may conveniently be received on-site ready loaded and sterile from e.g. Eckert & Ziegler BEBIG. Various magazine types are offered:
- Disposable Mick Magazines (single use): They can be autoclaved for one sterilization cycle and are compatible with Mick 200-TP and 200-TPV Applicators. The capacity per magazine is 15 or 20 each for I-125 or Pd-103 seeds.
- Reusable Mick Magazine: When loaded, seeds are held captive thus eliminating the loss of seeds during the handling and sterilization process. The capacity per magazine is 10 each for I-125 or Pd-103 seeds.
Further products of the Mick TP/TPV Applicator System include TP Needles, Diddler, Loading V-Block, Seed Sterilizer and Carrier, Reverse Action Tweezer, Reusable and Disposable Templates as well as the Radiation Inspector.
Stranded Seeds in Unique Radiation Protection Magazines
IsoCord - Innovative Strand Cutting
IsoCord seed chains (strands) contain IsoSeed® I-125 seeds and hourglass-shaped spacers in standard seed-spacer configuration, enclosed in a braided monofilament suture. IsoCord strands are delivered in shielded magazines containing up to 70 seeds.
IsoCord is available in two different designs: I25.S17plus and I25.S06. Both sealed source models are visible under X-ray, fluoroscopy, CT, and MR and additionally, show good ultrasound visibility.
- IsoSeed I25.S17plus features a full silver marker and has been designed for visibility under X-ray/fluoroscopic imaging. In addition, it enables MR Imaging and opens new perspectives for postoperative planning.
- IsoSeed I25.S06 contains a thin gold marker within a ceramic carrier, diminishing artifacts and providing good visibility in CT imaging.
Low Migration Rates
One advantage of strands is their low migration rate. IsoCord strands are specially designed to reduce the migration rates still further. The structured surface of the braided suture, as well as the unique, hourglass-shaped spacers, provide reliable fixation of the IsoCord strand in prostate tissue.
Strand Cutting and Needle Loading – Safe and Fast
With the help of the unique IsoCord Needle Loading Station, IsoCord is cut into any required length according to the treatment plan. Strand cutting is safe and convenient and takes place under full radiation protection. The IsoCord Needle Loading Station permits direct loading of the implantation needles in three simple steps avoiding the need to handle strands manually.
Stranded Seeds in Braided Monofilament Suture
I-125 Seed Chain
The IsoStrand seed chain consists of 10 IsoSeeds with standard seed-spacer configuration and a 1.0 cm centre-to-centre spacing. It can accommodate either IsoSeed I25.S06 or IsoSeed I25.S17plus.
IsoStrand is available with either I25.S06 or I25.S17plus source model designs. Both seed types are visible under X-ray, fluoroscopy, CT and MR, and additionally show good ultrasound visibility.
- IsoSeed I25.S17plus features a full silver marker and has been designed for visibility under X-ray/fluoroscopic imaging. In addition, it enables MR imaging and opens new perspectives for postoperative planning.
- IsoSeed I25.S06 contains a thin gold marker within a ceramic carrier, diminishing artifacts and providing optimal visibility in CT Imaging.
Low Migration Rates
One advantage of strands is their low migration rate. IsoStrand® is specially designed to reduce the migration rates still further. IsoStrand® consists of seeds and hourglass-shaped spacers which are embedded in a braided monofilament suture. This special design enables reliable fixation within prostate tissue and helps to reduce seed migration.
Needles for LDR Brachytherapy
High-Quality Consumables for Prostate Seed Implantation
IsoCord Needles are steerable thanks to their bevel shaped tip, which is aligned with a blue marking on the top of the needle hub, thus allowing precise needle guidance. The stylet features clearly visible 0.5 cm markings for seed quantity indication and numerically ordered centimetre markings on the outer cannula permit determination of penetration depth at one glance. IsoCord Needles are loaded quickly with the unique Needle Loading Station, which allows easy strand cutting under maximum radiation protection.
Post-Loading Needles come with two stylets, one for insertion and one for implantation. The insertion stylet is positioned in the notch of the needle hub during needle placement, forming an integrated cutting surface with the bevel shaped tip of the outer cannula. The specially cone-shaped needle hub easily accommodates post-loading transfer tubes. The centimetre markings on the outer cannula allow precise orientation regarding depth placement of the needle.
The slim hub design favours the implantation of loose seeds with the Mick Applicator. The trocar tip stylet avoids needle deflection. 0.5 cm markings on the outer cannula support orientation whilst pulling back the Mick Applicator during seed placement. 17 and 18G needles are available.
Two Types of Fixation Needles
The three hooks of the Pajunk Delta-Fix Fixation Needle are extended after puncturing the prostate, stabilizing it in the desired position. An adjustable locking spring, positioned directly at the needle template, prevents movement of the prostate. Prostate Stabilization Needles come in a set of two and deploy a side barb out of a side eyelet, which is located 2.0 cm proximal to the needlepoint and aligned with the point of the teardrop-shaped stylet cap. The side barb deploys once the stylet cap is pulled back. Prostate immobilization is achieved by securing the locking spring against the proximal side of the needle template.
Hawkins Blunt Needle Access System
This needle provides a lightweight method of targeting. It comes with two stylets. The sharp one is equipped with a pencil point for easy insertion and positioning of the needle. The blunt one is used for an atraumatic approach to the target structure and avoids damage at the prostate/bladder interface. The adjustable locking spring localizes the outer cannula to the target and prevents forward migration, while the numerically ordered centimetre markings on the outer cannula facilitate precise depth placement. Using Hawkins Blunt Needles, it is easy to locate and identify the reference plane during prostate seed implant procedures