Volume Study |

Volume Study

At the time of your first visit, we will ask you to undergo a volume study. A volume study is an ultrasound study of the prostate designed to help determine whether seed implantation is technically appropriate and is also used to plan the implant. It is a simple procedure which requires placing the ultrasound probe into the rectum and taking a series of pictures. It is minimally uncomfortable and takes approximately 10-15 minutes.

How do PCCS doctors plan the implant with a volume study?

The volume study images allow us to create a three dimensional model on the computer which is then used to create a plan or map of the implant. The map describes the correct placement and precise location of the needles and seeds. The volume study is performed in the office at the time of the first visit. It simply involves inserting the ultrasound probe into the rectum and then taking images, at 5 mm spacing, from the top to the bottom of the gland. This usually takes 10-15 minutes. The images will be reviewed with you by Dr. Grimm. or Dr Hsi Working with our dosimetry team (dosimetrist and physicist), we will draw out the area to be treated and customize a plan for you.

What does the team do with the ultrasound images?

Dr. Grimm or Dr Hsi draws the area to be treated on each ultrasound image of the prostate. This area includes the prostate and some tissue beyond the gland. The area treated is slightly larger than the prostate to insure that that the prostate and potential areas of cancer spread is well covered by the radiation dose. The physics team (dosimetrist and physicist) will create a plan or map of the implant on the computer. Seeds are placed throughout the gland in order to cover both the gland and the area of potential cancer spread outside the gland with the prescribed dose. Careful attention is made to insure that the bladder, rectum and urethra are protected from excessively high doses. The careful positioning of seeds results in a cloud of radiation that covers the prostate gland while minimizing exposure of the urinary bladder, urethra and rectum. Once a plan is completed by the physics team, it is sent to Dr. Grimm or Dr Hsi for final approval and adjustment, if necessary. Only when all four team members (doctor, nurse, physicist and dosimetrist) agree is the plan sent and seeds ordered.

How do I need to prepare for the volume study?

Prior to the volume study our staff or nurses will give or send you instructions on how to prepare your bowel. It is valuable to have the rectum clear of stool in order to get a clean image.

Will the ultrasound be uncomfortable?

The preoperative ultrasound must match the ultrasound at the time of the implant. It is valuable to have you relaxed during the study. We will endeavor to make this as comfortable as possible. The need for a sedative or anesthesia for a transrectal ultrasound is rare.

Do I need antibiotics or pain medication for the volume study?

No, you don’t need antibiotics or pain medication for the volume study. If you need a urinary catheter during the procedure, this will be explained to you but this is rare.

What will the doctor look for in the volume study?

The volume study is designed to evaluate the size and shape of the gland. Glands that are too large may not be suitable for an implant. Most prostates are small enough or can be converted to suitable size with medications prior to an implant.