ULTRASOUND GUIDANCE FOR PLACEMENT OF DIFFICULT INTRACAVITARY IMPLANTS

Placement of a radiation implant in patients with cervical cancer may be difficult because of distortion of the canal by tumor or fibrosis f rom previous radiation. The objective of this study was to determine w hether ultrasound may be useful in recognizing or preventing complicat ions associated with placement of an intracavitary implant. Transabdom inal ultrasound was used during and after 20 intracavitary implants in patients with cervical cancers. In placing 20 implants, there were 9 placed in less than satisfactory relation to the anatomy of the uterus . In 6 patients, occult perforations occurred, with two-thirds not det ected by the operator. Increased difficulty was seen at the time of pl acement of a second implant after external radiation. By using ultraso und, correction of the misplaced tandem could be made immediately with out resorting to more invasive surgical approaches. (C) 1994 Academic Press, Inc.