_ _. _ _ _ _ _ . _ _ _ . - _ _ -. - _ - - _ - _ _ _ _ . __

Y .

** L.A. WEISS MEMORIAT0'OSPTTAL, CHICAGO

NRC License 12-0218-01 Supplement #1

UNITED STAft$ ATOMIC ENERGY COMMi$$10N,,

(2-m APPLICATION FOR BYPRODUCT MATERIAL LICENSE-MEDICAL'* 3 SUPPLEMENT A-PRECEPTOR STATEMENT,

This page le to De completed try the apphcant physician's preceptor,11 more than one preceptor is necessary to document exponence. obtain aparu. statement from .ach. Page 2 may be used for cenaments and additional mtormation.

to. NAme mo Acomess or ArcucANT rwysiciAN to.cA, ze coa.iYashbir Mehta, M.D., Radiation TherapyLouis A. Weiss Memorial Hospital Chicago, Illinois 60640

f t. CUNICAL TRA4NING ANo EXPERIEteCE oF PHYSICIAN NAMED IN ITEM to A8oVE

lAl (s) (C) (0)

No. Cases Observed No. Cms inwel,mg Po,senetISOTOPE CONOmON: DIAGNOstD 04 TatATED (see I in key bele.) Pervicipehen (;ee 2 in key bete. ,

i

1

6131 Diagnosis of thyroid function 20'

orh125 Determination of blood and blood plasma volume 25

,

Uver function studies 20

Fat absorption studies 20

Kidney function studies 20, .

in vitro studies 20

Cr-51 Gastrointestinal protein loss studies 20Determination of red blood cell volume and

30studies of red blood cell survivat

Fe-5g tron turn over studies

Co-54or

Co60 Intestinal absorption studies

K-42 Potassium soace determinations

ptat Thyroid imaging 50

Brain tumor localization and cardiac imaging 40

Cisternography

Lung imaging 25''Uver imaging 40

Kidney imagmg - 40Placenta :ocal!zation 40

Cr-51 Placenta localization

spleen imaging 10Au-196 Liver imaging

Hg-197 Brain imagingI| Kidney imaging

Hg-20'J | Brain imaging

St-85 Bone imaging

Tc-99m Brain imaging 40Thyroid imaging 40,

Sativary gland imaging 40Blood peo! imaging |

e507230220 e50702 CONTROL.NO. 0 5 2 5 9REG 3 LIC3012-02418-01 PDR

_ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ - __ _ _. _ _ _ _ -

~_ _ .. . ,

w - .

Paes 4 APPLICATION FOR BYPRODUCT MATERIAL LICENSE-MEDICALSUPPLEMENT A-HUMAN USE

W (si A A60ToPg ccMomoses oiAoNosso on intATro N. ca ca d N ca in =*as P., sea s

(s tin 6.ytoe P.,tcape.n (s a 6. hoy beto.)

Tc49m Placenta localization

Uver and spleen imaging|

Lung imaging

Bone imaging

Xe-133 Blood flow studies and pulmonary functionstudies

So 75 Pancreas imaging

P42 Treatment of polycythemia, leukemia, and'

sone metastases 10

Intracavitary treatment 10

b131 Treatment of thyroid carcinoma 15

Treatment of hyperthyroidism and cardiaccondition .5

Au-196 Intracavitary treatment

Co40 or interstitial treatment 100CO-137

Intracavitary treatment 300

Ir192 Interstitial treatment 100

.

CO 137 Teletherapy trea* ment5000

Sr-90 Treatment of eye disease 100

s., e. ces.ma (c) ad (o) ebe.i . o b.. .n in..ad coa. e .e .b. .e ,.46 .c... ed. ..w.m a v.<heq . ad di.<... a ..a ,,.c.,e., eh. . h .rie. ....bi..h

.,,, . ,a..n .adiw * .: ,,.< i .. i. eem a. coa. adece ec.

2. rw .t p.ene. r a ih id coa .e .e (e) ...wm.d ...aeace.a .e ,*. .. e. de. . *. b.iny #= ,.d....e . d... . .ad/ e, .a.as.ad . .ad.=.a .a d. e. e. m. pee crib.d. Ib) .u.bwe aa ..i.6,c a .e eh. d. .ad en. i .d. .a .e ,n. .... . , n.a.,

.ach.d.ae .i.. .n.a m. ,.4.e.a d . ,.sc.4 ... an. .ad pse.w., e dee , .ad (c) d.q.c. , .d weame = 64. eh. ,*y.cma w

. . ,.d . . d = e.u ,. .a n,..o h da.,a . .ade., .. . a..

n. oares .No rota Numeen or Nouns or cuwitu uoosoroPe Tuamo 1968-1971; more than 1000 hrs.

.

13. rHe TRAININo AND (IPERIENC11NotCATED AGOVE WA5 oSTAINto uNoER THE SUPERVISION or

F. Hendrickson, M.D. , Presbyterian-St. Luke's Hospital , Chicago, IL 60612Byun, M.D., Edgewater Hospital Chicago, IllinoisR. Phillips, M.D., Lutern ieneral Hospital, Park Ridge, Illinois

I.

#Presbyterian-St. Luke's Hosp. 12-00929501 /-

Chicano. IL 60612 12-00929-13 F. Hendrickson, M.D.,,

<ia iN w ( u No , is . ,

. -

_ _ . _ . _ _ _ _

L.A. WEISS MEMORIAL HOSPITAL, CHICAGO#

Brachyth.nse #12-02ccessories .

NRC Lic 01 SUPPLEMENT #2-

'erap.

f'.

3M's brachytherapy accessories g.are designed to provide the iradiation therapist, physicist andtechnician with a well-shieldedstorage and work area.

A. Four drawer storage safeNo. 6624This locking safe has four solidlead drawers which are custom-drilled to accommodate the users .

ASource inventories. {", gThe safe's lead walls are 4 inches b ^L,'

N'MQ.ym,

/^ . ?thick. Each solid lead drawer ,;,. * $ g?

d - |~.$ydmeasures 1.5 x 2.0 x 9.0 inches. 8 ,

,CW = 4Overall safe dimensions are 11 x 11 [. , 4 . j

; W}x 12.5 |nches. Weight of safe is 565 ;p % -v

''tpounds. ; , 7.g . +

3 ' Q ,', ._ :* -Q'8. L Block No. 6621 N

This protective handling and [ ;loading block minimizes radiation ,# 0, ,

,

exposure to the user. It measures'

9|;;7 k I #,i"- 1 C''s ("

14 x 14 x 16.5 inches high,is 1.75~

|inches thick, and has a high- .

#"'q,

density lead glass viewing window, pk ,

Weight of L Block is 260 pounds. ;t

C. Heavyduty table No. 6622 i ) f"'4(ri gf )

Designed to support 3M's four-. drawer safe and L Block, this ..

stationary table is 28 x 36 x 34 74 ;i

inches high, and weighs 130 pounds. ,F'D. Magnifying viewing lamp

'

[ |,p -

No. 6620 #. #

Designed for placement on top of .} ',

i 3M's four drawer storage safe, this d'

I lamp uses shadow free fluorescent '

yW.

Illumination and a magnifying lens 15to aid the user in quick source E

,

identification and loading. g

--

_

Rolling Radiation ShieldNo. 6623

This movable shield provides radiation protection atbedside or in the operating room. Its 1 inch thick leadredaces the dose from a Cs 137 source by more than90% Dimensions of the shielded portion are 20 x 30inches; the top of the shield is 41 inches off the ground. 1

Weight is 300 pounds.

CONTROL NO. 0525912-

J

_

L.A. WEISS MEMORIA r 0 SPITAL, CHICAGO (3'..

NR'C LICENSE #,12-0 C -01 V SUPPLEMENT #3-

.

.

O 'I N ( I./t!' 'Id

St.nnie .s

3M Cesium-137 s --.Capsule

i

Tube Sources !<p, st-es

The U S Nuclear Regulatory Com. f ',s i,-

nnussion tNRC) has granted a three- I place andAll of 3M's af terloadmg apphcatorsyear leak test interval on 3M stan* welded to

for treating utenne/ cervical cancerdard Cs 137 tube sources (models - y! seal inner,

use 3M Cesium 137 tube sources u.00 L'.0 A Ihe NHC has a perificil . . .p. n t. ..

All 3M tot a '.oun e- .uo .." u n n. .n na .n imn m h . A 1. .. t- !

. . '

structed of two stamless steel interval for thu miniatunzed tube -l Stamies:D---- steel innercdpsules - an inner core and an socces (models 6510-6513)

outer i.mang This itout le encap ,, i ..psnir

solation mamtams the inteqnty ol 3M Gesluin 13/ sources we rah A'hv' Icouthhiated m uniin of unihtune:the nount and helps en .ute te,ei ! packeu vuth

j safety. Each source is loaded with cesium 13/. Output from each .

I thousands of ceramic micro- source is compared directly with ip ceranuc micro-

'

spheres labeled with Cs 137 which that from a National Bureau of [~[h cesu'

37

are tightly packed along the Standards (NBS) cahbrated | tspheres are; approximatelysource's active length resulting in cesium-137 source in a 4nioniza- r

a consistently uniform dose tion chamber. Calibration accuracy ( 50 microns in,

es within 5%. i |1 diametendistr:Dution pattern. f.'

3M Cesium-137 tube sources are Mill gram radium equivalent values-

/ ,

available m standard or miniaturized for the Cs 137 sources are, Stainless

S 'Psize, calculated by multiplying the / elde. n

cesium-137 millicurie value by y e# place toEach tube source is nicket plated seal outer0.398. This factor is a ratio of

-(tand engraved with a nominal activity exposure rate constants for i capsule

and senal number. In addition. cesium-137 (3.28 R ecm'/hr emCi)each source is color coded on the and radium-226 (8.25 Recm3/hremCi) have met 3M's stringent qualitynyelet end for quick. safe identili- as found in National Cous.J on control standants.cation of source strength, resulhng

Radiation Protection and Measure- Actual source activity at time ofin min mal exposure during handling. ment (NCRP) Report No. 41. shipment is 0 to 10% above theA certification sheet accompanies nominal activity. Tube source

3 y g, ,,,,,,,n, g,,,each order and lists the nominal activities in an order are grouped

to rng Ra mwvdent Green and aClual aClivities for each within 5% of the mean activityts mg Ha eqwvalent Yeiio*

1 20 mg sa eqwvamnt orange serialized source at the date of of those sources.

N N ba Nu$aYicalibration. The certification alsoguarantees that bubble leak. There is no additional charge for,

,

et

ImrT,crsion soak, and wipe tests calibration and certification.' as mg Ra muivaiant w nite.tc mg sa egwwaient stack

.

Cs-137 Sources ,Yearly

Active Purchase Lease Price

New Cat. No. Old Cat.No. mg Ra equiv. Length (mm) Price Each Each

.

Standard Tube Sources (20.0 mm x 3.1 mm)

6500 6D6C-CA 5 14 5265 $61.69

6501 6D6C-CA 10 14 $280 $65.18

6502 6D6C-CA 15 14 $295 $68.68

6503 6D6C-CA 20 14 $310 $72.17

6504 6DGC-CA 25 14 $325 $75.66

6505 6D6C-CA 30 14 $340 $79.15

6506 6D6C-CA 35 14 $355 $82.64

6507 GDCC CA 40 14 $3EONTRO57kM 0 5 2 5 9$20

6509 dummy source -

__ _ _- - __

J

L.h. WEISS MEMORIAL 10 SPITAL8

NRC LICENSE #12-02 h1 SUPPLEMENT #4

MtCK AppLECATOR.

~

FOR IMPLANTATION. OF l-125 SEEDS AND AU-198 GR AINSi

|

|

11. dae-

t

.1|ad.-

,

|

|- ::

. . .

c- - ,

. ,y :.,

,

??TI'*

* .* W ; .~ -.

,

, _

*D| _r _

. s;\'b!-? ~

.

j | gg;Bh,

. . ,

.~ .-

4 <, . .;-su::7;".

, : ~ '' 23;,.,3;a's~ ,,

:

fHiMsf i fhn asr hsinmmis, m.'

.

b oo venhe,krhnh, k Y.10465f" 5 1

'' (212) 597-39992

'

O O~

-...

DESCP11PTION

PUSHWIRE ROD HANDLE - --PUSHWIRE ROD

MAIN BARREL END CAP

( -FINGERRING( ~-#ADJUSTABLE BALL PLUNGER

BLACK CONE?

' SCALE: Spocing 5 mm/ notch(inscribed in main barrel)

MAIN BARREL STOPPERg

|'

MAIN BARREL

I MAGAZINE CUBICLE

NEEDLE CHUCK

INSTRUMENT IDENTIFICATION NUMBERH NEEDLE CHUCK CAP PINi

NEEDLE CHUCK CAP- -

FUNNEL FOR NEEDLE ATTACHMENT

TISSUE RING ROD-l >TISSUE OR TUMOR SURFACE RING

|

17 GAUGE HYPODERMIC NEEDLE(guide needle),15 cm long 450 point

CONTROL NO. 05259lL J

-

.

f% p/~

*

%IVIAGAZINE' . '

8" ?"4Au-198 |-125 ~ |p'Vl

: -

ng j plunger under spn.ng tens.ion n;

gf hexogonal ,.

(ymagazine head 2 T Mj

- *

I ,

n-

A CIL @ -

-:n 2

rectangular carfridges- i c (see , instructions for loading) cy ,

Nb;f'.

s J ,

-w unloaded r loaded emptys

THE IVilCK APPLICATOA|

is based on the same ofterloading principle os the Henschke implant Instrument and the I-125 Gun. These instru-ments are provided with a rotched mechanism assuring occurate placement of seeds at any desired depth up to 12cm. Needles con be withdrawn at 5 mm steps and seeds are manually transferred by means of a stylet into the tumor.

FEATURES- lightweight

easy handling due to simplicity of instrument-

quick exchange of needles without removal of magazine-

suitable for single seed or superficial implants s-

|- ideal for implants of the prostate

|fast insertion of seeds

|-

1

accurate placement of seeds up to 12 cm-

minimum exposure due to high density material in magazine-

rugged construction-

all material stainless steel or surface treated-

- easy cleaning

SET INCLUDES:7308 - Mick Applicator 7701 - obturators (4)7609 - magazines (5) 7702 - loop wire (1)7308-3 - hypodermic stainless steel needles 7703 - needle funnel attachment (1)

(15 cm long)(32) 7704 - stainless steel L-ruler (1)7610 - stainless steel ruler (1) 7308-7 - stainless steel lift-out tray7308-5 - needle holder (1) for sterilization (1)7308-6 - magazine holder (1) 7308-8 - wooden carrying case (1)

CONTROL NO 0 5 2 5 9)

.

i O'

~' INSTAUCTONS.

Modified by P.Veerling

INTRODUCTION over the prmod1ng part of the need!c and when it t'as readed a definiteTne preparabon of tre Ma k apphca'or pr or to surgery is most important s'cn turn the need|e chxk cap clockw se as far as poss.ble

Wry rt *hcu'fses and inconveniences will be avoided t.y carefully follow:ng W.th the nee He f,rmly attached to the instru nent, a p,n forated m the needlecria'n smps As a.th any other nea equ pmert il is v.tal to get acquainted ( h+ k i .u' * o appear ,n the midate of the tmue ong cut out check if neete

A th its feaNres and funct.ons before us ng in surgery Particular attention 6 t only atta:hed to the 'nstrument by shgn!!y 1.tt,ng the inst'ument upwa 1should be given to the det3 is of attachina the guide need'as to the apphcator wh, e g*aspar 1 the need e firmly Care must be taken at this point not to d S-M insure profer seit ng and fit. and to the vert rat spacing procedures durtrtg pId': e the ccrrectly inserted needle by pufhng it out ct the tissue.<mplantahon of the seeds With one hand hold the ms.n barrel end-cap and w.th the ot*'er hand push

The Mir k apphrave r i; hageally a very vmple me.f rument and its ennstrue- dn*n the finqor r nqs Th's will br nq the f.s%a r nq rjo An to the f Mun surfar.eg ,s .es p,, ,,gg g ,ne e se f s I.riq f r o - t ie s s af D' les m '.t.il the he n e' t et Di is li#e f r*me ws'et at rhm' or i e . t ri tr),ul e ri. e gl. i th,it el ani sqe ,1, se ,r s 3 e . ., sv ,,1 e, p.

& . i t .I - (J et. i. I' , . . .. ! i er.. niu .f t e 1 d e es e'I. # e e h e e s. AH p ee. .l.i enhl I- ' 'l l h" ' ' ' " 'I " ' 4 'I '* '8 ' H+ 1 ''h la 'D ' 'l l'" l'l 8' b * ' ' ' ' "' t t '* * 3 " ' ' 8 1 * 8 ' H 'IDiellu where lhe hbl beet! Should t e pt.fi Ud

'MI C AI"S d" 'b'DIh d II"q' 1z,ne is as follo A sDe- ( le,srienj af pl t t ;f e j n l''enf de'. yte.nled li n ,5! ons (tie needles should beinsertion of the seed ma The loaded magazine is takenflated in the r*(cre ho, der, which conta ns four slots for eight needles ear.h

Tlie rn,tg gy,r# t r ktor ,s pf noderj with t.ve holem in e, tore ! ve m trg.tf,non The ' nit of ""* st'mi4e p"'t'on and intested all t!.e way ,nto the rnagazine cub,ctero +t Note nul lb. ttylet inust t,e tay ve'r.u ted out et se it..in. c.f ron-nt . .in t . . t.smed t ,y n ibing .n h e t,eq,.n prim,ite unme<tutely et the in .tn

si ter use fMiowest by gentle Sr rut tor 91 oth a sett titu*.h anrt spr:nonq with 'n Order hi .imw the raMr dqe to lie mwet.'.1 Itui m.tq11 ne is f.rmly in placet

arnhia e,n iray . an t cleaned wah . requi.n stainless u.. e a r hi k is heard morannq that ttie sm in twi a caught in the indentahonr s of 6 ater thee v

steel dein:nq spray Af ter a'l parts are correr. tty stored it is immediately M the t u'> ee and the cartr.dge slot is f acin) in the same d.rection as the<es,ble if the set is complete slot in the cubecle

{ Imptantation at the seeds is accomplished as follows. The f,rst of the tenPREPARATION FOR USE seeds in the cartr.dle is deposited into the nee 1 e by pushing the stytet all

,

The et tenle*,r <; teel tr:ty a ont.aminq the ag plg ,ite.g and ;n , e e,r.nrie'; e,houhj be lhe' way sloa ti in <irder to pent tr.ste hierd tva.ur it anay be fwrestary in applyjs

naminad for rompie eness All part; <,hould tm visuet'ly entmmed and any estia pre'.sur to pust, the w.re rod handte a'; it reaches ils end || ther

mov.ng g arts rh-)uid be quckiy tested for smoothness or motton The guide sty >et e not c orrNetely depressed the seed m!i rema n in the need'e Palpa.,

l need.e , sneuid ne stra,gni. noi cnmped. and inn pom,s snnuid be sharp i n ni it e under s.de of the tumor mass der.n 4 ih,2 process can generairyIhe f rSt Step sn prepating the ingt , ment for implintaban of l-125 seeds es rt. ,e a ssuorn .tha: the ed I'as n fact 1;et'n defus d at the bottom of the%f n1 Of the malannes The rnig'.abnes are s!')ted m t'ie maganne holder r'ec d t en' |he s' i r lee,' t el tr3y an't rnly be remiived by unstreA.nq counter-Clar k- To insert the next seed. first hold the ma.n barrel of the apphca'or Il'e 3&'o (rp r k A o f sr * tar 11rq The m.iqayine rorire",'s of two r omponents pencil, s nm"annou'ly res!<ng the middle and rird f.ngers all,rst the black.

. and ra se the Inain t'arrel try two notc he5 f a 1 Cm spac.n1 is desiredr* I'l lt,Pa he d'') aWj r.artridge The mag 1/ine t.ead is a hMalonat tindy con- soref } n'n i a plunger under spr r q tensior. The c artridge has a rectinqular shape (thrae notc he ; for 15cml Pull the sty!et out ta its extreme end and observo01 &n'3ais a stri f a hold the |-125 seeds The front of t*e cartodge is open the retract cm of the ex: ended p'unger in the hexagonal magaz.ne head

test teided umn 3 our V tm. k (see our leaflet Th.s inovement ind cafes that the nett seed has placed itsett into the properr load ng The r 1r'rirl le' e

' 3r load rg ac r s mr.. 5) P.ek up the speds with our sper al forceps and feed pos t On an lt e cartridge for tf ansfer into the guide need's Repeat procedure' ento IN slOf tr')r') t .p (3 in!?Om 11 is ,mportant that the Feed !s not dropped lf the plunger dacS not r"ove. a sf ght tapp.na or amount of pressure with thertn the cacy, be ptued r arefully at the t,of tom of the cartridge The next hnger t=p to the plunger wl! most I kely place tne seed into the proper positron

',eed as fy bed up <n the sarrse mannet anrj fed mio the slot unt.1 it rests parallelit the stytet st.Il does net go through, enchange the magazine and check for

n top ni the prev,ous one This procedure is repeated until the cartndge is deformed seeds Never force the stylet. After the plunger has dropped com-tJIed to capaats of ten (tDi seeds The seeds should si de smoothly and fit ple:ely. the rragazine is empty and the stylet can no longer be advancedv res the o[ en4Dg .n the front of the carthd e Seeds which are under or A new cartndle may be exchanged m read. ness for sut' sequent seed im-l

omrs led should nel te used s.nce they could cause lamm,nq of the maga- plan'atton

I De Cr aDpl Ca'Or When the car'r dv is loaded to caparity, msert the maga- Dunng the ut plant prccedure, at is recommended that the instrument te nnsed71ne her1 p?unger mio the cartr'dle slot and turn cinckwise with si;ght frecaently in normal saline or heparin solut:on in order to remove tissue ordow'Twarj f'ressura urbl it Stops The ma'ta?ine is now ready for implant 3 tion binnd Ah.ch will interfere with smooth movement of the moving parts of theFid Ca" De put b.le k into the sta'Otess steel tr1y applcatof A small syhnge or asepto is he!rtul in forcing the solution throughIhe ent ra st1 Dies $ s' eel tray and its contents may be stenbzed by autoclaving the chuck and magazine cubecle areas.Just prer to use The wooden case is used for transportahon and shelf storage in add'tton to rad ation exposure precaut.ons, an accurate accoun'3bihty ofcniv. a!I sources rau .t te marria ned For this reason, records at sources impian'ed\ tali 7me% fer Au 1 % qnns are m tht4e lad work with the 9 ime pnneeple. and rem +nmq sources rrust comride with the number of seeds avtlable A!;** ej l u..it the rei e4y>f r) sl. it e r y!!ce to a, 4 0 ntm .if ite It e :,a.s of the mntrumer I .ri.t arrivat .u a eWJ'es includ n g r p.nge and nor tion vievo m"I'mns Au 19H m.iq1bres are easilf denbf r d t erause n! their q,lden color simuW to nmyel umedialetV d!!ct the im[lant prot edure I ollow up of

'" 5AFTERLOADING TECHNIQUE [ * h """ * * '"e .

The irwrtat on of the 1-1?S seeds e, dane ty means e,t an a'fer loadin9 Another danc.er in use et the apphcator for I-125 seeds is the rupture of thever hn,m.. Th.s tec hnmue c onosts of five tiasic steps t) plan derribution of outer rnet il e ncapsulation This could occur through excessive use of forceteerts. 2) msert 9%2e rmedies. 3) attach apphrator to r eedlet 4 msert maga- in tne event of a sticking seed or seed m a cartedge The tiny ceramic beads' ne coraain.ng ratoact ve seeds and 5) implant seeds through guide needles. containing ratcact,ve 1125 are barely visible once the capsute is ruptured

, dose.'na the tumor volume and shape. seed strength. and desired therapeuticTh,s can t e avoided by proper use of the mstrument and smng of the seedsUS

| the sp3cmq betweer. guide needles and between seeds should be before use.j planned so as to achieve the desired therapeutic effect with a minimum of An endividua: tamil ar with radiation safety procedures and pert nent regula-

romplicat ons. The dosimetry of I-125 seed implants is discussed m Hand- tions should be consufted prior to undertaking an implant program m orderj i

boe8i cf 17ferst.fraf Buchyrherapy, edited tiy Dasil S. Rians. M D of Memonal to assure preper radaation satefy of personnet, patient, patient s family, ar!d|

Moan Ve'tenna Cancer Cen'er lpubbshed by Publishmq Sciences Group, Inc.. the general pubhc. A number of guidehnes are availab!e through the NationalA(. ton, Miss 1975) Council on R idiahon Protect.on and Measurements. 4201 Connecticut Avenue.i

Inserhnn of qwde noemes may be ar enmphshed as fnitows insert hollow 17 NW Washingten D C. 20008 and the source suppliersgauge stainless steel needles.15 cm long. and ground to a 45 degree point,amund the penchery of the tumnt mass (For ireplants throuqh the ntact skm. immMately after the implant procedure an1 before start of the rieanmqnes A. s with h,vp r o.nts are preferratile. but far intrathmaric and mfro ah

"D*I*"\ d 4"# "" es u be < het W br WW rtuntning seedshmnat impf-ints. it is better to use less sharp needles that do not penetrate ihm can be ar comphshed by mserting the loop were through each needlemd * hanqr the.r positinn so catly) Inr a sphencal shaped tumor. O % milli- and hmnq b ag Ws wM am ejeM Dom N Wom'urre nommal seed strength.and an aim of 16000 rads dehvered through totag For best results remove fissue and blood from instrument immed-ately afterde(ay needfes a'e usuaFly spaceif t cm apart for tumors up to 4 cm in %aking m hydrogen peroode or heparin solut on shou!d loosen allusetameter 15 cm apart for tumors from 4 cm to 8 cm, and 2 crn arart for largerf amers MI needaq chould be mserted para!!el to each other The d,rection biolog' cat matenals The apphcator and accessories should be gently

scrubbed w:th a soft. brush and loose matertats washed away with a let ofM f*e need!cs mu',1 be considered carefully before start,ng. so that the r pose water A leer wire is mctuded for remov,nq stubborn debns from gwdeLon mar t'e pa! pated and the maximum numt'er of seeds nserted through Keep,nq the instruments clean and m qood operating ennd. tion m-reediesone neete Fach qmde needle is 16 r m long whn h rneans that the length surn a prer as ? and eff.c ent implant procedureof Qu.de needie unplanted with.n a tumor bed may be calculated once thetength of protrud ng needle is known This will give a guide as to the number RADIATION SAFETY

,

ef seeds to be in'.erted in each needle, nnre the vert cal spacmq is also de- Usmo the M ck apphcator and accessones entails handhng sol.d radtoactive| "rm ned sauces, namely 1-125 seeds. Au-198 grains and similar sources As with any| At auhment et IN appbcator to the gu.de need!es may be accomphshed as other sources, the pnricmles of t.me, distance. and shield ng should be

twows After a'l need'es have been ;nserted m!o the turaor to the required uttlaed Personnel monitanng devices. such as low energy pocl'et chambers.'

derth, remove ar phcator mstrument from the Stain'ess steel tray With one f.im badges and thermolumenescence dosimeter devices. should be util1ed.,

hand he'd the mstrumeqt m vertical pcotion t'y msert ng thumt and mdex Portable sh olding devg es for bodies and eyes are available as accessor,es|

t,eaer through 19 f:nger rmg and w in the other hand pull out stytet to its through this company lead-rubber gloves are ava.labte for surgical manipu-Ntreme end in ruder to avoid deeper penetrit.on of the quide needte, a labon and handhng dur ng the implant procedure These are especially ef-r emmtat ma'/ be clamped to the needle at the tissue surface pnor to at. tect we for 1-125 seed implants because of the Ion energy of the rado-tach nq rhe appl.cator to the needle Next lower the appt,cator instrument nuchde

(RMs0 fimbst hsinmmi. 05I5 9s, m.CONTROL NO:

-