How do you minimize urethral dose when doing LDR prostate seed brachytherapy with small glands (<20 cc)?

These cases can be challenging, especially when you approach the 10 to 15cc range. I’ve approached them using back to back sources in the peripheral needles, and loading the central needles in a manner to minimize the 150 isodose line overlap with the urethra. One should pay special attention at the...