what is MUPIT
martinez univerisal site perineal interstitial template for treatment of prostatic, anorectal, and gynecologic malignancies
- allows for intra-cavitary and interstitial
- cylinder goes into vagina and rectum
- ‘holes’ (like prostate template) are for needles into tissue
- typically used for any vaginal disease because standard treatment only covers pear-shaped distribution (intact cervix), vault only does 1 channel, and Miami is for superficial tumor (doesn’t go as deep)
when is gyne brachy usually performed if combined with EBRT?
after EBRT
process for MUPIT insertion
patient is under anasthesia
needles, cylinders are inserted
patient is simmed (must be medically stable- some anesthesia has to wear off)
-plan is completed
purpose of stopper and template cover
stopper stops needles from pushing into patient
template stops needles from coming out
describe overall MUPIT procedure
patient under anasthesia
-catheter inserted
cylinder inserted into vagina, template on top
template sutured to patient (half hitch knots)- at least 4 knots
needles placed and tightened
template cover overlaid and screwed in
-cylinder has screw and washer to keep it immobilized
-patient is recovered
-patient is simmed
-patient is treated (awake)
why do we use CTSim and not CBCT with MUPITs
to see needles, need CT Sim quality
doctor avoids poking this structure with needle
bladder
how is the motion dealt with?
template moves with the organ it is attached to
