Calypso/Fiducial Seed Placement


The Calypso Localization System and Cybermark Fiducial System are tools used by doctors to increase the accuracy of external beam radiation therapy. Three transponder “seeds” are placed inside the prostate and help radiation therapists identify the exact location of the prostate.

The marker seeds are made of gold or platinum and are smaller than a grain of rice. These seeds are not radioactive and will remain in the prostate permanently without harming the body in any way.

Patients should speak with their radiation oncologist if they:

  • Have a heart condition
  • Have an allergy to latex, gold, platinum, lidocaine or the antibiotic ciprofloxacin
  • Take a blood thinner such as:
    • Heparin
    • Warfarin (Coumadin®)
    • Dalteparin (Fragmin®)
    • Clopidogrel (Plavix®)
    • Rivaroxaban (Xarelto®)

How To Prepare For The Procedure

One week before the procedure, patients will visit their doctor to review medications and allergies and obtain instructions on how to prepare for the procedure. During the visit, patients will receive a dose of the antibiotic Cipro to make sure they are not allergic.

Unless otherwise instructed, patients should stop taking the following five days before the procedure:

  • Aspirin
  • Ibuprofen
  • Naproxen sodium
  • Fish oil
  • Vitamin E

One day before the procedure, the patient will need to perform a saline enema to cleanse their bowels. The day of the procedure, patients may eat a light breakfast and take an oral medication to help them relax (if they wish). However, they should discuss this with a nurse in advance.

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What To Expect During The Procedure

Once the patient has arrived at the facility, a nurse will check their vitals and weight. The patient will then be taken to the exam room to speak with the physician performing the procedure. Next, the patient will receive a dose of antibiotic and will be taken to the procedure room.

The patient will sit in an exam chair with their legs up in stirrups. The radiation oncologist will then apply local anesthetic to numb the area around the prostate. An ultrasound probe will be placed into the patient’s rectum and three marker seeds will be inserted into the prostate through ultrasound-based needle guidance. The seeds are injected through the skin on the outside of the body between the rectum and the scrotum.

The entire procedure will take about 20 to 30 minutes, after which the patient will have a CT scan of the prostate to make sure the seeds were inserted properly and into the right locations.

Potential Side Effects And Risks

The procedure is relatively safe, with about one out of three patients likely to develop one of the following temporary symptoms:

  • Blood in the ejaculate
  • Slight burning with urination
  • Small amounts of blood in the urine
  • Increased urine frequency

In most cases, symptoms subside within two weeks. However, if patients experience any of the following symptoms, they should call their doctor or visit the emergency room:

  • Shaking chills
  • Inability to urinate
  • Pain that is becoming more severe
  • Bright red blood or large clots in the urine
  • A temperature of 101° F (38.3 °C) or higher