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In this study described herein, we assessed safety and efficacy of image-guided HDR Liothyronine Sodium brachytherapy in patients with metastases of malignant melanoma. Material and methods Patient characteristics Between February 2007 and April 2012, 14 patients with malignant melanoma with an overall amount of 52 unresectable metastases were included in this retrospective study. There were 37 visceral metastases, including 31 hepatic metastases, 4 lesions located in the adrenal gland and kidney, and 2 lymph node metastases. In addition, 15 pulmonary metastases were treated. No patient with pulmonary lesions had a history of previous lung surgery. All the patients who underwent lung treatments had a clinically fully compensated lung function. The patient population comprised 12 men and 2 women; the median age was 66 years (range: 50-81 years) (Table 1). All patients had been pretreated with systemic chemotherapy or chemo-immunological treatment. In detail, eight patients were pretreated with interferon alpha. After treatment with interferon alpha, six patients showed a progressive disease. Furthermore, one patient who was pretreated with interferon alpha finished the therapy because of side effects. Four patients were treated with Dacarbazine and three patients received Fotemustine. All patients displayed tumor selleck compound progression at the time of referral to our institution for local treatment. Table 1 Patient characteristics Study design and eligibility criteria In this retrospective study, primary endpoint was the local tumor control and secondary endpoint was the safety of CT- or magnetic resonance imaging (MRI)-guided HDR brachytherapy. The indication selleck chemical for the HDR brachytherapy was determined for all patients in an interdisciplinary consensus of dermatologists, oncologists, visceral surgeons, and interventional radiologists. The inclusion criteria for performing image-guided brachytherapy were technically unresectable tumor due to its location or due to e.g. reduced liver function or low residual tissue, medical contraindication for resection or comorbidities, and denial of operation. In case of pulmonary lesions, we performed pulmonary function tests before the treatment to secure sufficient lung capacity. A Karnofsky Index �� 70% as well as appropriate coagulation parameters (thrombocytes > 100,000/nl, prothrombin > 50%, partial thromboplastin time