@surftohealth88 This is what I found out as to why they use them still. The other RO I dealt with pooh-poohed them and said today's machine technology takes care of delivering the dose accurately but this is what the expert "google" says. Gold seeds (fiducial markers) are not strictly required for all photon radiation therapy, but they are still commonly used in prostate cancer treatment to significantly improve daily targeting accuracy (IGRT). While technology has advanced, seeds help minimize radiation dose to nearby healthy tissues, such as the rectum, ensuring maximum precision. Why they are used: The prostate can move slightly on a daily basis due to bladder fullness or bowel gas. The non-radioactive seeds allow therapists to track the prostate's exact position before each treatment session.
Alternatives: Modern techniques like MRI-guided radiation (MR-Linac) or soft-tissue imaging techniques (cone-beam CT) can sometimes allow for daily adjustment without permanent fiducial marker implantation. When they are used: They are frequently used with Intensity Modulated Radiation Therapy (IMRT) to safely deliver higher, more effective doses to the prostate. In summary, while advanced technology has created alternatives, gold seeds are considered a "gold standard" for managing prostate movement during External Beam Radiation Therapy (EBRT) to maximize precision.

@surftohealth88 Don’t freak, Surf! Just ask him WHY?
I assume treatment will be to the bed plus the nodes so…?
I am sure there are reasons for this but I can’t figure what they are since I am not a RO and my grasp of nuclear medicine is limited.
I am sure you will get clarity on this!
Phil