A commissioning procedure for breast intracavitary electronic brachytherapy systems

Hiatt, Jessica R.; Cardarelli, Gene A.; Hepel, Jaroslaw T.; Wazer, David E.; Sternick, Edward S.

doi:10.1120/jacmp.v9i3.2775

Cited by 15 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A QA process has also been described for the Xoft source. 55 Participants in the TARGIT trial are expected to follow national standards for quality assurance, so no further exercises have been performed. 49 Until national or international standards include specific guidance on electronic brachytherapy devices, this schedule is suggested.…”

Section: Quality Assurance Programmentioning

confidence: 99%

Quality assurance and independent dosimetry for an intraoperative x‐ray device

Eaton

2012

Medical Physics

View full text Add to dashboard Cite

show abstract

Section: Quality Assurance Programmentioning

confidence: 99%

Quality assurance and independent dosimetry for an intraoperative x‐ray device

Eaton

2012

Medical Physics

View full text Add to dashboard Cite

show abstract

“…[4][5][6][7][8] At the present, balloon brachytherapy is conventionally delivered with a HDR 192 Ir source, but it can also be delivered with an electronic brachytherapy ͑eBx͒ source involving a miniaturized x-ray tube. [9][10][11][12] Ir radionuclide emits several gamma rays with energies up to 1.4 MeV that can easily penetrate through a large portion of the patient's body. On the other hand, eBx devices such as the model S700 Xoft Axxent x-ray source ͑Xoft Inc., Fremont, CA͒ utilize 50 kVp x rays in the range of 20-50 keV, which can be selected by changing the applied electrical voltage.…”

mentioning

confidence: 99%

Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR or electronic sources using Monte Carlo simulations in a heterogeneous human phantoma)

Mille

Rivard

2010

Medical Physics

View full text Add to dashboard Cite

Purpose: Accelerated partial breast irradiation via interstitial balloon brachytherapy is a fast and effective treatment method for certain early stage breast cancers. The radiation can be delivered using a conventional high-dose rate ͑HDR͒ 192Ir gamma-emitting source or a novel electronic brachytherapy ͑eBx͒ source which uses lower energy x rays that do not penetrate as far within the patient. A previous study ͓A. Dickler, M. C. Kirk, N. Seif, K. Griem, K. Dowlatshahi, D. Francescatti, and R. A. Abrams, "A dosimetric comparison of MammoSite high-dose-rate brachytherapy and Xoft Axxent electronic brachytherapy," Brachytherapy 6, 164-168 ͑2007͔͒ showed that the target dose is similar for HDR 192 Ir and eBx. This study compares these sources based on the dose received by healthy organs and tissues away from the treatment site. Methods: A virtual patient with left breast cancer was represented by a whole-body, tissueheterogeneous female voxel phantom. Monte Carlo methods were used to calculate the dose to healthy organs in a virtual patient undergoing balloon brachytherapy of the left breast with HDR 192Ir or eBx sources. The dose-volume histograms for a few organs which received large doses were also calculated. Additional simulations were performed with all tissues in the phantom defined as water to study the effect of tissue inhomogeneities. Results: For both HDR192 Ir and eBx, the largest mean organ doses were received by the ribs, thymus gland, left lung, heart, and sternum which were close to the brachytherapy source in the left breast. eBx yielded mean healthy organ doses that were more than a factor of ϳ1.4 smaller than for HDR 192 Ir for all organs considered, except for the three closest ribs. Excluding these ribs, the average and median dose-reduction factors were ϳ28 and ϳ11, respectively. The volume distribution of doses in nearby soft tissue organs that were outside the PTV were also improved with eBx. However, the maximum dose to the closest rib with the eBx source was 5.4 times greater than that of the HDR 192Ir source. The ratio of tissue-to-water maximum rib dose for the eBx source was ϳ5. Conclusions:The results of this study indicate that eBx may offer lower toxicity to most healthy tissues, except nearby bone. TG-43 methods have a tendency to underestimate dose to bone, especially the ribs. Clinical studies evaluating the negative health effects caused by irradiating healthy organs are needed so that physicians can better understand when HDR 192 Ir or eBx might best benefit a patient.

show abstract

“…Figures 6 and 7 show some of the tools included in the QA Toolkit and Shielded Test Fixture. 17 The QA Toolkit includes six components:…”

Section: B5 Manufacturer's Qa Toolsmentioning

confidence: 99%

Electronic intracavitary brachytherapy quality management based on risk analysis: The report of AAPM TG 182

et al. 2019

View full text Add to dashboard Cite

Purpose: The purpose of this study was to provide guidance on quality management for electronic brachytherapy. Materials and Methods: The task group used the risk-assessment approach of Task Group 100 of the American Association of Physicists in Medicine. Because the quality management program for a device is intimately tied to the procedure in which it is used, the task group first designed quality interventions for intracavitary brachytherapy for both commercial electronic brachytherapy units in the setting of accelerated partial-breast irradiation. To demonstrate the methodology to extend an existing risk analysis for a different application, the task group modified the analysis for the case of post-hysterectomy, vaginal cuff irradiation for one of the devices. Results: The analysis illustrated how the TG-100 methodology can lead to interventions to reduce risks and improve quality for each unit and procedure addressed. Conclusion: This report provides a model to guide facilities establishing a quality management program for electronic brachytherapy.

show abstract

A commissioning procedure for breast intracavitary electronic brachytherapy systems

Cited by 15 publications

References 13 publications

Quality assurance and independent dosimetry for an intraoperative x‐ray device

Quality assurance and independent dosimetry for an intraoperative x‐ray device

Comparison of organ doses for patients undergoing balloon brachytherapy of the breast with HDR or electronic sources using Monte Carlo simulations in a heterogeneous human phantoma)

Electronic intracavitary brachytherapy quality management based on risk analysis: The report of AAPM TG 182

Contact Info

Product

Resources

About