A Multi-Institutional Study of Feasibility, Implementation, and Early Clinical Results With Noninvasive Breast Brachytherapy for Tumor Bed Boost

Commissioning and quality assurance for the treatment delivery components of the AccuBoost system

“…The Markus chamber was a priori calibrated for ${\hspace{0.17em}}^{60}\text{Co}$ in water. The calibration factor for ${\hspace{0.17em}}^{192}\text{Ir}$ is 1.0% to 2.0% lower than the calibration factor for ${\hspace{0.17em}}^{60}\text{Co}$, (1) but this effect was neglected. ${\mathrm{P}}_{\text{pol}}$ and ${\mathrm{P}}_{\text{ion}}$ were a priori measured in solid water and polystyrene at different depths, and both were found to be within 0.4% of unity.…”

“…Circular (standard and skin dose‐optimized (SDO)) and D‐shaped applicators of various sizes are designed with a channel running along the interior periphery so as to collimate the HDR ${\hspace{0.17em}}^{192}\text{Ir}$ source's photons and to optimize the dose distribution at depth. The system is intended to deliver noninvasive targeted brachytherapy to the lumpectomy cavity either as an alternative to an electron boost 1 , 2 employed during external beam treatment, or as a monotherapy form of partial breast irradiation (3) . In both cases, the breast is first immobilized using moderate compression prior to each treatment.…”

Guidelines by the AAPM and GEC‐ESTRO on the use of innovative brachytherapy devices and applications: Report of Task Group 167

“…The rationale for NIBB is to immobilize the breast and standardize the geometry compared to en face irradiation with electrons, to direct the radiation away from the chestwall, and use mammographic image-guidance to guide irradiation of the target. 155,156 Both applicator types are approved by the FDA and have CE Marking for their respective disease sites. Another type of applicator used in brachytherapy is the shielded applicator as used for treating the vagina or rectum.…”

Accelerated Partial Breast Irradiation: A Review and Description of an Early North American Surgical Experience with the Intrabeam Delivery System

“…A variety of additional noninvasive partial breast irradiation techniques including intensity-modulated radiotherapy (IMRT), 84 volumetric-modulated arc therapy (VMAT), 85 continuous arc rotation of the couch (C-ARC), 86 Accuboost, 87,88 and photon beam therapy 89 are currently under clinical investigation. Results are continuing to accrue with these techniques and will provide additional future information.…”