Quality control of brachytherapy equipment in the Netherlands and Belgium: current practice and minimum requirements

Elfrink, R.J.M.; Kolkman-Deurloo, Inger Karine; Kleffens, H.J. van; Rijnders, Alex; Schaeken, B.; Aalbers, Tony H.L; Dries, Wim; Venselaar, J.L.M.

doi:10.1016/s0167-8140(01)00489-3

Cited by 15 publications

(6 citation statements)

References 15 publications

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“…Because of the anatomic advantage of being able to place catheters directly within the tumor, a high dose can be given locally while still limiting the dose to neighboring organs. Due to the global effort to provide improved access to radiation therapy and the importance of brachytherapy in the management of gynecologic malignancies in recent decades, there has been an increase in the number of high‐dose rate (HDR) gynecologic (GYN) brachytherapy programs world‐wide . Brachytherapy has become an integral treatment for locally advanced cervical cancer and other gynecologic malignancies .…”

Section: Introductionmentioning

confidence: 99%

Clinical implementation, logistics and workflow guide for MRI image based interstitial HDR brachytherapy for gynecological cancers

Zhang

Donnelly

Strauss

et al. 2019

J Applied Clin Med Phys

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Interstitial brachytherapy (IBT) is often utilized to treat women with bulky endometrial or cervical cancers not amendable to intracavitary treatments. A modern trend in IBT is the utilization of magnetic resonance imaging (MRI) with a high dose rate (HDR) afterloader for conformal 3D image‐based treatments. The challenging part of this procedure is to properly complete many sequenced and co‐related physics preparations. We presented the physics preparations and clinical workflow required for implementing MRI‐based HDR IBT (MRI‐HDR‐IBT) of gynecologic cancer patients in a high‐volume brachytherapy center. The present document is designed to focus on the clinical steps required from a physicist’s standpoint. Those steps include: (a) testing IBT equipment with MRI scanner, (b) preparation of templates and catheters, (c) preparation of MRI line markers, (d) acquisition, importation and registration of MRI images, (e) development of treatment plans and (f) treatment evaluation and documentation. The checklists of imaging acquisition, registration and plan development are also presented. Based on the TG‐100 recommendations, a workflow chart, a fault tree analysis and an error‐solution table listing the speculated errors and solutions of each step are provided. Our workflow and practice indicated the MRI‐HDR‐IBT is achievable in most radiation oncology clinics if the following equipment is available: MRI scanner, CT (computed tomography) scanner, MRI/CT compatible templates and applicators, MRI line markers, HDR afterloader and a brachytherapy treatment planning system capable of utilizing MRI images. The OR/procedure room availability and anesthesiology support are also important. The techniques and approaches adopted from the GEC‐ESTRO (Groupe Européen de Curiethérapie ‐ European Society for Therapeutic Radiology and Oncology) recommendations and other publications are proven to be feasible. The MRI‐HDR‐IBT program can be developed over time and progressively validated through clinical experience, this document is expected to serve as a reference workflow guideline for implementing and performing the procedure.

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Section: Introductionmentioning

confidence: 99%

Clinical implementation, logistics and workflow guide for MRI image based interstitial HDR brachytherapy for gynecological cancers

Zhang

Donnelly

Strauss

et al. 2019

J Applied Clin Med Phys

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“…Bu aşamada gama analizinde 1mm uyum mesafesi (UM) ve %1 doz farkı (DF) kriterleri üzerinden karşılaştırma yapılmıştır ve ilk ışınlama referans olarak alınmıştır. Üçüncü aşamada ise Şekil 3'te belirlenen referans kaynak pozisyonunda farklı zaman dilimlerinde (4,8,10,15,20,40…”

Section: Mekanik Kk Testleriunclassified

Use of 2D-Array Ionization Chamber in the Quality Control of High Dose Rate Brachytherapy Treatmet Unit: Dosimetric Feasibility Study

Biltekin

2020

Uludağ Üniversitesi Tıp Fakültesi Dergisi

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Çalışma kapsamında yüksek doz hızlı (YDH) brakiterapi (BRT) cihazına ait kalite kontrol (KK) testlerinde 2D-Array iyon odası sisteminin kullanılabilirliği araştırılmıştır. Ölçümler kliniğimizde kullanılmakta olan GammaMed Plus TM iX YDH BRT cihazında PTW Seven29 2D-Array iyon odası sistemi kullanılarak gerçekleştirilmiştir. Mekanik KK testleri; kaynak pozisyon doğruluğu, lineerite ve farklı adım mesafeleri için cihazın tekrarlanabilirliği olmak üzere üç farklı seride alınmıştır. Ölçümlerin ikinci aşamasında ise 2D-Array iyon odası sisteminin dozimetrik KK testlerinde kullanılabilirliğini araştırmak amacı ile aktivite, gün içerisindeki aktivite değişiminin tedavi dozuna etkisi, planlanan ve ölçülen doz dağılımlarının uyumu olmak üzere üç farklı seride ölçümler gerçekleştirilmiştir. Mekanik KK testleri için, 2D-Array iyon odası sistemi 0,5 mm'nin altında hassasiyetle kaynak pozisyon hatalarını tespit edebilmektedir. Farklı adım mesafeleri için uygulanan referans tedavi planlanlamalarının tekrarlanabilirliği 2D-Array iyon odası sistemi ile teyit edilmiştir. 4 ile 100 saniye arasındaki maksimum rölatif farklılık %1'in altında bulunmuştur. Dozimetrik KK testlerinde ise 2D-Array iyon odası sistemi ile ölçülen aktivite değeri gerçek değer ile %3,3 içerisinde uyumlu bulunmuştur. Ayrıca gün içindeki aktivite değişiminin tedavi dozuna etkisini kontrol etmek amacı ile 1 saat ara ile tekrarlanan 10 ölçüme ait gama analizi sonucu 3 mm uyum mesafesi (UM) ve %3 doz farkı (DF) için %98'in üzerinde bulunurken, 1 mm UM ve %1 DF kriteri üzerinden değerlendirme yapıldığı zaman 6 saat ve 8 saat sonra alınan ölçümlere ait gama analizi sonucu sırası ile %85.7 ve %84.9 olarak bulunmuştur. 2D-Array iyon odası sistemi BRT uygulamaları için cihaz tabanlı KK testlerinde tercih edilebilir bir sistem performansına sahiptir.

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“…The present survey has been endorsed by the IPEM Radiotherapy Special Interest Group. A similar survey was conducted in 2002 in the Netherlands and Belgium [16], which reported large variations in test frequencies and methods, and differences in QC-philosophy and available equipment. The authors are unaware of any contemporary comparisons of brachytherapy QC practice.…”

Section: Purposementioning

confidence: 99%

Physics Contributions A survey of quality control practices for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy in the United Kingdom

Palmer¹,

Bidmead²,

Nisbet³

2012

jcb

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PurposeA survey of quality control (QC) currently undertaken in UK radiotherapy centres for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy has been conducted. The purpose was to benchmark current accepted practice of tests, frequencies and tolerances to assure acceptable HDR/PDR equipment performance. It is 20 years since a similar survey was conducted in the UK and the current review is timed to coincide with a revision of the IPEM Report 81 guidelines for quality control in radiotherapy.Material and methodsAll radiotherapy centres in the UK were invited by email to complete a comprehensive questionnaire on their current brachytherapy QC practice, including: equipment type, patient workload, source calibration method, level of image guidance for planning, prescribing practices, QC tests, method used, staff involved, test frequencies, and acceptable tolerance limits.ResultsSurvey data was acquired between June and August 2012. Of the 64 centres invited, 47 (73%) responded, with 31 centres having brachytherapy equipment (3 PDR) and fully completing the survey, 13 reporting no HDR/PDR brachytherapy, and 3 intending to commence HDR brachytherapy in the near future. All centres had comprehensive QC schedules in place and there was general agreement on key test frequencies and tolerances. Greatest discord was whether source strength for treatment planning should be derived from measurement, as at 58% of centres, or from the certified value, at 42%. IPEM Report 81 continues to be the most frequently cited source of QC guidance, followed by ESTRO Booklet No. 8.ConclusionsA comprehensive survey of QC practices for HDR/PDR brachytherapy in UK has been conducted. This is a useful reference to which centres may benchmark their own practice. However, individuals should take a risk-assessment based approach, employing full knowledge of local equipment, clinical procedures and available test equipment in order to determine individual QC needs.

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Quality control of brachytherapy equipment in the Netherlands and Belgium: current practice and minimum requirements

Cited by 15 publications

References 15 publications

Clinical implementation, logistics and workflow guide for MRI image based interstitial HDR brachytherapy for gynecological cancers

Clinical implementation, logistics and workflow guide for MRI image based interstitial HDR brachytherapy for gynecological cancers

Use of 2D-Array Ionization Chamber in the Quality Control of High Dose Rate Brachytherapy Treatmet Unit: Dosimetric Feasibility Study

Physics Contributions A survey of quality control practices for high dose rate (HDR) and pulsed dose rate (PDR) brachytherapy in the United Kingdom

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