The routine quality assurance (QA) procedure for a high‐dose‐rate (HDR) 192Ir radioactive source is an important task to provide appropriate brachytherapy. Traditionally, it has been difficult to obtain good quality images using the 192Ir source due to irradiation from the high‐energy gamma rays. However, a direct‐conversion flat‐panel detector (d‐FPD) has made it possible to confirm the localization and configuration of the 192Ir source. The purpose of the present study was to evaluate positional and temporal accuracy of the 192Ir source using a d‐FPD system, and the usefulness of d‐FPD as a QA tool. As a weekly verification of source positional accuracy test, we obtained 192Ir core imaging by single‐shot radiography for three different positions (1300/1400/1500 mm) of a check ruler. To acquire images for measurement of the 192Ir source movement distance with varying interval steps (2.5/5.0/10.0 mm) and temporal accuracy, we used the high‐speed image acquisition technique and digital subtraction. For accuracy of the 192Ir source dwell time, sequential images were obtained using various dwell times ranging from 0.5 to 30.0 sec, and the acquired number of image frames was assessed. Analysis of the data was performed using the measurement analysis function of the d‐FPD system. Although there were slight weekly variations in source positional accuracy, the measured positional errors were less than 1.0 mm. For source temporal accuracy, the temporal errors were less than 1.0%, and the correlation between acquired frames and programmed time showed excellent linearity (normalR2=1). All 192Ir core images were acquired clearly without image halation, and the data were obtained quantitatively. All data were successfully stored in the picture archiving and communication system (PACS) for time‐series analysis. The d‐FPD is considered useful as the QA tool for the 192Ir source.PACS number: 87.56.Fc

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In high-dose-rate (HDR) brachytherapy, a direct-conversion flat-panel detector (d-FPD) clearly depicts a Ir source without image halation, even under the emission of high-energy gamma rays. However, it was unknown why iridium is visible when using a d-FPD. The purpose of this study was to clarify the reasons for visibility of the source core based on physical imaging characteristics, including the modulation transfer functions (MTF), noise power spectral (NPS), contrast transfer functions, and linearity of d-FPD to high-energy gamma rays. The acquired data included: x-rays, [X]; gamma rays, [γ]; dual rays (X  +  γ), [D], and subtracted data for depicting the source ([D]  -  [γ]). In the quality assurance (QA) test for the positional accuracy of a source core, the coordinates of each dwelling point were compared between the planned and actual source core positions using a CT/MR-compatible ovoid applicator and a Fletcher-Williamson applicator. The profile curves of [X] and ([D]  -  [γ]) matched well on MTF and NPS. The contrast resolutions of [D] and [X] were equivalent. A strongly positive linear correlation was found between the output data of [γ] and source strength (r > 0.99). With regard to the accuracy of the source core position, the largest coordinate difference (3D distance) was noted at the maximum curvature of the CT/MR-compatible ovoid and Fletcher-Williamson applicators, showing 1.74  ±  0.02 mm and 1.01  ±  0.01 mm, respectively. A d-FPD system provides high-quality images of a source, even when high-energy gamma rays are emitted to the detector, and positional accuracy tests with clinical applicators are useful in identifying source positions (source movements) within the applicator for QA.

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