Australasian brachytherapy audit: Results of the ‘end‐to‐end’ dosimetry pilot study

Haworth, Annette; Wilfert, Lisa; Butler, Duncan; Ebert, Martin A.; Todd, Stephen; Bucci, Joseph; Duchesne, Gillian; Joseph, David; Kron, Tomas

doi:10.1111/1754-9485.12042

Cited by 16 publications

(15 citation statements)

References 16 publications

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“…63 A review of dosimetric audit in brachytherapy has also recently been presented by Palmer et al, 64 considering eight international dosimetry audits published over the last two decades in HDR brachytherapy. [65][66][67] The majority of these were concerned with verification of source strength, 65,66,[68][69][70][71][72] although Haworth et al 67 had undertaken a pilot end-to-end audit in Australia, performed in a jig for straight catheters designed to deliver a uniform dose to the measurement point. Within the UK, a recent co-ordinated audit approach has brought together three Meanwhile, there have also been advances in the techniques, which have been identified for audit within the IPEM interdepartmental audit.…”

Section: Recent National Radiotherapy Dosimetry Audits For More Advanmentioning

confidence: 99%

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

Clark

Aird

Bolton

et al. 2015

BJR

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Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed.

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Section: Recent National Radiotherapy Dosimetry Audits For More Advanmentioning

confidence: 99%

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

Clark

Aird

Bolton

et al. 2015

BJR

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“…Indeed, the high-dose gradients, orders of magnitude variation in dose deposition across clinical regions of interest and small scales, mean measurements to verify absolute dose and dose distribution are challenging. Haworth et al 18 states "to date, dosimetric audits of high dose rate (HDR) facilities have not been conducted in Australia despite the high risks associated with these treatments due to the challenges presented by measuring doses in steep dose gradients". In the UK, the National Cancer Peer Review Programme Manual for Cancer Services: Radiotherapy Measures 14 states there is a requirement that "the department should have taken part in the External Quality Control programme", but this is only specifically listed within the external beam radiotherapy measures, not within the brachytherapy measures.…”

Section: The Need For Audit In Brachytherapymentioning

confidence: 99%

“…MEDLINE and Embase databases were searched, internet search engines utilized and several brachytherapy experts across the world consulted. Eight peer-reviewed journal publications were obtained that presented results of fully completed audits or pilot audits at several centres, involving dosimetric measurement, 18,[37][38][39][40][41][42][43] and one concerned with a geometric applicator reconstruction audit. 44 Two more journal publications presented methodologies for brachytherapy audit currently in progress, 45,46 and the authors are aware of another two audits currently in progress in the UK that are not yet described in the literature: a well-type chamber intercomparison and an alanine dosimetry phantom measurement of source strength, discussed later.…”

Section: Dosimetric Audits In Brachytherapymentioning

confidence: 99%

Section: Dosimetric Audits In Brachytherapymentioning

confidence: 99%

“…One incorporated brachytherapy imaging to assert full system test, 18 and the other used optically stimulated luminescence (OSL) dosimetry as a novel detector for brachytherapy audit. 43 The "end-to-end" brachytherapy audit was conducted at seven clinics in Australia, reported by Haworth et al, 18 as a pilot study to demonstrate feasibility prior to a more complex audit to be devised. The current phantom was based on the design described by Roue et al, 41 using two source dwell positions (630 mm) in each of the three straight catheters with a central TLD measurement in a homogeneous dose region.…”

Section: Dosimetric Audits In Brachytherapymentioning

confidence: 99%

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Dosimetric audit in brachytherapy

Palmer¹,

Bradley²,

Nisbet³

2014

BJR

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Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace.

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Beam quality correction factors for dose measurements around ¹⁹²Ir brachytherapy sources

Thrapsanioti,

Peppa,

Hourdakis

et al. 2024

J Applied Clin Med Phys

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PurposeTo provide beam quality correction factors () for detectors used in 192Ir brachytherapy dosimetry measurements.Materials and MethodsTen detectors were studied, including the PTW 30013 and Exrading12 Farmer large cavity chambers, seven medium (0.1–0.3 cm3) and small (< 0.1 cm3) cavity chambers, and a synthetic microdiamond detector. The kQ,Qo correction factors were calculated at distances from 1 to 10 cm away from an 192Ir source, using the EGSnrc Monte Carlo (MC) code. All detectors were calibrated in a 60Co 10 × 10 cm2 reference field provided by standard calibration laboratories. The impact of the central electrode, stem and wall on the detectors’ responses in 192Ir photon energies was investigated. An experimental procedure was additionally applied for dose measurements around a microSelectron‐v2 192Ir high dose rate (HDR) brachytherapy source using a motorized water phantom.ResultsFarmer chambers underestimated the dose near the source due to signal volume averaging effects, resulting in kQ,Qo values ranging from 1.177 and 1.317 at 1 cm, decreasing with distance to between 0.980 and 1.005 at 10 cm. Small cavity volume detectors should be used close to the source. The kQ,Qo for the studied small and medium cavity volume detectors were found to be close to unity (within 1.3%), showing also a small dependence on source‐to‐detector distance, except for ion chambers containing high‐Z materials in their construction. The presence of high‐Z materials caused an overresponse in these detectors, resulting in kQ,Qo values ranging from 0.950 at 1 cm to 0.729 at 10 cm away from the source. A dose rate constant of (1.114 ± 0.023)cGyh−1U−1 was found in agreement with the literature (within 0.5%).ConclusionskQ,Qo values were calculated for dose measurements around 192Ir brachytherapy sources. Farmer chambers should be preferred for measurements at increased distances, whereas small or medium cavity volume detectors, not containing high‐Z materials, should be used close to the source.

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Australasian brachytherapy audit: Results of the ‘end‐to‐end’ dosimetry pilot study

Cited by 16 publications

References 16 publications

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

Dosimetric audit in brachytherapy

Beam quality correction factors for dose measurements around ¹⁹²Ir brachytherapy sources

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Australasian brachytherapy audit: Results of the ‘end‐to‐end’ dosimetry pilot study

Cited by 16 publications

References 16 publications

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

Dosimetric audit in brachytherapy

Beam quality correction factors for dose measurements around 192Ir brachytherapy sources

Contact Info

Product

Resources

About

Beam quality correction factors for dose measurements around ¹⁹²Ir brachytherapy sources