Antony L Palmer1, Patricia Diez2, Laura Gandon3, Andrea Wynn-Jones3, Peter Bownes3, Chris Lee3, Edwin Aird2, Margaret Bidmead3, Gerry Lowe3, David Bradley4, Andrew Nisbet4. 1. Portsmouth Hospitals NHS Trust, Portsmouth, UK; University of Surrey, Guildford, UK; IPEM RT-SIG Brachytherapy Audit Working Party, UK. Electronic address: antony.palmer@porthosp.nhs.uk. 2. IPEM RT-SIG Brachytherapy Audit Working Party, UK; Radiotherapy Trials Quality Assurance Group, Mount Vernon Cancer Centre, UK. 3. IPEM RT-SIG Brachytherapy Audit Working Party, UK. 4. University of Surrey, Guildford, UK.
Abstract
PURPOSE: To undertake the first multicentre fully 'end to end' dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. MATERIALS AND METHODS: A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. RESULTS: The mean difference between planned and measured dose at Point A was -0.6% for plastic applicators and -3.0% for metal applicators, at standard uncertainty 3.0% (k=1). Isodose distributions agreed within 1mm over a dose range 2-16Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. CONCLUSIONS: The concept of 'end to end' dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved.
PURPOSE: To undertake the first multicentre fully 'end to end' dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. MATERIALS AND METHODS: A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. RESULTS: The mean difference between planned and measured dose at Point A was -0.6% for plastic applicators and -3.0% for metal applicators, at standard uncertainty 3.0% (k=1). Isodose distributions agreed within 1mm over a dose range 2-16Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. CONCLUSIONS: The concept of 'end to end' dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved.
Authors: Alexis Dimitriadis; Antony L Palmer; Russell A S Thomas; Andrew Nisbet; Catharine H Clark Journal: Br J Radiol Date: 2017-05-25 Impact factor: 3.039
Authors: Catharine H Clark; Edwin G A Aird; Steve Bolton; Elizabeth A Miles; Andrew Nisbet; Julia A D Snaith; Russell A S Thomas; Karen Venables; David I Thwaites Journal: Br J Radiol Date: 2015-09-02 Impact factor: 3.039
Authors: Gabriel P Fonseca; Jacob G Johansen; Ryan L Smith; Luc Beaulieu; Sam Beddar; Gustavo Kertzscher; Frank Verhaegen; Kari Tanderup Journal: Phys Imaging Radiat Oncol Date: 2020-09-28