Department of Radiation Oncology, Saitama Medical University International Medical Center, Saitama, Japan.
Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
J Appl Clin Med Phys. 2020 Dec;21(12):84-89. doi: 10.1002/acm2.13063. Epub 2020 Nov 2.
This study aimed to develop a high-dose-rate brachytherapy (HDR-BT) quality assurance (QA) tool for verification of source positions, and to report on its effectiveness.
We fabricated a cuboid phantom measuring 30 × 30×3 cm with spaces to embed Fletcher-Williamson tandem and ovoid applicators. Lead-based, cylindrically shaped radiopaque markers, which scatter radiation and blacken the Gafchromic RTQA2 films placed on the applicators, were inserted into the phantom to determine the applicator tip and reference source positions. A three-dimensional image-guided brachytherapy (3D-IGBT) plan was generated, and the source positions on the film and radiation treatment planning system (RTPS) were verified with the tool. Source position errors were evaluated as the distance in the applicator axis direction between the source position and the center position of two radiopaque marker pairs.
Source position errors on the film and RTPS were in good agreement with one another and were all within 0.5 mm for all applicators. Offset values of each applicator were in good agreement with the value determined in treatment planning (6 mm). The expanded measurement uncertainty of our QA tool was estimated to be 0.87 mm, with a coverage factor k of 2.
Our new HDR-BT QA tool developed for comprehensive source position verification will be useful for cross checking actual source positions and planned source positions on the RTPS.
本研究旨在开发一种用于验证源位置的高剂量率近距离放射治疗(HDR-BT)质量保证(QA)工具,并报告其有效性。
我们制作了一个 30×30×3cm 的长方体体模,其中有空位可嵌入 Fletcher-Williamson 施源器和卵圆形施源器。将具有放射性不透性的圆柱形铅制标记物插入体模中,这些标记物会散射辐射并使放置在施源器上的 Gafchromic RTQA2 胶片变黑,以确定施源器尖端和参考源位置。生成了一个三维图像引导近距离放射治疗(3D-IGBT)计划,并使用该工具验证胶片和放射治疗计划系统(RTPS)上的源位置。源位置误差评估为源位置与两个放射性不透性标记物对中心位置在施源器轴向上的距离。
胶片和 RTPS 上的源位置误差彼此之间非常吻合,所有施源器的误差均在 0.5mm 以内。每个施源器的偏移值与治疗计划中确定的值(6mm)非常吻合。我们的 QA 工具的扩展测量不确定度估计为 0.87mm,覆盖因子 k 为 2。
我们为全面验证源位置开发的新 HDR-BT QA 工具将有助于交叉检查 RTPS 上的实际源位置和计划源位置。