Brachytherapy最新文献

{"title":"3D-printed template design to improve 125I seed plaque assembly accuracy for uveal brachytherapy","authors":"Kaitlyn Calabresi ,&nbsp;Jacqueline Emrich ,&nbsp;Sara Belko ,&nbsp;Robert Pugliese ,&nbsp;Lydia Komarnicky-Kocher ,&nbsp;Firas Mourtada","doi":"10.1016/j.brachy.2025.01.004","DOIUrl":"10.1016/j.brachy.2025.01.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To demonstrate the utility of a QA program for seed localization, and to design a 3D-printed template to improve the accuracy of seed placement on custom-built ¹²⁵I eye plaques for uveal brachytherapy.</div></div><div><h3>Methods and Materials</h3><div>A seed localization analysis tool (SLAT) was developed in MATLAB to detect variations in seed placement relative to a treatment plan. A flexible seed placement template (3D-FSPT) was designed in CAD and printed using a Formlabs Form-3 3D printer. The 3D-FSPT and SLAT were tested using 3D-printed model eye plaques with nonradioactive seeds arranged following clinically-relevant treatment plans. Five clinical plaques were also evaluated.</div></div><div><h3>Results</h3><div>SLAT detected submillimeter scale variations in seed position with 2.3% error relative to the plan's seed coordinates, and with an uncertainty of ± 0.01 mm. The average seed displacement on the model plaques with free-handed seed placement was 1.31 mm (SD = 0.61), and the average seed orientation difference was 5.27 degrees (SD = 4.77). The average seed displacement on the clinical plaques was 0.77 mm (SD = 0.42), and the average seed orientation difference was 4.41 degrees (SD = 3.00). For the clinical plaques, changes in dosimetry to the tumor apex and critical eye structures were within acceptable tolerances. Seed displacement (mm) (<em>p</em> &lt; 0.001) and seed orientation differences (degrees) (<em>p</em> = 0.008) were significantly lower using the template to guide seed placement on the model plaques compared to free-handed seed placement.</div></div><div><h3>Conclusions</h3><div>The feasibility of a 3D-FSPT and SLAT is demonstrated for improving seed placement accuracy relative to a treatment plan.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 420-430"},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do you do it?: Gynecologic brachytherapy best practices at high volume institutions within the United States and Canada","authors":"Christina Small ,&nbsp;Saryleine Ortiz ,&nbsp;Meena Bedi ,&nbsp;Melissa Joyner ,&nbsp;Emma Fields ,&nbsp;Scott Glaser ,&nbsp;Beth Erickson","doi":"10.1016/j.brachy.2024.11.011","DOIUrl":"10.1016/j.brachy.2024.11.011","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Definitive treatment including chemoradiation and brachytherapy for patients diagnosed with locally advanced cervical cancer requires significant multidisciplinary coordination. Our goal was to assess and share gynecologic brachytherapy best practices from high volume brachytherapy centers.</div></div><div><h3>METHODS</h3><div>A survey was sent to 42 centers within the United States and Canada that perform a high volume of complex gynecologic brachytherapy.</div></div><div><h3>RESULTS</h3><div>Responses were collected from 32/42 (76%) institutions. 41% of responding institutions perform &gt; 100 complex brachytherapy procedures per year. Most departments have &gt;1 brachytherapist and 85% of respondents complete 1–2 complex brachytherapy procedures per day. 91% of surveyed departments have support staff specifically devoted to brachytherapy. Approximately 50% of intracavitary/hybrid procedures are performed in departmental brachytherapy suites. Institutions use MRI (35%), CT (24%) or a combination (24%) for treatment planning. 88% of respondents use sedation for tandem based procedures. Respondents cite high complexity of care, insufficient reimbursement, untimely referrals, shared operative and clinical duties, expensive applicator acquisition and complex scheduling as challenging aspects of providing brachytherapy services. Conversely, respondents cite a dedicated team, departmental brachytherapy suite, well organized coordination of procedures and personnel, anesthesia support, a full range of applicators, image-based planning near the department and supportive administration as integral components in providing brachytherapy.</div></div><div><h3>CONCLUSIONS</h3><div>Most surveyed institutions have &gt;1 brachytherapist who perform 1–2 procedures per day in a dedicated brachytherapy space with a team that assists with coordination and scheduling efforts. A well supported multidisciplinary team is vital to ensure state of the art brachytherapy which is essential in curing these challenging malignancies.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 365-370"},"PeriodicalIF":1.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality control study of cervical cancer interstitial brachytherapy treatment plans using statistical process control","authors":"Xiao Chen ,&nbsp;Xiangxiang Shi ,&nbsp;Huaiwen Zhang ,&nbsp;Haowen Pang","doi":"10.1016/j.brachy.2024.12.007","DOIUrl":"10.1016/j.brachy.2024.12.007","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study explored using statistical process control for quality control of cervical cancer interstitial brachytherapy treatment plans.</div></div><div><h3>MATERIALS AND METHODS</h3><div>For retrospective analysis, interstitial brachytherapy treatment plans were divided into first (<em>n</em> = 300) and second phases (<em>n</em> = 200). The first phase was chronologically divided 2:1 into training and validation sets. The Dn2cm³ (D2cm³ divided by the high-risk clinical target volume D90) of the organs at risk (the bladder, rectum, and sigmoid colon) were analyzed to draw individual control charts. Process capability analysis charts were drawn, and the statistical process capability was evaluated using the process capability index C_pk. The centerline of the organ at risk dose in the first-phase plan's training set was used as the optimization parameter for the second-phase dataset plan.</div></div><div><h3>RESULTS</h3><div>The Dn2cm³ centerlines for the bladder, rectum, and sigmoid colon were 0.6980, 0.5440, and 0.4910 in the training set and 0.6845, 0.4528, and 0.4144 in the second phase, respectively. The first-phase δ values were 0.0099, 0.0530, and 0.0268, respectively. The process capability analysis for the first and second phases showed that all indicators had a C_pk &gt;1.</div></div><div><h3>CONCLUSION</h3><div>For all organs at risk, the Dn2cm³ centerlines were lower in the second phase than in the first phase, indicating that quality control of cervical cancer interstitial brachytherapy treatment plans continuously improved through statistical process control. This method is simple and practical and warrants promotion for application in radiotherapy treatment plan quality control.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 371-378"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haralick texture feature analysis for Monte Carlo dose distributions of permanent implant prostate brachytherapy","authors":"Iymad R. Mansour ,&nbsp;Nelson Miksys ,&nbsp;Luc Beaulieu ,&nbsp;Éric Vigneault ,&nbsp;Rowan M. Thomson","doi":"10.1016/j.brachy.2024.08.256","DOIUrl":"10.1016/j.brachy.2024.08.256","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Demonstrate quantitative characterization of 3D patient-specific absorbed dose distributions using Haralick texture analysis, and interpret measures in terms of underlying physics and radiation dosimetry.</div></div><div><h3>METHODS</h3><div>Retrospective analysis is performed for 137 patients who underwent permanent implant prostate brachytherapy using two simulation conditions: “TG186” (realistic tissues including 0–3.8% intraprostatic calcifications; interseed attenuation) and “TG43” (water-model; no interseed attenuation). Five Haralick features (homogeneity, contrast, correlation, local homogeneity, entropy) are calculated using the original Haralick formalism, and a modified approach designed to reduce grey-level quantization sensitivity. Trends in textural features are compared to clinical dosimetric measures (D90; minimum absorbed dose to the hottest 90% of a volume) and changes in patient target volume % intraprostatic calcifications by volume (%IC).</div></div><div><h3>RESULTS</h3><div>Both original and modified measures quantify the spatial differences in absorbed dose distributions. Strong correlations between differences in textural measures calculated under TG43 and TG186 conditions and %IC are observed for all measures. For example, differences between measures of contrast and correlation increase and decrease respectively as patients with higher levels of %IC are evaluated, reflecting the large differences across adjacent voxels (higher absorbed dose in voxels with calcification) when calculated under TG186 conditions. Conversely, the D90 metric is relatively weakly correlated with textural measures, as it generally does not characterize the spatial distribution of absorbed dose.</div></div><div><h3>CONCLUSION</h3><div>Patient-specific 3D dose distributions may be quantified using Haralick analysis, and trends may be interpreted in terms of fundamental physics. Promising future directions include investigations of novel treatment modalities and clinical outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 122-133"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of MRI-based planning in transperineal interstitial brachytherapy for locally advanced cervix tumors: Clinical, dosimetric and toxicity outcomes","authors":"Diana Guevara Barrera ,&nbsp;Silvia Rodríguez Villalba ,&nbsp;Luis Suso-Martí ,&nbsp;Enrique Sanchis-Sánchez ,&nbsp;Jose Perez-Calatayud ,&nbsp;Jose Domingo Lago Martín ,&nbsp;Francisco Blázquez Molina ,&nbsp;Manuel Santos Ortega","doi":"10.1016/j.brachy.2024.10.005","DOIUrl":"10.1016/j.brachy.2024.10.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To compare dosimetric characteristics, clinical outcomes, and toxicity in patients with locally advanced cervical cancer(LACC) treated with transperineal interstitial brachytherapy(P-ISBT), using CT-based planning or MRI-based planning with a monoinstitutional MRI-compatible applicator, Template Benidorm(TB).</div></div><div><h3>MATERIALS AND METHODS</h3><div>We retrospectively analyzed 106 women treated with P-ISBT for LACC from 2006 to 2022. P-ISBT was CT-based, with Martinez Universal Perineal Interstitial Template(MUPIT) between 2006 and 2012, or MRI-based planning (TB) since 2013. Volumetric, clinical, and dosimetric parameters were compared between applicators.</div></div><div><h3>RESULTS</h3><div>Forty-six (43.4%) patients were treated with MUPIT, and 60 (56.6%) with TB. Median follow-up was 42 months (4–188). No significant difference was observed in 5-year local control (LC), regional control (RC), distant failure (DF), overall survival (OS), and disease-specific survival (DSS) between applicators. The TB cohort had fewer needles (<em>p = 0.001</em>), halved median CTV volume (<em>p &lt; 0.001</em>), increased median D_90%CTV dose (<em>p &lt; 0.005</em>), and lower D_2cc values in rectum/bladder (<em>p &lt; 0.001</em>). G3 chronic toxicity was 15% in the MUPIT group and 6% in TB (<em>p = 0.15</em>), with no G4 toxicity reported. Rectal hemorrhage was lower in the TB group (<em>p = 0.002</em>). Larger CTV volumes correlated with higher rectal D2cc and rectal hemorrhage (<em>p = 0.001; p = 0.029</em>, respectively), and enterovaginal fistula (<em>p = 0.03; p &lt; 0.001</em>, respectively). Median CTV volume was 152.82 cc (35.3–256.78) in patients with chronic rectal toxicity and 102.9 cc (21.4–329.41) in those without (<em>p = 0.001</em>).</div></div><div><h3>CONCLUSION</h3><div>MRI's superior CTV-volume definition results in smaller treatment volumes, lower D_2cc for rectum and bladder, and a trend towards higher CTV D_90%. Rectal hemorrhage was significantly lower in the MRI-based group. A significant correlation was observed between larger CTV-volumes, higher rectal D_2cc and rectal hemorrhage/enterovaginal fistula.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 134-143"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of balloon rectal spacer implantation in HDR and LDR brachytherapy for prostate cancer treatment","authors":"Tomer Charas,&nbsp;Salem Billan","doi":"10.1016/j.brachy.2024.10.003","DOIUrl":"10.1016/j.brachy.2024.10.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>This study evaluates the use of a biodegradable balloon rectal spacer in two prostate cancer patients undergoing low dose radiation (LDR) and salvage high dose radiation (HDR) brachytherapy. The spacer aims to reduce radiation dose to adjacent organs, particularly the rectum, in patients previously treated with radiation.</div></div><div><h3>METHODS</h3><div>The balloon spacer was implanted transperineally under transrectal ultrasonography (TRUS) guidance in two patients. For the LDR case (73-year-old, intermediate-risk), the balloon was placed postimplant with 55 iodine-125 seeds delivering 145 Gy. For the HDR case (66-year-old, high-risk), the balloon was placed one week before treatment, which delivered 23 Gy in two weekly fractions using 16 channels.</div></div><div><h3>RESULTS</h3><div>The balloon provided a 14-15mm separation between rectum and prostate. In the LDR case, prostate D90 was 149.1Gy (102.83%), V100 was 91.95%, and rectum D30 was 23.93Gy (16.50%). For the HDR case, prostate D90 was 11.63Gy (105.79%), V100 was 93.63%, and rectum D0.5cc was 8.04Gy (73.15%). Both patients tolerated the treatment well, with no observed postoperative complications at 6-month follow-up.</div></div><div><h3>CONCLUSIONS</h3><div>The use of a rectal balloon spacer in both salvage HDR and LDR brachytherapy is feasible and safe, allowing for controlled placement and providing rectal protection from high radiation doses.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 186-189"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image guided cervical brachytherapy practice patterns: 2023/2024 survey of the American brachytherapy society","authors":"Elizabeth A. Kidd ,&nbsp;Santino S. Butler ,&nbsp;Ulysses Gardner Jr ,&nbsp;Akila N. Viswanathan","doi":"10.1016/j.brachy.2024.10.013","DOIUrl":"10.1016/j.brachy.2024.10.013","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>An update of the 2007 and 2014 surveys of the American Brachytherapy Society (ABS) will elucidate current practice patterns of cervical cancer brachytherapy.</div></div><div><h3>METHODS</h3><div>A 40-question survey was sent to all ABS members in June-July 2023 and February 2024; 167 responses were received, with 140 used for analysis. Results were compared to the 2014 survey using chi-squared testing. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI) for outcomes of interest.</div></div><div><h3>RESULTS</h3><div>Compared to 2014, MRI use for treatment planning of the first brachytherapy fraction increased from 34% to 63% (<em>p</em> &lt; 0.001), prescription to the high-risk clinical target volume (HR-CTV) increased from 52% to 94% (<em>p</em> &lt; 0.001), while Point A prescription decreased from 42% to 16% (<em>p</em> &lt; 0.001). Additionally, procedural guidance with ultrasound significantly increased (79% vs. 32%, <em>p</em> &lt; 0.001) along with the use of interstitial needles (always or nearly always, &gt;80%) (29% vs. 4%, <em>p</em> &lt; 0.001). MRI availability around the time of procedure was the largest challenge to incorporating MRI into brachytherapy treatment planning. Compared to those with MRI access reserved specifically for Radiation Oncology, respondents with shared-access or out-of-department MRI were less likely to obtain treatment planning MRIs for each brachytherapy fraction (22% vs. 75%; aOR 0.10 [95% CI, 0.03–0.30], <em>p</em> &lt; 0.001).</div></div><div><h3>CONCLUSION</h3><div>For cervix cancer brachytherapy there has been significant increase in the use of MRI-based volumetric brachytherapy treatment planning, ultrasound guidance during procedures and the addition of interstitial needles. These advancements in practice patterns are congruent with published consensus guidelines and ongoing training initiatives. However, MRI access and lack of easy availability continue to be significant challenges for optimizing cervix brachytherapy.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 18-29"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definitive treatment for primary urethral cancer: A single institution's experience with organ-preserving brachytherapy","authors":"R. Merten ,&nbsp;V. Strnad ,&nbsp;A. Karius ,&nbsp;M. Lotter ,&nbsp;S. Kreppner ,&nbsp;C. Schweizer ,&nbsp;R. Fietkau ,&nbsp;P. Schubert","doi":"10.1016/j.brachy.2024.09.001","DOIUrl":"10.1016/j.brachy.2024.09.001","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Radical urethectomy ± cystectomy has long represented the standard of care for rare primary urethral cancer (PUC). With our analysis, we want to demonstrate the efficacy and safety of brachytherapy (BT) of urethra for organ preservation.</div></div><div><h3>MATERIALS AND METHODS</h3><div>We analyzed treatment procedures and results of 3 patients with PUC, which have been treated in our department between 2011 and 2020 with brachytherapy. One male patient underwent brachytherapy with chemoradiotherapy after transurethral resection (TUR). Brachytherapy has been performed as high-dose-rate (HDR) boost with a cumulative dose of 8 Gy (9.3 Gy _{EQD2-α/β = 10 Gy}). The 2 further female patients have been treated with sole pulsed-dose-rate (PDR) brachytherapy with a total dose of 49.9 Gy (50.3 Gy _{EQD2-α/β = 10 Gy}) and 62.2 Gy (64.6 Gy _{EQD2-α/β = 10 Gy}).</div></div><div><h3>RESULTS</h3><div>Median follow-up was 103 months (41–153). No local recurrence occurred and all patients are still alive. For the male patient we documented Grade 3 cystitis. As late side effects the pre-existing Grade 2 incontinence worsened to Grade 3. Among female patients one developed Grade 3 vaginal synechiae. There was no Grade ≥4 toxicity.</div></div><div><h3>CONCLUSION</h3><div>Brachytherapy in PUC is a feasible and promising option with high local control rate and tolerable toxicity. It provides a good alternative to surgery for organ preservation in selected patients.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 62-67"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and implementation of a brachytherapy procedure scoring system to optimize clinic and physics staffing schedule: A retrospective study of a single institution with a busy brachytherapy program","authors":"Arjit Baghwala,&nbsp;Chengfeng Li,&nbsp;Devin Olek,&nbsp;Forrest Ivey,&nbsp;Ramiro Pino,&nbsp;Andrew Farach","doi":"10.1016/j.brachy.2024.10.007","DOIUrl":"10.1016/j.brachy.2024.10.007","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Brachytherapy (BT) is a time and resource intensive treatment modality. Constraints to efficiency and throughput include resource, staff and physician availability. Herein, we introduce a daily BT procedure scorecard, designed to ensure adequate resource allocation based on the type of procedure(s) being performed.</div></div><div><h3>METHODS</h3><div>Data on BT procedures, number of fractions, number of patients, and the average daily caseload from 2021 to 2024 in our clinic were collected. Each BT procedure was assigned a score from 1 to 3 based on complexity and labor intensity, with 1 representing the least and 3 the most complex procedures. This data was then used to evaluate the efficiency of the BT scoring system.</div></div><div><h3>RESULTS</h3><div>Implementing the BT scorecard improved scheduling efficiency without compromising patient throughput. Despite the growth in case complexity, we demonstrated that the scoring system effectively prevents understaffing in our clinics. The goal is to limit the daily BT score to 10 per day when creating the schedule, ensuring balanced resource allocation.</div></div><div><h3>CONCLUSION</h3><div>The strategies presented can enhance scheduling by ensuring an equitable workload distribution based on the BT schedule. These approaches should be considered in all high-volume BT clinics to optimize patient scheduling and throughput. Additionally, the scoring system allows clinics to develop full-time equivalent (FTE) staffing models that account for patient volume and case types, ensuring optimal resource utilization.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 190-196"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of an absolute measurement of the reference air kerma rate for HDR 192Ir brachytherapy sources","authors":"Jinpeng Han ,&nbsp;Shijie Zhi ,&nbsp;Peiwei Wang ,&nbsp;Ji Wang ,&nbsp;Zhijun Yang ,&nbsp;Kun Wang ,&nbsp;Xingtao An","doi":"10.1016/j.brachy.2024.09.006","DOIUrl":"10.1016/j.brachy.2024.09.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Before this study, no institution in China had undertaken the calculation and official establishment of reference values for the reference air kerma rate associated with high-dose rate ¹⁹²Ir sources used in brachytherapy. This research, carried out at the National Institute of Metrology (NIM) in China, has successfully established an ¹⁹²Ir reference radiation facility. Consequently, it has achieved the absolute measurement of the reference air kerma rate for high-dose rate brachytherapy using ¹⁹²Ir sources.</div></div><div><h3>METHODS AND MATERIALS</h3><div>For this study, a medical afterloader machine was acquired. The radiation source employed was a high-dose rate ¹⁹²Ir source for brachytherapy, produced by HTA Co., Ltd. A reference graphite cavity ionization chamber with a volume of 100 cm³ was designed to serve as the ionization chamber for absolute measurements. The determination of various correction factors and physical constants was achieved through a method that combines Monte Carlo simulations with experimental techniques.</div></div><div><h3>RESULTS</h3><div>The study successfully accomplished the absolute measurement of the reference air kerma rate for the high-dose rate brachytherapy ¹⁹²Ir radiation source. The expanded uncertainty of the measurement results was 0.72% (k = 2). The relative standard deviation for the RAKR of the same ¹⁹²Ir radiation source was 0.073%.</div></div><div><h3>CONCLUSIONS</h3><div>This study marks a significant advancement in the field of radiation therapy in China, particularly in the accurate dosimetry for brachytherapy using high-dose rate ¹⁹²Ir sources. The study will contribute to the BIPM.RI(I)-K8 international comparison, organized by the Bureau International des Poids et Mesures (BIPM), thus facilitating the international recognition of the measurement values.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 110-121"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}