Brachytherapy最新文献

{"title":"On the value of an EM tracking quality assurance system for pretreatment verification of needle digitization accuracy in ultrasound-based prostate HDR brachytherapy.","authors":"Christopher L Deufel, Eric E Brost, Justine M Dupere, Jessica M Wilson, Mark R Waddle, Bradley J Stish","doi":"10.1016/j.brachy.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.01.003","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and deploy an electromagnetic (EM) tracking-based platform for pretreatment, patient-specific quality assurance of brachytherapy applicator digitization, with the goals of intercepting human errors and quantifying treatment planning dose uncertainties.</p><p><strong>Methods: </strong>An EM tracking platform, EMQA, was developed for patient-specific quality assurance of HDR treatment plan needle reconstructions. EMQA compared needle geometry between a manually digitized clinical HDR treatment plan and EM-tracked positions. Pretreatment quality assurance (QA) was performed for 25 implants (20 patients). Distance and dose metric differences were reported. Factors influencing accuracy were analyzed, including radial distance from the ultrasound probe and EM field generator (EFG), needle 'shadowing' artifacts, needle depth adjustments using exposed needle length protruding from the implant template, and TRUS calibrated speed of sound, v_{SoundEffective}.</p><p><strong>Results: </strong>Needle digitization differences between the clinical plan and EM tracking had a magnitude (mean ± standard deviation [minimum, maximum]) of 0.46 ± 0.36 (0.002, 2.19) millimeters for the needle depths and 0.62 ± 0.44 (0.01, 3.26) millimeters for needle shafts. Dose metric differences (% of Rx) for PTV, CTV, bladder, rectum, and urethra were <1.7% on average, but differences >5% were observed in two patients. Accuracy was notably worse for locations shadowed by more than one needle, decreased with distance from the probe and EFG, and was optimal for v_{SoundEffective}=1570 m/s.</p><p><strong>Conclusion: </strong>Clinical evaluation of an EMQA platform demonstrated the potential to intercept errors in the digital reconstruction of ultrasound-based prostate HDR brachytherapy needles prior to radiation delivery, which may be due to poor image quality or human error. Manual needle digitization accuracy was typically submillimeter, however errors as great as 3 mm were observed. The adoption of EMQA as standard of care is expected to reduce the potential for mistreatment.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed template design to improve ¹²⁵I seed plaque assembly accuracy for uveal brachytherapy.","authors":"Kaitlyn Calabresi, Jacqueline Emrich, Sara Belko, Robert Pugliese, Lydia Komarnicky-Kocher, Firas Mourtada","doi":"10.1016/j.brachy.2025.01.004","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.01.004","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods and materials: </strong>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.</p><p><strong>Results: </strong>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) (p < 0.001) and seed orientation differences (degrees) (p = 0.008) were significantly lower using the template to guide seed placement on the model plaques compared to free-handed seed placement.</p><p><strong>Conclusions: </strong>The feasibility of a 3D-FSPT and SLAT is demonstrated for improving seed placement accuracy relative to a treatment plan.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed needle guides for cervical cancer brachytherapy: Optimized dosimetry and improved local control outcomes.","authors":"Santino Butler, Thomas Niedermayr, Elizabeth A Kidd","doi":"10.1016/j.brachy.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.01.001","url":null,"abstract":"<p><strong>Purpose: </strong>We previously designed three-dimensionally-printed needle guides (3D-NG) for cervical cancer brachytherapy, which improved procedure efficiency and tumor coverage while achieving similar organs at risk (OAR) sparing compared to non-3D-printed techniques (non-3D). The subject of this study was whether 3D-NG can help improve local control and other brachytherapy outcomes.</p><p><strong>Methods: </strong>This single institution cohort study includes 130 patients who underwent definitive external-beam radiotherapy and high-dose-rate intracavitary +/- interstitial brachytherapy from February 2017 to July 2023. 3D-NG were implemented for all cases after December 2019 (N = 77). Non-3D included applicator-only/no-needles (N = 28) or freehand-placed needles (N = 25).</p><p><strong>Results: </strong>Median follow-up was 24 months. 3D-NG, versus non-3D, achieved higher mean D90 (+5.2 Gy, p < 0.001), D98 (+4.3 Gy, p < 0.001), and V100_average (+5.9%, p < 0.001)-with greater improvement for larger tumors (high-risk[HR]-CTV>30 cubic-centimeters[cc]) (P_interaction<0.10 for all). Maximum D2cc for all OAR were comparable between 3D-NG and non-3D (p > 0.05). 2-year LF was lower with 3D-NG compared to non-3D (8.2% vs. 22.0%; aHR 0.31, p = 0.036)-and compared to freehand-needles alone (8.2% vs. 20.6%, p < 0.001 [log-rank])-particularly among cases with higher cumulative HR-CTV dose (D90 >85 Gy; p_interaction = 0.013) and lower HR-CTV volume (≤30 cc; p_interaction = 0.048). 2-year LF was also lower with concurrent cisplatin (aHR 0.20, p = 0.001) and ≥40% decrease in tumor diameter after EBRT (aHR 0.16, p = 0.010); but higher among minority race (aHR 4.21, p = 0.06).</p><p><strong>Conclusions: </strong>3D-NG for cervix brachytherapy were associated with improved 2-year LF compared to non-3D/freehand-needles, with higher achievement of EMBRACE II goals for D90 and D98, with similar OAR doses. This study highlights the potential for 3D-NG to simplify needle insertion while simultaneously improving needle position, dosimetry, and disease control outcomes.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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, Saryleine Ortiz, Meena Bedi, Melissa Joyner, Emma Fields, Scott Glaser, Beth Erickson","doi":"10.1016/j.brachy.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.11.011","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>A survey was sent to 42 centers within the United States and Canada that perform a high volume of complex gynecologic brachytherapy.</p><p><strong>Results: </strong>Responses were collected from 32/42 (76%) institutions. 41% of responding institutions perform > 100 complex brachytherapy procedures per year. Most departments have >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.</p><p><strong>Conclusions: </strong>Most surveyed institutions have >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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","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, Xiangxiang Shi, Huaiwen Zhang, Haowen Pang","doi":"10.1016/j.brachy.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>This study explored using statistical process control for quality control of cervical cancer interstitial brachytherapy treatment plans.</p><p><strong>Materials and methods: </strong>For retrospective analysis, interstitial brachytherapy treatment plans were divided into first (n = 300) and second phases (n = 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.</p><p><strong>Results: </strong>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 >1.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed radiopaque episcleral plaques with radioactive collimating cavities for enhanced dose delivery in brachytherapy.","authors":"Souheib Zekraoui, Théophraste Lescot, Mahdokht Akbari Taemeh, Marc-André Fortin","doi":"10.1016/j.brachy.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.12.001","url":null,"abstract":"<p><strong>Purpose: </strong>Episcleral plaque brachytherapy (EPBT) is a well-established treatment. However, the lateral dose to healthy tissues, such as the sclera, retina, and optic nerve is often problematic and results in side effects. This study proposes an innovative approach based on the 3D-printing of radiopaque polymer plaques featuring cylindrical radioactive cavities (CRC) with a potential collimating effect on radiation delivery to tumors.</p><p><strong>Methods and materials: </strong>A CAD model based on the COMS protocol was created and 3D-printed using radiopaque PEEK polymer. Cylindrical cavities (1 mm depth/diameter) were evenly spaced on the plaque's inner surface. Two radioactive layouts (RL₁: uniform loading; RL₂: radial gradient loading) were designed. µCT imaging was used to assess the geometric accuracy of the 3D-printed CRC EPs, and dose distribution was evaluated for the two (2) radioactive layouts using MAGIC-pf gel dosimetry and T₂-weighted MRI. The resulting dose profiles were compared with those generated by both COMS and SEP plaques.</p><p><strong>Results: </strong>Radiopaque CRC EPs showed higher central axis dose deposition while minimizing lateral overexposure compared to COMS and SEP plaques, while also providing robust back-shielding. Dose profiles from RL₁ CRC EPs (uniform layout) extended deeper into the eye, whereas RL₂ CRC EPs (with gradient) exhibited a more rapid dose fall-off, producing a concentrated, spherical dose distribution.</p><p><strong>Conclusions: </strong>3D-printed radiopaque EPs with radioactivity encapsulated in cylindrical cavities demonstrated the ability to achieve more forward-projected dose profiles in EPBT. This fabrication design and a modulated radioactivity distribution across the EP surface would enable more precise and deeper dose delivery while reducing radiation exposure to lateral healthy tissues.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound and CT-guided implantation of iodine-125 seeds combined with transarterial chemoembolization for recurrent hepatocellular carcinoma at complex sites after hepatectomy.","authors":"Yeyan Wang, Jie Feng","doi":"10.1016/j.brachy.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.12.002","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the efficacy and safety of TACE combined with 125I seeds (TACE-125I) in the treatment of recurrent HCC at complex sites after hepatectomy.</p><p><strong>Methods: </strong>This study retrospectively analyzed the clinical data of recurrent HCC patients located at complex sites (such as large blood vessels, diaphragm dome, etc.) after hepatectomy from January 2012 to December 2023, all of whom received TACE-125I or TACE therapy. Recur rence, overall survival (OS), progression-free survival (PFS) and complications were compared be tween the 2 groups.</p><p><strong>Results: </strong>A total of 152 patients with recurrent HCC were enrolled in this study, including 69 in the TACE-125I group and 83 in the TACE group. During follow-up, a total of 41 patients in the TACE-125I group experienced tumor recurrence, compared to 67 patients in the TACE group. The median OS in the TACE-125I group was 31 months, which was significantly higher than that in the TACE group (16 months, p < 0.001). Similarly, the median PFS was significantly higher in the TACE-125I group than in the TACE group.</p><p><strong>Conclusions: </strong>Compared with TACE treatment, TACE-125I may be a more effective method for the treatment of recurrent HCC located at complex sites.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HDR brachytherapy combined with external beam radiotherapy for unfavorable localized prostate cancer: A single center experience from inception to standard of care.","authors":"Ka-Kit David Yeung, Juanita Crook, Gregory Arbour, Cynthia Araujo, Deidre Batchelar, David Kim, David Petrik, Tracey Rose, Francois Bachand","doi":"10.1016/j.brachy.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.12.005","url":null,"abstract":"<p><strong>Purpose: </strong>High dose rate (HDR) brachytherapy is increasingly adopted for dose escalation in prostate cancer treatment. We report the clinical efficacy and toxicity of HDR prostate brachytherapy combined with external beam radiotherapy (EBRT) and evaluate the predictability of the biochemical definition of cure of 4-year PSA ≤0.2 ng/mL for failure free survival (FFS).</p><p><strong>Methods: </strong>A single centre retrospective study was conducted, including all patients with high-tier intermediate risk and high-risk prostate cancer treated with HDR brachytherapy combined with EBRT from 2011 to 2019. Patient and prostate cancer characteristics, treatment, clinical endpoints, and follow up were collected.</p><p><strong>Results: </strong>Total 319 patients were analyzed. The median age was 68 with median follow up of 77.1 months. Total 142 had high-tier intermediate and 177 had high-risk disease. Brachytherapy doses were initially 20 Gy/2 fractions, and subsequently 15 Gy/1 fraction. All patients received 46 Gy/23 fractions of EBRT. Overall survival at 5 and 9 years was 92.2% and 77.0%, respectively. Failure-free survival (FFS) was 86.0% at 5 years and 76.1% at 9 years. PSA ≤ 0.2 ng/mL at 4 years was seen in 79.3% of patients and was associated with FFS of 94.1% at 9 years. Grade 3 urethral stricture, hematuria, or proctitis occurred in 2.8%, 0%, and 0%, respectively.</p><p><strong>Conclusion: </strong>HDR brachytherapy in addition to EBRT is effective treatment for unfavourable localized prostate cancer with a very acceptable toxicity profile. The biochemical definition of cure of PSA < 0.2 ng/mL at 4 years was predictive for FFS at 9 years.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From patient to pioneer: The inspiring journey of Dr. Brian Moran.","authors":"Manuj Agarwal, Peter Orio","doi":"10.1016/j.brachy.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.11.002","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve and proficiency assessment for gynecological brachytherapy amongst radiation oncology trainees in India: Results from a prospective study.","authors":"Bharath Kumar, Prachi Mittal, Ankita Gupta, Jaahid Mulani, Rajesh Bhajbhuje, Sadhana Kannan, Jeevanshu Jain, Supriya Chopra","doi":"10.1016/j.brachy.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.11.013","url":null,"abstract":"<p><strong>Purpose: </strong>The quality of cervical cancer intracavitary brachytherapy (ICBT) depends on the training and experience of the radiation oncologist (RO). The present study was performed to establish primary learning curve for ICBT.</p><p><strong>Materials and methods: </strong>Forty-three skill parameters were identified for performing ICBT and were included for Brachytherapy Proficiency Assessment and Scoring System (Brachy-PASS) questionnaire. Brachy-PASS score was first compared with blinded objective scoring of implant quality for 10 trainees by two ROs. Twenty eight consecutive trainees were scored with Brachy-PASS by two RO's. The impact of number of procedures and training years was ascertained using Mann Whitney-U test. Minimum number of intracavitary procedures to attain proficiency (score≥ 75%) were ascertained and learning curve plot of proficiency and procedures was generated.</p><p><strong>Results: </strong>Between January, 2022 to September, 2023 38 trainees were evaluated (20: post graduate year (PGY) 1-3, and 18: PGY 4-5) after due consent for skill evaluation. Good congruence was reported of objective scoring and Brachy-PASS (83.4% vs 88%). Ten trainees had performed <15 ICBT, and 28 had performed ≥15 ICBT procedures. Overall 30/38 trainees (78.9%) achieved a Brachy-PASS score of ≥129 (75%). The average score for trainees with <15 procedures was 126.6 (73.6%) vs 148.8 (86.5%) in trainees who performed ≥15 procedures. PGY 4-5 trainees had higher score (153.8 (89.4%) vs 134 (77.9%)). Learning curve threshold of 15 ICBT was identified to attain 75% score (129/172) with no plateauing of learning curve even with ≥30 procedures.</p><p><strong>Conclusion: </strong>Competency is established for independently performing intracavitary brachytherapy at 15 procedures and further increase in competency scores continues with increasing procedures.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}