Brachytherapy最新文献

{"title":"Transition from pulsed dose rate to high dose rate brachytherapy: Experience of a single centre.","authors":"S Renard, E Meknaci, C Cuisinier, J Perrin-Lhuillier, L Lemoine, M Bruand, C Charra-Brunaud, J F Py, N Demogeot, N Martz, I Buchheit, V Marchesi, D Peiffert","doi":"10.1016/j.brachy.2025.03.004","DOIUrl":"10.1016/j.brachy.2025.03.004","url":null,"abstract":"<p><strong>Background: </strong>In February 2021, the Brachytherapy department of the Lorraine Cancer Institute began a transition away from pulsed dose rate (PDR) towards high dose rate (HDR) brachytherapy, for gynaecological cancer, cancers of the oral cavity, oropharynx and anal canal, penile cancer and sarcoma. We describe our experience here; for the benefit of other brachytherapy departments that may be envisaging a similar transition in care.</p><p><strong>Medical viewpoint: </strong>Fractionation. The 7 brachytherapists of our unit performed a literature search then validated, in a group meeting, the different fractionation regimens. The aim was to select HDR fractionation regimens that would produce comparable results to PDR in terms of tumor control and toxicity, following the recommendations of the GEC-ESTRO, when such guidelines exist. We also chose fractionation regimens that would avoid patients having the brachytherapy device in place over the weekend. The most difficult decisions related to rare indications where only very small series exist. Cohorts of patients treated with HDR will be followed up closely over time. To date, no unexpected toxicity has been observed. It is no longer necessary to have a physician on call at night.</p><p><strong>Medical physicist's viewpoint: </strong>The discontinuation of PDR has made it possible to reduce the number of radiation sources present in the department, with a reduction of the working time needed for changing out radiation sources and for quality control. There are no longer any difficulties with night duties since all treatment is now performed during the day, in the presence of a physician during normal workday hours. Changes to the treatment planning schedules have been integrated, notably the calculation of biological equivalents for the most complex gynecological dosimetries.</p><p><strong>Radiation therapists' viewpoint: </strong>The work organization changed markedly, requiring the presence of at least 2 radiation therapists on treatment days, whereas previously, radiation therapists were mainly present on the days of insertion and removal of the brachytherapy source applicators. The schedule for the HDR delivery platform is similar to that of the radiotherapy accelerator. The radiation therapist team has observed benefits in terms of treatment safety, with visual control of the positioning of the equipment before each session, but also in terms of relations with the patient, with more regular interactions with patients. This creates a better atmosphere of trust for implant removal.</p><p><strong>Conclusion: </strong>With meticulous preparation and close collaboration between the different professions involved in brachytherapy delivery, the transition from PDR to HDR led to significant organizational changes in terms of treatment planning for different cancer sites. Nevertheless, overall, the whole team is satisfied with the new work model. The involvement of all the team members","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340691","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 accurate is applicator reconstruction in HDR gynecological brachytherapy? Patient-specific results from an electromagnetic tracking system designed to intercept errors before radiation delivery.","authors":"Christopher L Deufel, Justine M Dupere, Eric E Brost, Michael G Haddock, Allison E Garda","doi":"10.1016/j.brachy.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.04.007","url":null,"abstract":"<p><strong>Purpose: </strong>To measure brachytherapy applicator reconstruction accuracy for intracavitary and interstitial gynecological patients before HDR treatment delivery, with an emphasis on intercepting errors and quantifying dose uncertainties METHODS AND MATERIALS: A custom electromagnetic tracking quality assurance (QA) system, EMQA, was employed for pretreatment verification of the treatment planning system (TPS) applicator reconstruction for 25 gynecological HDR brachytherapy implants. TPS versus EMQA differences were quantified for applicator channel tips and shafts, and corresponding dose metric differences were calculated for the target and nearby organs at risk. Accuracy was evaluated as a function of applicator device type and EM sensor position and orientation with respect to the CT table and EM field generator.</p><p><strong>Results: </strong>Applicator channel reconstruction differences between the clinical plan and EM tracking were (mean ± standard deviation [minimum, maximum]) 0.76 ± 0.43 (0.05, 2.48) mm for channel tips and 0.41 ± 0.26 (0.03, 2.47) mm for shafts. Dose metric differences (% of Rx) for the HRCTV, bladder, rectum, large bowel, and small bowel were <2.3% on average, but differences up to 10.5% were observed. Agreement for needles was improved for needles implanted within a hybrid applicator compared with freehand placement.</p><p><strong>Conclusions: </strong>An EM tracking-based QA system enabled patient-specific, pretreatment verification of applicator channel reconstruction before radiation delivery. Although applicator channel reconstruction errors were observed to be small for a variety of gynecological brachytherapy applicator and implant types, the system has the potential to intercept rare and serious errors.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251309","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":"Interstitial cervical needle-guide ring-cap prototype for patient-specific ring-and-tandem brachytherapy.","authors":"Larence T Kuete, Alyssa Glennon, Sarah Ptashnik, Maureen Schickel, Shari Damast, Christopher J Tien","doi":"10.1016/j.brachy.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.04.009","url":null,"abstract":"<p><strong>Purpose: </strong>We have developed a unique cap that could be paired with our existing commercially-available MRI-compatible ring-and-tandem applicator (R&T) that can provide a patient-specific cervical needle guide for hybrid intracavitary-interstitial brachytherapy (IC/ISBT).</p><p><strong>Material and methods: </strong>Prototype guide caps with six channels for interstitial needles were rendered in SolidWorks (Dassault Systèmes SE, Vélizy-Villacoublay, France), coupled with Mick Radio-Nuclear Instruments (Mt Vernon, NY, USA) R&T. Prototypes were printed using Formlabs 3B printers and Gray Resin (Formlabs, Somerville, MA, USA). Achievable bend radii for interstitial needles were determined using custom jigs. A pilot cohort of previously-treated IC/ISBT patients was replanned with virtual needle paths reconstructed in EclipseBV (Varian Medical Systems, Palo Alto, CA, USA). Physical design constraints (bend radius, position) were used to determine the impact on EQD₂ for the HR-CTV D_90% and D_2cc for bladder, rectum, sigmoid, and small bowel.</p><p><strong>Results: </strong>Software-rendered guide caps prototypes were 3D-printed and tested to all be physically compatible with our existing commercially-available R&T. The channels physically accommodated six interstitial needles with bending precision ±1°. Among the cohort, the HR-CTV D_90% was increased for every patient (9.60% max, 1.30% median) and D_2cc to the bladder, rectum, sigmoid, and small bowel was decreased (17.45% max).</p><p><strong>Conclusions: </strong>We have designed and produced a guide cap prototype that can be used to improve our existing commercially-available R&T with IC/ISBT capabilities for customizable angles and positions. The guide caps have been shown to enhance dosimetry and can be used for patient-specific treatment.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251310","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":"Clinical implementation of an open-source Monte Carlo system across multiple centers for permanent implant brachytherapy dose evaluation.","authors":"Narjes Moghadam, Fatemeh Akbari, Claire Zhang, Samuel Ouellet, Dakota McKeown, Mojtaba Hoseini-Ghahfarokhi, Sandra Parent, Jean-François Carrier, Marie-Claude Lavallée, Joanna E Cygler, Michelle Hilts, Eric Vigneault, Juanita Crook, Luc Beaulieu, Rowan M Thomson","doi":"10.1016/j.brachy.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.04.005","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to clinically implement eb_gui, a user-friendly toolkit for Monte Carlo simulations utilizing egs_brachy, in the context of low-dose-rate (LDR) brachytherapy for prostate and breast cancers.</p><p><strong>Methods: </strong>A set of test cases, ranging from simple to complex scenarios including single- and multi-seed patient models, was developed for LDR brachytherapy of both breast (¹⁰³Pd) and prostate (¹²⁵I). Utilizing Digital Imaging and Communications in Medicine (DICOM) files, the open-source interface eb_gui was employed to compute doses. The commissioning process involved comparing eb_gui results against clinical TG-43 treatment planning system (TG43-TPS) calculations, encompassing point-by-point differences across 3D dose distributions, dose volume histograms, and dose metrics. Additionally, patient-specific dose distributions were computed using eb_gui's full-tissue models (TG186-MC) and compared against TG-43 Monte Carlo calculations (TG43-MC) across multiple cancer centers.</p><p><strong>Results: </strong>Excellent agreement was observed between TG43-TPS and TG43-MC calculated doses, with point-to-point differences of less than 1 Gy (∼1% of prescription dose) for breast and prostate cases. Comparisons between multicenter TG186-MC and TG43-MC doses highlighted discrepancies that underscore the limitations of the TG-43 formalism and affirming the necessity for a model-based dose calculation algorithm (MBDCA).</p><p><strong>Conclusion: </strong>This study successfully developed a series of test cases and a commissioning workflow for implementing eb_gui in LDR brachytherapy across multiple centers. The findings underscore the potential of TG-186 MBDCA to enhance the precision of patient dosimetry and improve the accuracy of treatment outcome predictions in LDR brachytherapy. This work represents a significant step toward broader adoption of advanced dose calculation methodologies in clinical practice.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227967","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":"Evaluation of the dosimetric impact and safety of MucoUp as a spacer in gynecologic brachytherapy.","authors":"Kae Okuma, Akane Yoshiba, Hiroyuki Okamoto, Koji Inaba, Tomoya Kaneda, Tairo Kashihara, Kyohei Nakatani, Kana Takahashi, Madoka Sakuramachi, Ayaka Nagao, Yuko Nakayama, Hiroshi Igaki","doi":"10.1016/j.brachy.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.04.006","url":null,"abstract":"<p><strong>Background: </strong>Gynecologic brachytherapy (BT) is an essential component of definitive radiation therapy, but excessive radiation exposure to organs at risk (OARs) remains a major concern. MucoUp, a hyaluronic acid-based spacer, has been introduced to physically separate the high-risk clinical target volume (HR-CTV) from adjacent OARs. However, its clinical feasibility and dosimetric impact remain underexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the dosimetric impact and clinical feasibility of MucoUp in high-dose-rate (HDR) gynecologic BT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 5 patients with gynecologic malignancies who underwent HDR BT with and without MucoUp injection. Dosimetric parameters, including HR-CTV D90 and OAR D2cc (bladder, rectum), were compared between sessions with and without MucoUp. Spacer volume retention was assessed using pre- and post-treatment CT scans.</p><p><strong>Results: </strong>MucoUp injection resulted in a significant reduction in rectal D2cc (7.19 Gy vs. 6.73 Gy, p = 0.043), while maintaining HR-CTV dose coverage (D90: 8.82 Gy vs. 9.15 Gy, p = 0.043). A nonsignificant reduction in bladder D2cc was observed (7.51 Gy vs. 7.16 Gy, p = 0.34). Spacer volume retention remained stable throughout treatment. No procedural complications or acute toxicity were observed.</p><p><strong>Conclusion: </strong>This study suggests that MucoUp is a promising spacer for gynecologic BT, effectively reducing rectal dose while preserving HR-CTV coverage. Given its high stability and safety, MucoUp may serve as an alternative to existing spacer materials. Further large-scale and long-term studies are warranted to evaluate its impact on late toxicities.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227974","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":"Clinical outcomes following brachytherapy for endometrial cancer patients with narrow vaginal anatomy.","authors":"Bethel Adefres, Christopher J Tien, Susan Gueble, Shari Damast","doi":"10.1016/j.brachy.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.04.002","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant high-dose-rate (HDR) vaginal brachytherapy (VBT) for endometrial cancer (EC) is delivered with vaginal cylinders ranging from 2.0 to 4.0 cm in diameter. Dose heterogeneities as high as 170-210% can be observed with the narrowest 2.0 cm cylinders potentially increasing the risk of vaginal scarring. Therefore, use of larger diameter cylinders is favored when clinically feasible. Nonetheless, certain clinical scenarios necessitate the use of narrow cylinders despite their unfavorable dosimetry. This study reports the clinical outcomes of EC patients treated with 2.0 cm diameter cylinders at a single institution.</p><p><strong>Methods: </strong>From an IRB-approved database of 770 EC patients treated with VBT (11/2015-07/2024), 45 (5.8%) treated with 2.0 cm diameter cylinders were retrospectively reviewed. All received 10 Gy x 3 fractions prescribed to the cylinder surface, to mitigate high surface doses. Patient demographics, recurrence rates, and toxicities were analyzed. Toxicities were assessed using CTCAE v4.0, and freedom from vaginal recurrence was determined by Kaplan-Meier analysis.</p><p><strong>Results: </strong>The median age was 69 years, and 80% were nulliparous. Most had stage I-II disease (82%), and the most common histology was endometrioid (69%). The 2-year freedom from vaginal recurrence was 97% with only 1 in-field recurrence. No grade ≥2 gastrointestinal or urinary toxicities were observed. Freedom from grade ≥2 vaginal stenosis was 85%.</p><p><strong>Conclusion: </strong>Use of the 2.0 cm diameter cylinder was rare and used in <6% of EC patients treated with VBT. The regimen of 10 Gy x 3 fractions to the cylinder surface was well-tolerated and achieved excellent local control.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188682","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":"A novel technique for the quality assurance of dwell positions for ovoid applicators using 2D optical imaging.","authors":"Jette Borg, Akbar Beiki-Ardakani, Hedi Mohseni, Maryam Golshan, Alexandra Rink, Robert A Weersink","doi":"10.1016/j.brachy.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.03.003","url":null,"abstract":"<p><strong>Purpose: </strong>We propose a new method for commissioning lunar ovoid applicators in high dose rate gynecology brachytherapy based on 2D optical scintillating imaging of the applicators.</p><p><strong>Methods: </strong>Treatment plans were generated for 22 mm and 26 mm diameter Venezia applicators, using four to eight dwell positions in each ovoid. Images of the applicator dwell positions were acquired using a pinhole apparatus combined with scintillating material and optical camera. Images were acquired for individual dwell positions and processed to identify pixel locations with peak signal intensity. Catheter dwell positions were used to register pixel locations in the optical images and absolute coordinates of the applicator in the treatment planning system. Errors were calculated using the standard deviation in the Euclidean distance between measured and expected ovoid dwell positions. Measurements were repeated three times, including repositioning the applicator on the measurement system.</p><p><strong>Results: </strong>Imaging of each applicator required between 20 and 25 min for all dwell positions. Catheter registration errors were 0.14 ± 0.09 mm and 0.21 ± 0.04 mm for the 26 and 22 mm applicators, respectively. Average differences between the imaged and planned ovoid dwell positions were 0.48 ± 0.14 mm and 0.48 ± 0.16 mm for the 26 and 22 mm applicators, respectively. The maximum difference between the measured and planned ovoid positions was 0.7 mm and 1.3 mm measured for the 26 and 22 mm applicators, respectively. These uncertainties are lower than our clinical tolerance of 2.0 mm.</p><p><strong>Conclusions: </strong>2D-Scintillating imaging of lunar ovoid applicator dwell positions is feasible, accurate and faster than previous methods used at our center.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055218","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":"Prostate Posters PO51","authors":"Nahuel Eduardo Paesano, Nuria Jornet i Sala, Jadi Rojas Cordero, Nahuel Paesano, Alicia Maccagno, Gilberto Chechile Toniolo","doi":"10.1016/j.brachy.2023.06.152","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.152","url":null,"abstract":"Purpose Since 1983, Brachytherapy (BT) has been used for the treatment of localized prostate cancer (CaP). Over the years, this technique has been consolidated, updated and perfected as a curative treatment for low-risk PCa, and its indication has been extended to intermediate-risk cancer as monotherapy. To evaluate oncological outcomes and genitourinary and gastrointestinal adverse events in patients treated with real-time low dose rate (LDR) Iodine-125 BT as a treatment for localized prostate cancer. Materials and Methods To carry out this study, all patients treated with BT in monotherapy with or without associated androgen deprivation therapy for the treatment of localized PCa were prospectively included from June 2003 to August 2021. Strict post-treatment follow-up was performed. was performed every 6 months. Reviews include quality of life (QoL) test, assessment of urinary obstructive symptoms using IPSS (International Prostate Examples Score), SHIM (Sexual Health Inventory for Men), IIEF-15 questionnaires to assess sexual quality, specific total stretching prostate (PSA), ultrasound and flowmetry. The statistical method used was the Kaplan Meier and Cox regression with the SPSS computer system. Results A total of 445 patients were evaluated. The mean age at which the BT was performed was 65.3 years (SD=7.7). The mean prostate volume was 41.0 cm3. (SD=14.3). The mean PSA before BT was 7.28 (SD= 4.33). Regarding the D'Amico risk classification, 48.3% (215/445) of the patients were low risk, 45.1% (201/445) intermediate risk, and 6.6% (29/445). 445) high risk. 22.5% (100/445) received associated hormonal therapy. 47.8% (213/445) of the patients presented urological complications after CT, with urinary frequency being the most frequent. Rectal complications manifested in 17.7% (78/445) of the patients and the most frequent was tenesmus. The main urinary complication was urinary frequency, which was significantly associated between the first 3 months and the year after CT. After one year, most patients had the same micturition quality as before BT. The mean follow-up is 6 years, showing an overall biochemical recurrence-free survival (BLFS) of 92.3% (411/445). Regarding biochemical recurrence according to risk group, 14 patients with treatment failure were low risk, 15 intermediate risk and 5 high risk. No statistically significant association was found between risk stratification and recurrence. However, for the group of patients considered to be at high risk, the percentage of recurrence was higher. Conclusions BT offers excellent oncological control in the treatment of low and intermediate risk prostate cancer with acceptable rates of adverse events. Since 1983, Brachytherapy (BT) has been used for the treatment of localized prostate cancer (CaP). Over the years, this technique has been consolidated, updated and perfected as a curative treatment for low-risk PCa, and its indication has been extended to intermediate-risk cancer as monotherapy","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434225","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":"PO126","authors":"Ron Digiaimo","doi":"10.1016/j.brachy.2023.06.226","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.226","url":null,"abstract":"This session will review common Brachytherapy Coding and Documentation opportunities and risks. The information provided will help the provider and the institution know the appropriate coding for compliant submission to payers as well as reasons for denial of payment. For example Prostate and Breast HDR, Skin HDR, Prostate LDR may be reviewed with associated coding and documentation requirements. Brachytherapy generally requires insurance authorization and may be a cause of denial of payment if not done properly or timely. In addition financial counseling can contribute material benefits to both the provider and institution as well as create psychological benefit to the patient. Examples of coding and denials will be provided along with suggestions on how to deal with appeals for payments from both government and commercial payers. This session will review common Brachytherapy Coding and Documentation opportunities and risks. The information provided will help the provider and the institution know the appropriate coding for compliant submission to payers as well as reasons for denial of payment. For example Prostate and Breast HDR, Skin HDR, Prostate LDR may be reviewed with associated coding and documentation requirements. Brachytherapy generally requires insurance authorization and may be a cause of denial of payment if not done properly or timely. In addition financial counseling can contribute material benefits to both the provider and institution as well as create psychological benefit to the patient. Examples of coding and denials will be provided along with suggestions on how to deal with appeals for payments from both government and commercial payers.","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434363","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":"PO67","authors":"Tyler E. Gutschenritter, Anthony Pham, Homayon Parsai, Joe Bradlo, Merriah Montague, Sarah Reith, Justin Bell, Rosanna Mangibin, Richard Alex Hsi","doi":"10.1016/j.brachy.2023.06.168","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.168","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434378","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}