Brachytherapy最新文献

{"title":"Randomized trial comparing hypnosis versus standard management on patient anxiety and pain during pelvic brachytherapy applicator removal.","authors":"Lydie Lemoine, Virginie Adam, Julia Salleron, Christelle Cuisinier, July Perrin, Claire Charra Brunaud, Py Jean-François, Marie Bruand, Didier Peiffert, Rémi Etienne, Cécile Huin Schohn, Sophie Renard","doi":"10.1016/j.brachy.2025.07.010","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.07.010","url":null,"abstract":"<p><strong>Purpose: </strong>Removal of brachytherapy applicator is routinely performed under premedication including Kalinox® gas inhalation without general anesthesia. The applicator removal is nevertheless associated with discomfort, anxiety or pain. We assessed the adjunction of formal hypnosis during this procedure.</p><p><strong>Methods and materials: </strong>This prospective, randomized, single-center study focused on adult patients undergoing pelvic brachytherapy applicator removal. Patients were randomly assigned to (1:1): standard management including Kalinox® (control group) vs. standard management including Kalinox® accompanied by formal hypnosis (hypnosis group). The primary endpoint was anxiety using the State-Trait Anxiety Inventory (STAI) Y-A form (state anxiety). A secondary endpoint was pain after applicator removal (numerical scale).</p><p><strong>Results: </strong>A total of 68 patients (mean age, 51.9 years) were included (cervical cancer, 86.6%). Before applicator removal, mean (SD) STAI Y-A anxiety score was 45.9 (5.6) in the control group vs. 47.5 (5.9) in the hypnosis group. After applicator removal, the scores were 48.1 (4.3) versus 47.7 (4.2), respectively (p = 0.76). Pain score was not significantly different after applicator removal (p = 0.055) in the hypnosis group compared to the control group: 1.29 (1.72) versus 0.71 (1.51), respectively. There were no significant differences between the 2 groups concerning caregiver satisfaction with patient management (p = 0.27), ease of realization (p = 0.17) and caregiver comfort (p = 0.42).</p><p><strong>Conclusion: </strong>This study failed to demonstrate a substantial benefit of formal hypnosis on anxiety in patients undergoing pelvic brachytherapy applicator removal. But this study suggests that the use of hypnotic communication techniques enables a positive attitude to patient care, thus reinforcing the patient-caregiver relationship.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982346","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":"Dosimetric characterization and experimental validation for a low-kV FPXS electronic brachytherapy system.","authors":"Mengke Qi, Sifu Luo, Jing Kang, Song Kang, Xingyu Lu, Ting He, Liang Cui, Jun Chen, Linghong Zhou, Yuan Xu","doi":"10.1016/j.brachy.2025.07.008","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.07.008","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the feasibility of using flat-panel X-ray source (FPXS) for brachytherapy through preclinical animal irradiation experiments.</p><p><strong>Material and methods: </strong>A low-kV FPXS electronic brachytherapy (EB) system was constructed for dosimetry measurements and experimental validation. The surface and depth dose characteristics of FPXS were measured employing a 34013 chamber. An FPXS-based EB workflow was established, enabling the calculation of required exposure times for FPXS at a given prescription dose. The accuracy of the delivered dose and the therapeutic efficacy of FPXS irradiation were validated through brachytherapy experiments conducted on murine models with breast cancer.</p><p><strong>Results: </strong>The FPXS operates with a maximum voltage of up to 50 kV and a maximum surface dose rate exceeding 2.30 Gy/min. The surface dose rate and current demonstrate an exponential increase with voltage, and the dose rate exhibits a linear correlation with the current. The calculated cumulative dose delivered to mice in the experimental group was slightly higher than the average in-field dose measured by film (21.88±0.61 Gy vs. 20.83 ± 1.03 Gy). Following FPXS irradiation, the increase in tumor volume of mice in the experimental group was markedly less pronounced than that observed in the control group, and the survival rate of mice in the experimental group over time was significantly higher than that of the control group (66.67% vs 12.50%).</p><p><strong>Conclusion: </strong>The intensity of FPXS is comparable to current EB systems, and its surface dose rate is adequate for therapeutic applications. Animal irradiation experiments confirm the accuracy of FPXS-delivered doses and demonstrate its efficacy in tumor irradiation.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982438","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":"Intraoperative low-dose rate brachytherapy as an adjunct to surgery for marginally resectable rectal and recurrent anorectal carcinomas.","authors":"Mustafa M Al Balushi, Teresia M Perkins, Kee-Young Shin, Ivan M Buzurovic, Simon G Talbot, Joel E Goldberg, Desmond A O'Farrell, Martin T King, Harvey J Mamon, Philip M Devlin","doi":"10.1016/j.brachy.2025.07.009","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.07.009","url":null,"abstract":"<p><strong>Background: </strong>Locally recurrent and marginally resectable rectal and anorectal carcinomas present significant therapeutic challenges due to high recurrence rates and limited treatment options. Intraoperative low-dose rate brachytherapy (LDRBT) has emerged as a potential adjunct to improve local control in these cases. This study aims to evaluate the clinical outcomes associated with intraoperative LDRBT for these difficult cases.</p><p><strong>Methods: </strong>This was a retrospective study that was approved by the institutional review board. Patients who had undergone intraoperative pelvic LDRBT for locally recurrent and marginally resectable rectal and anorectal carcinomas between February 2004 and April 2022 were included. Morbidity and survival were assessed using toxicity CTCAE V5.0 and Kaplan-Meyer curves, respectively.</p><p><strong>Results: </strong>29 patients were found to have been treated with surgical resection and intraoperative pelvic seed brachytherapy with either I-125 or Cs-131. The 1-year and 2-year overall survival rates were 88.7% (95% CI, 69.0-96.2) and 70.6% (95% CI, 47.7-84.9), respectively. Furthermore, the 1-year and 2-year local progression free survival rates were 55.4% (95% CI, 34.9-71.8) and 41.7% (95% CI, 22.3-60.1), respectively. Median number of months for local progression free survival was 15.6% (95% CI, 7.4-34.4). The most common toxicity was Grade 1-2 neuralgia in 41.4% of patients, with no Grade 4 or higher observed.</p><p><strong>Conclusion: </strong>Our results suggest that intraoperative LDRBT may play a broader role in managing these challenging conditions. Morbidity was moderate and primarily dependent on disease progression. Survival and progression rates were consistent with published reports, highlighting the therapeutic potential of this treatment approach.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982264","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 variability in applicator position and organs at risk dose in fractionated intracavitary brachytherapy for cervical cancer.","authors":"Francis Kazoba, Elingarami Sauli, Elias Nyanza, Aloyce I Amasi","doi":"10.1016/j.brachy.2025.07.012","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.07.012","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer remains a major cause of mortality in low- and middle-income countries (LMICs). Intracavitary brachytherapy (ICBT) is critical for curative radiotherapy; however, inter-fractional variability in applicator positioning may compromise treatment reproducibility and organ-at-risk (OAR) sparing.</p><p><strong>Objective: </strong>This study assessed inter-fractional applicator positional stability and its dosimetric impact on OARs during fractionated ICBT for cervical cancer.</p><p><strong>Materials and methods: </strong>A prospective analysis of 60 treatment plans from 20 patients receiving three ICBT fractions was conducted. Applicator shifts along the X, Y, and Z axes and corresponding bladder and rectal doses were evaluated. Descriptive statistics and repeated measures ANOVA determined positional reproducibility and dose variability, while correlation analysis examined associations between applicator displacement and OAR dose changes.</p><p><strong>Results: </strong>Applicator positioning was reproducible across fractions, with no significant differences in any axis p > 0.05). Bladder dose, however, demonstrated significant variation (p = 0.027), progressively increasing across fractions. Moderate correlations (r ≈ 0.39) were observed between bladder dose escalation and applicator shifts along the X and Y axes, especially in the Y-axis. Rectal dose remained stable (p = 0.776).</p><p><strong>Conclusion: </strong>Although applicator positioning was geometrically stable, significant bladder dose variability occurred. Adaptive replanning and real-time imaging are recommended to optimize treatment precision in fractionated ICBT.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982285","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 machine learning-based decision support tool for standardizing intracavitary versus interstitial brachytherapy technique selection in high-dose-rate cervical cancer.","authors":"Tomohiro Kajikawa, Koji Masui, Koji Sakai, Tadashi Takenaka, Gen Suzuki, Yuki Yoshino, Hikaru Nemoto, Hideya Yamazaki, Kei Yamada","doi":"10.1016/j.brachy.2025.07.011","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.07.011","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and evaluate a machine-learning (ML) decision-support tool that standardizes selection of intracavitary brachytherapy (ICBT) versus hybrid intracavitary/interstitial brachytherapy (IC/ISBT) in high-dose-rate (HDR) cervical cancer.</p><p><strong>Methods and materials: </strong>We retrospectively analyzed 159 HDR brachytherapy plans from 50 consecutive patients treated between April 2022 and June 2024. Brachytherapy techniques (ICBT or IC/ISBT) were determined by an experienced radiation oncologist using CT/MRI-based 3-D image-guided brachytherapy. For each plan, 144 shape- and distance-based geometric features describing the high-risk clinical target volume (HR-CTV), bladder, rectum, and applicator were extracted. Nested five-fold cross-validation combined minimum-redundancy-maximum-relevance feature selection with five classifiers (k-nearest neighbors, logistic regression, naïve Bayes, random forest, support-vector classifier) and two voting ensembles (hard and soft voting). Model performance was benchmarked against single-factor rules (HR-CTV > 30 cm³; maximum lateral HR-CTV-tandem distance > 25 mm).</p><p><strong>Results: </strong>Logistic regression achieved the highest test accuracy 0.849 ± 0.023 and a mean area-under-the-curve (AUC) 0.903 ± 0.033, outperforming the volume rule and matching the distance rule's AUC 0.907 ± 0.057 while providing greater accuracy 0.805 ± 0.114. These differences were not statistically significant. Feature-importance analysis showed that the maximum HR-CTV-tandem lateral distance and the bladder's minimal short-axis length consistently dominated model decisions.​ CONCLUSIONS: A compact ML tool using two readily measurable geometric features can reliably assist clinicians in choosing between ICBT and IC/ISBT, thereby reducing inter-physician variability and promoting standardized HDR cervical brachytherapy technique selection.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982382","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 biologically effective dose-based framework for integrating LDR brachytherapy and EBRT in glioblastoma treatment.","authors":"Adam C Turner, Elliot M Abbott, Michael A Garcia, Sita Patel, Kimberly M Johnson, David G Brachman","doi":"10.1016/j.brachy.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.07.003","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation therapy is a core component of the standard of care (SOC) for glioblastoma (GBM), yet outcomes remain poor. Rapid early progression (REP) between maximal safe resection and start of external beam radiation therapy (EBRT) is associated with reduced survival. The GESTALT trial (NCT05342883) investigates whether initiating low-dose-rate brachytherapy (LDRBT) at time of resection can mitigate rates of REP prior to EBRT. This work presents a framework for integrating LDRBT and EBRT to deliver a composite biologically effective dose (BED) distribution comparable to SOC and demonstrates its feasibility for clinical use.</p><p><strong>Methods: </strong>A voxel-level optimization framework was developed to account for LDRBT BED when planning EBRT. The method was applied to generate EBRT plans for 34 GESTALT trial patients following resection and intraoperative implantation of GammaTile® cesium-131 LDRBT devices. Plan quality metrics and doses to organs at risk (OAR) were compared to trial requirements to demonstrate feasibility and safety.</p><p><strong>Results: </strong>Mean composite target dose coverage was statistically equivalent to prescribed doses while achieving similar dose conformity as SOC EBRT delivered using modern techniques. Composite dose constraints for OARs were met in most cases, with constraint violations observed in fewer than 10% of patients for any individual structure.</p><p><strong>Conclusion: </strong>These findings demonstrate the feasibility of a novel approach to account for LDRBT when optimizing EBRT to deliver a desired composite BED. These results support earlier initiation of radiation with LDRBT for GBM and establish a basis for forthcoming analyses of clinical outcomes and model performance in the GESTALT trial.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144982360","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":"Iterative intraoperative 3T MRI (iMRI)-guided brachytherapy: A prospective study on enhancing implantation precision and dosimetric gains in advanced gynecologic cancers.","authors":"Shrikiriti S Rajan, Matthew S Ning, Megan Jacobson, Samantha J Simiele, Teresa Bruno, Ramez Kouzy, Kyoko Yoshida-Court, Tatiana Cisneros-Napravnik, Henry Yu, Jason Stafford, Yusung Kim, Geena Mathew, Rauda Alicia Cordova, Maliah Domingo, Anuja Jhingran, Lilie L Lin, Melissa Joyner, Travis T Sims, Lauren Colbert, Aradhana M Venkatesan, Ann Klopp","doi":"10.1016/j.brachy.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.06.010","url":null,"abstract":"<p><strong>Purpose: </strong>To report on primary outcomes and dosimetric results of a prospective clinical trial and protocol for use of iterative intraoperative magnetic resonance imaging (iMRI) in gynecologic brachytherapy.</p><p><strong>Methods: </strong>Patients with locally advanced cervical or vaginal cancer (FIGO stages IB2 - IVA, and stage II-IVA, respectively) undergoing pulsed dose rate (PDR) brachytherapy were enrolled in a prospective clinical trial (NCT03634267) using iterative 3T iMRI during brachytherapy implant placement. Applicator and optional interstitial needles were placed under iMRI guidance in a 3T clinical MRI scanner. Imaging, dosimetry and clinical outcomes (local control (LC), recurrence-free survival (RFS), overall survival (OS)), and acute and long-term toxicity were evaluated prospectively and confirmed by chart review. To explore dosimetric gains, an EQD2 estimate comparing iMRI-guidance versus standard of care guidance, as well as a 3-patient analysis of dose changes with iMRI-guided optimization was included.</p><p><strong>Results: </strong>Fourteen patients underwent iMRI-guided brachytherapy. Seventy percent (70%) of patients presented with FIGO stage III disease or higher. Median follow-up was 44 months. . Patients had 2-year median LC, RFS, and OS rates of 83.3%, 76%, and 84.6%, respectively. Acute toxicities were minimal with one (1) case of grade 3 nausea. No grade 3 or higher long-term toxicities were observed. Median operating room (OR) time was 283 minutes (range 174-380 mins). On exploratory analysis, implant placement performed with iMRI guidance demonstrated higher HR-CTV D90 doses (mean difference of +784.7 cGy, p = NS) were achieved compared to US and CT guided implantation in the same patients.</p><p><strong>Discussion: </strong>iMRI-guidance for gynecologic brachytherapy is safe, associated with minimal high-grade toxicity and excellent clinical outcomes. Future studies to optimize resource use, image acquisition efficiency, and identifying predictive imaging features are warranted.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860000","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}