Dosimetry of ruthenium-106 ophthalmic applicators with thin layer thermoluminescence dosimeters - Clinical quality control.

Ruthenium-106 ophthalmic applicators have proven to be effective when using beta emitters in brachytherapy. For dose calculations , typically, the dosimetric reference data given by the manufacturer are used. An additional check of the applicators is usually not provided. However, the medical physicist is responsible for correct dosimetry in the clinic; therefore dosimetric verification is desirable. Despite the fact that the use of beta-ray emitting sealed brachytherapy sources is a safe treatment method, errors can occur (Kaulich et al., 2004). Hence, a method for absolute dose measurements based on the use of thin layer MCP-N-thermoluminescence detectors (TLD Poland, Krakow, Poland) is described in this study. A custom-made polymethyl methacrylate (PMMA)- based phantom was developed for this study. The surface of the phantom was designed to fit with spherical shells of ruthenium-106 ophthalmic applicators (e.g. applicator type CCA, CCB and CIA by Eckert & Ziegler BEBIG GmbH, Berlin, Germany) studied in this work. To verify the reference data from the source certificates, absolute point dose values were measured at different phantom depths with the thermoluminescence detectors and compared to the certificate values. Calibrations of the thermoluminescence detectors were performed in a water phantom with a 6 MV CLINAC (Artiste, Siemens Medical, Erlangen, Germany) before. A comparison with scintillator measurement results given by the manufacturer in the applicator certificate shows the measurement series of absolute dose using MCP-N thin layer detectors being in good accordance with the values of the applicator certificate. The dose values calculated with the source certificate can be confirmed with a maximum deviation of 6.5%. Further, it can be shown that compared to TLD-100, the use of MCP-N thermoluminescence detectors is an advantage, when calibrating with 6 MV photons. The phantom measuring procedure presented in this study provides a practice-oriented realization for quality control of ruthenium-106 ophthalmic applicators in clinical routine The phantom seems capable of performing periodic system tests, as well as controlling the introduction of new applicators delivered by the manufacturer.

End-to-end test for computed tomography-based high-dose-rate brachytherapy.

PURPOSE: One of the important developments in brachytherapy in recent years has been the clinical implementation of complex modern technical procedures. Today, 3D-imaging has become the standard procedure and it is used for contouring and precise position determination and reconstruction of used brachytherapy applicators. Treatment planning is performed on the basis of these imaging methods, followed by data transfer to the afterloading device. Therefore, checking the entire treatment chain is of high importance. In this work, we describe an end-to-end test for computed tomography (CT)-based brachytherapy with an high-dose-rate (HDR) afterloading device, which fulfills the recommendation of the German radiation-protection-commission. MATERIAL AND METHODS: The treatment chain consists of a SOMATOM S64 CT scanner (Siemens Medical), the treatment planning system (TPS) BrachyVision v.13.7 (VMS), which utilizes the calculation formalism TG-43 and the Acuros algorithm v. 1.5.0 (VMS) as well as GammaMedplus HDR afterloader (VMS) using an Ir-192 source. Measurement setups for common brachytherapy applicators are defined in a water phantom, and the required PMMA applicator holders are developed. These setups are scanned with the CT and the data is imported into the TPS. Computed TPS reference dose values for significant points located on the side of the applicator are compared with dose measurements performed with a PinPoint 3D chamber 31016 (PTW Freiburg). RESULTS: The deviations for the end-to-end test between computed and measured values are shown to be ≤ 5%, when using an implant needle or vaginal cylinder. Furthermore, it can be demonstrated that the test procedure provides reproducible results, while repositioning the applicators without carrying out a new CT-scan. CONCLUSIONS: The end-to-end test presented allows a practice-oriented realization for checking the whole treatment chain for HDR afterloading technique and CT-imaging. The presented phantom seems feasible for performing periodic system checks as well as to verify newly introduced brachytherapy techniques with sufficient accuracy.