COMMISSIONING AND ACCEPTANCE

PROCEDURE FOR BRACHYTHERAPY

Presented by,
Roll:496, 498 & 501
24th Batch
6th semester
MPBME, Gono Bishawbidyalay
CONTENTS

 Introduction
 Acceptance testing
 Safety checks
 Mechanical checks
 Dosimetry measurements
 Commissioning of brachytherapy computer TPSs
 Source commissioning
 INTRODUCTION

 Brachytherapy is defined as a short-distance treatment of malignant disease

with radiation emanating from small sealed (encapsulated) sources.
 The sources are placed directly into the treatment volume or near the treatment
volume.
 Acceptance tests and commissioning constitute a major part in this QA
program for brachytherapy.
ACCEPTANCE TESTS
Acceptance tests assure that
• Specifications contained in the purchase order are fulfilled.
• Environment is free of radiation.
• Radiotherapy equipment is free of electrical hazards to staff
and patients.

Tests are performed in the presence of a manufacturer’s representative.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 Acceptance tests may be divided into three groups:

1. Safety checks.

2. Mechanical checks.

3. Dosimetry measurements.

 A number of national and international protocols exist to guide the physicist in the
performance of acceptance tests.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

SAFETY CHECKS
 Safety checks include:

 Interlocks.
 Warning lights.
 Patient monitoring equipment.
 Radiation survey.
 Afterloader and applicator head leakage

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 Door Interlocks

Radiation survey.

Patient monitoring equipment.

Warning lights.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

MECHANICAL CHECKS
Mechanical checks include:

1. Source strength,
2. Positional accuracy of the source (Applicator and transfer tubes)
3. Timer accuracy (timer linearity, timer accuracy, and source transit time),
4. Treatment planning system: functionality
5.calibration of optical and pneumatic source position/status detection systems.
6.correct operation of all applicators, transfer tubes and source localization
dummies
7.positional accuracy: single stepping source
8.positional accuracy: multiple-source machines
9.source calibration
10.redundant source calibration checks
11.timer accuracy and linearity measurement

Code of practice for brachytherapy physics report of the aapm radiation therapy
DOSIMETRY MEASUREMENTS
After completion of the mechanical checks, dosimetry
measurements must be performed.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 Dosimetry measurements include:

1. Photon energy.
2. Photon beam uniformity.
3. Photon penumbra.
4. Electron energy.
5. Electron beam bremsstrahlung contamination.
6. Electron beam uniformity.
7. Electron penumbra.
8. Monitor characteristics.
9. Arc therapy.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 COMMISSIONING

All testing, data input and verification check that are needed
to get the system ready for clinical are commissioning of an
external beam therapy or Brachytherapy device.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 COMMISSIONING OF BRACHYTHERAPY
 Check of the reconstruction procedure
 Major hardware devices of brachytherapy treatment planning systems (TPSs)
are:
 Computer
 Digitizer
 Plotter

 Accuracy of the devices and the planning process should be checked

routinely with simple test cases.

 Verification test should include translation from film to Cartesian

coordinates, rotations, and corrections for magnification.

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 CHECK OF CONSISTENCY BETWEEN QUANTITIES AND
UNITS
 Major sources of errors in brachytherapy are:
 Incorrect source calibration
 Incorrect use of dosimetric quantities and units in the calculational
algorithms.

 It is essential to verify correct labeling of the input and output quantities

and units used in the dose calculation software.

 Special care must be taken with regard to the specification of source

strength (activity).

Review of Radiation Oncology Physics: A Handbook for Teachers and Students

 CHECK OF THE DECAY CORRECTIONS

 For temporary implants, the accuracy of the computer calculated dose rate at
specific times within the duration of the implant should be verified with manual
calculations.

 For permanent implants, the accuracy of the computer calculated dose

to complete source decay should be verified.

 For both types of implants (temporary and permanent) the

choice of units for the source strength, dose rate, and total dose
should be verified.
Review of Radiation Oncology Physics: A Handbook for Teachers and Students
THANK YOU