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Advances in Brachytherapy Dose Calculations

Luc Beaulieu

L Beaulieu1*, F Mourtada2*, (1) Centre Hospitalier Univ de Quebec, Quebec, QC, (2) Christiana Care Hospital, Newark, DE

MO-A-Salon EF-1 Monday 7:30:00 AM - 9:30:00 AM Room: Salon EF

Recent advances in dose calculation algorithms for brachytherapy will have profound impact on how the end users will be required to integrate the necessary new information into the treatment planning system (TPS), commission a TPS that integrate model-based dose calculation algorithms (MBDCA) and dose reporting requirements. Until recently, all clinical TPS followed the well-known TG-43 dose calculation protocol. It is now possible for medical physics to take into account the complete geometry of a treatment i.e. finite patient boundary (breast, superficial application, ...) and the heterogeneous tissue composition and any non-water applicators, shields or other devices.
The recently-published AAPM TG-186 report discusses important issues for clinical implementation of these algorithms. We will review the motivation leading to TG-186 work, present in a clinically oriented fashion the key point of TG-186 recommendations. In particular, specific examples on how to perform the commissioning process will be presented. A proposed commissioning flowchart will be discussed, guiding the audience through the clinical process, with pitfalls identified to minimize likelihood for errors.

Learning Objectives:
1. Identify key clinical applications needing advanced dose calculation in brachytherapy.
2. Provide an overview of the alternatives to TG43.
3. Explains in practical terms the recommendations of TG186.
4. Identify relevant commissioning processes for safe clinical integration.
5. Provide practical clinical examples using a commercially available system.

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