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Brachytherapy Patient Specific Quality Assurance for a HDR Vaginal Cylinder Case

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J Barbiere

J Barbiere*, J Napoli , A Ndlovu , Hackensack Univ Medical Center, Hackensack, NJ

Presentations

SU-E-T-149 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall


Purpose:
Commonly Ir-192 HDR treatment planning system commissioning is only based on a single absolute measurement of source activity supplemented by tabulated parameters for multiple factors without independent verification that the planned distribution corresponds to the actual delivered dose.
The purpose on this work is to present a methodology using Gafchromic film with a statistically valid calibration curve that can be used to validate clinical HDR vaginal cylinder cases by comparing the calculated plan dose distribution in a plane with the corresponding measured planar dose.

Methods:
A vaginal cylinder plan was created with Oncentra treatment planning system. The 3D dose matrix was exported to a Varian Eclipse work station for convenient extraction of a 2D coronal dose plane corresponding to the film position. The plan was delivered with a sheet of Gafchromic EBT3 film positioned 1mm from the catheter using an Ir-192 Nucletron HDR source. The film was then digitized with an Epson 10000 XL color scanner.
Film analysis is performed with MatLab imaging toolbox. A density to dose calibration curve was created using TG43 formalism for a single dwell position exposure at over 100 points for statistical accuracy. The plan and measured film dose planes were registered using a known dwell position relative to four film marks. The plan delivered 500 cGy to points 2 cm from the sources.

Results:
The distance to agreement of the 500 cGy isodose between the plan and film measurement laterally was 0.5 mm but can be as much as 1.5 mm superior and inferior.
The difference between the computed plan dose and film measurement was calculated per pixel. The greatest errors up to 50 cGy are near the apex.

Conclusion:
The methodology presented will be useful to implement more comprehensive quality assurance to verify patient-specific dose distributions


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