PubMed HealthSearch

PubMed · 9209529

Physics and basic parameters of brachytherapy.

Abstract

Brachytherapy (short-distance therapy) is the therapeutic process whereby radioactive sources are placed into very close proximity to target tissue. Radioactive materials were so used beginning shortly after the discovery of radium by Marie and Pierre Curie in 1898. For the purposes of brachytherapy, radioactive materials are those that emit "rays" that can cause ionization (and hence DNA damage and the destruction of target cells). The potentially useful rays include beta, gamma, and other possibilities such as neutrons. Beta rays, properly beta particles, are simply high energy electrons. Gamma rays are high energy photons (part of the electromagnetic spectrum like visible light, but with much higher energy). These particles are produced during the radioactive decay of certain isotopes. The physics of those events and the parameters that apply to the therapeutic use of the isotopes are the primary topics of this report.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

E J Lee, M S Weinhous. 1997. Physics and basic parameters of brachytherapy.. https://doi.org/10.1002/(sici)1096-9098(199706)65%3A2%3C143%3A%3Aaid-jso14%3E3.0.co%3B2-6

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Mucosal dose prescription in endobronchial brachytherapy: a study based on CT-dosimetry.

PURPOSE: To investigate the consequences of using different dose prescription methods for endobronchial brachytherapy (EB), both with and without the use of a centered applicator. MATERIALS AND METHODS: A CT scan was performed during EB procedures in 13 patients after insertion of the lung applicator. A dosimetric analysis was subsequently performed in five of these patients using a 3D-brachytherapy treatment planning system (PLATO v13.3, Nucletron). RESULTS: Dose prescription to the mucosa yields uniform dose distributions to the bronchial mucosa when a centrally positioned applicator is used. When non-centrally positioned applicators are used, mucosal dosing results in a significant underdosage to parts of the target volume. Due to the rapid dose fall-off in EB, dose prescription to the mucosa resulted in inadequate coverage of the outer portion of the bronchial wall and adjacent peribronchial space. When compared to mucosal dose prescription, prescription to the outer aspect of the bronchial wall appears to improve target coverage while limiting the hyperdose (i.e., 200%) volume. The diameters of the different bronchial segments, as determined by CT measurements in 13 patients, correlated well with calculated values based upon the tracheal diameter. CONCLUSIONS: Mucosal dose prescription should only be used in combination with centered EB applicators. Given the rapid dose fall-off in EB mucosal dose prescription should be used with caution in curative treatments where EB, without additional external radiotherapy, is used as the sole treatment modality. In curative EB, both improved target coverage and a limited hyperdose volume can be achieved by dose prescription to the outer aspect of the bronchial wall.

Brachytherapy

The American Brachytherapy Society recommendations for permanent prostate brachytherapy postimplant dosimetric analysis.

PURPOSE: The purpose of this report is to establish guidelines for postimplant dosimetric analysis of permanent prostate brachytherapy. METHODS: Members of the American Brachytherapy Society (ABS) with expertise in prostate dosimetry evaluation performed a literature review and supplemented with their clinical experience formulated guidelines for performing and analyzing postimplant dosimetry of permanent prostate brachytherapy. RESULTS: The ABS recommends that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy for optimal patient care. At present, computed tomography (CT)-based dosimetry is recommended, based on availability cost and the ability to image the prostate as well as the seeds. Additional plane radiographs should be obtained to verify the seed count. Until the ideal postoperative interval for CT scanning has been determined, each center should perform dosimetric evaluation of prostate implants at a consistent postoperative interval. This interval should be reported. Isodose displays should be obtained at 50%, 80%, 90%, 100%, 150%, and 200% of the prescription dose and displayed on multiple cross-sectional images of the prostate. A dose-volume histogram (DVH) of the prostate should be performed and the D90 (dose to 90% of the prostate gland) reported by all centers. Additionally, the D80, D100, the fractional V80, V90, V100, V150 and V200 (i.e., the percentage of prostate volume receiving 80%, 90%, 100%, 150%, and 200% of the prescribed dose, respectively), the rectal, and urethral doses should be reported and ultimately correlated with clinical outcome in the research environment. On-line real-time dosimetry, the effects of dose heterogeneity, and the effects of tissue heterogeneity need further investigation. CONCLUSION: It is essential that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy. Guidelines were established for the performance and analysis of such dosimetry.

Brachytherapy

A clinical method for real-time dosimetric guidance of transperineal 125I prostate implants using interventional magnetic resonance imaging.

PURPOSE: The clinical utility of an interventional magnetic resonance (IMR)-guided implant technique with real-time dosimetric feedback is presented. METHODS AND MATERIALS: The work was carried out at a IMR unit at Brigham and Women's Hospital. Planning and dosimetric feedback were provided by a software system that provides an interface to the IMR images, anatomy demarcation, template registration, dose calculation engine for planning, and evaluating the implant. Planning during the procedure permits the incorporation of actual needle trajectories in the dose calculations. RESULTS: Fifteen patients were planned in the treatment position. During source placement, actual needle locations were incorporated into the dose calculations. After accounting for the observed needle trajectories of the planned needles, 14 of 15 patients (93%) required additional sources to achieve the desired coverage of the target volume. CONCLUSION: A brachytherapy implant procedure which provides clinically significant advances has been implemented. Specifically, the planning system allows dosimetric validation of the needle placement. This procedure is effective in delivering brachytherapy to the target volume and assuring that the implant is delivered in accordance with the preplan. The dosimetric feedback could be incorporated in ultrasound-guided implants.

Brachytherapy