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Related Experiment Videos

Conversion from Cs-137 to Ir-192 for high dose rate remote afterloading: practical considerations.

J E Bellotti1, A R Kagan, A Olch

  • 1Department of Radiation Oncology, Southern California Permanente Medical Group, Los Angeles 90027.

Medical Physics
|March 1, 1992
PubMed
Summary

This study compares high dose rate (HDR) Ir-192 brachytherapy to low dose rate (LDR) Cs-137 brachytherapy. Adjustments to HDR Ir-192 loading are needed to match LDR Cs-137 dosimetry, particularly for uterine cervix treatments.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Brachytherapy

Background:

  • High dose rate (HDR) remote afterloading is replacing low dose rate (LDR) brachytherapy.
  • Implementation of microSelectron-HDR with Iridium-192 (Ir-192) requires dosimetric comparison with Cesium-137 (Cs-137).

Purpose of the Study:

  • To achieve equivalent dosimetric distributions between HDR Ir-192 and LDR Cs-137 techniques.
  • To adapt current treatment planning systems for HDR brachytherapy implementation.

Main Methods:

  • Comparison of dosimetric distributions for nasopharynx, esophagus, and uterine cervix using HDR Ir-192 and LDR Cs-137.
  • Accounting for the anisotropy of Cs-137 tubes when converting to Ir-192.
  • Modifying HDR Ir-192 loading for uterine cervix treatments to maintain dose levels to organs at risk.

Related Experiment Videos

Main Results:

  • HDR Ir-192 yields longer isodose curves than LDR Cs-137 for linear geometries.
  • Fletcher-Suit treatments with HDR Ir-192 require approximately 85% of Cs-137 activity in vaginal ovoids to protect bladder and rectum.
  • A chart for converting LDR to HDR dwell times was developed.

Conclusions:

  • Equivalent dosimetry between HDR Ir-192 and LDR Cs-137 is achievable with specific adjustments.
  • The developed methods and chart facilitate the transition to HDR brachytherapy using existing treatment planning systems.