A commissioning procedure for breast intracavitary electronic brachytherapy systems

Area of Science:

• Medical Physics
• Radiation Oncology
• Brachytherapy

Background:

• Electronic Brachytherapy (EB) systems are emerging for clinical use, primarily in intracavitary breast treatments.
• EB for Accelerated Partial Breast Irradiation (APBI) is an understudied modality, posing commissioning challenges for medical physicists.
• Standardized quality assurance (QA) protocols are essential for the safe and effective implementation of new radiation therapy technologies.

Purpose of the Study:

• To report a comprehensive quality assurance (QA) process for the commissioning of an Electronic Brachytherapy (EB) system.
• To provide a documented guide for other institutions undertaking EB system commissioning.
• To ensure the accurate and safe clinical application of EB for brachytherapy treatments.

Main Methods:

• Developed and executed a QA process encompassing eight critical elements for EB system commissioning.
• Included tests for well-chamber constancy, beam stability, source positional accuracy, output stability, and timer linearity.
• Verified dummy marker/source position coincidence, controller functionality, safety interlocks, and treatment planning data per AAPM TG-43 recommendations.

Main Results:

• Successfully commissioned an Electronic Brachytherapy (EB) system at a leading U.S. clinical site.
• The implemented QA process covered all essential aspects of EB system performance and safety.
• The methodology ensures adherence to established dosimetry protocols like AAPM TG-43.

Conclusions:

• The documented QA process provides a robust framework for EB system commissioning.
• This methodology is vital for medical physicists unfamiliar with EB technology.
• Successful commissioning enables the safe and effective clinical use of EB for APBI.