First clinical implementation of GammaTile permanent brain implants after FDA clearance

Area of Science:

• Medical Physics
• Radiation Oncology
• Neurosurgery

Background:

• GammaTile cesium-131 (¹³¹Cs) is an FDA-cleared permanent brain implant for treating specific brain tumors.
• Our center was the first in the U.S. to offer GammaTile brachytherapy clinically post-FDA clearance, outside of a trial.

Purpose of the Study:

• To provide a practical implementation roadmap for medical physicists and radiation oncologists adopting GammaTile collagen carrier tile brachytherapy (CTBT).
• To share clinical experience and establish best practices for GammaTile brachytherapy program implementation.

Main Methods:

• Treatment planning system (TPS) commissioning for ¹³¹Cs sources and dose validation using AAPM TG-43U1S2 consensus data.
• Established clinical procedures for implant, dosimetry, postimplant planning, and target delineation based on initial patient treatments.
• Evaluated radiation safety through exposure rate measurements and personnel dosimetry.

Main Results:

• Presented estimated timeframes for GammaTile clinical responsibilities across medical physics, radiation oncology, and neurosurgery teams.
• Validated TPS doses against published ¹³¹Cs dose-to-water data.
• Detailed clinical aspects including tile count estimation, treatment planning, dosimetry, and radiation safety protocols.

Conclusions:

• Successful GammaTile program implementation necessitates interdisciplinary collaboration among medical physics, radiation oncology, and neurosurgery.
• This manuscript serves as a comprehensive guide for establishing a GammaTile CTBT program.