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Combining flat-panel imaging with internal BB markers for precise HDR brachytherapy source localization: A simulation

Yibin Ling1,2, Catherine H Frank2, Naoki Dominguez Kondo2

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|February 10, 2026
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Summary
This summary is machine-generated.

This study optimized a flat-panel system for High Dose Rate (HDR) brachytherapy, improving source localization accuracy relative to the implant. The new method significantly reduces errors caused by implant movement, enhancing treatment precision.

Keywords:
HDR techniquesbrachytherapyimage‐guided therapy

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Medical Imaging

Background:

  • High Dose Rate (HDR) brachytherapy uses internal radiation sources for precise tumor targeting.
  • Sharp radiation dose falloff in HDR brachytherapy increases sensitivity to localization errors.

Purpose of the Study:

  • To optimize a flat-panel-based system for enhanced source localization accuracy in HDR brachytherapy.
  • To improve localization relative to both room coordinates and the implanted target.

Main Methods:

  • Simulated Ir-192 gamma rays using Monte Carlo for image reconstruction.
  • Employed a flat-panel detector with tungsten ball bearings (BBs) on the couch for room coordinate localization.
  • Utilized a dummy wire with BBs inserted into catheters for implant-relative localization via rigid transformation.

Main Results:

  • Achieved 0.78 mm accuracy for source localization relative to room coordinates.
  • Demonstrated that localization error is influenced by BB-to-source and BB-to-detector distances.
  • Reduced source localization error from 15.8 mm to 1.26 mm relative to the implant during simulated motion.

Conclusions:

  • Validated a flat-panel detector system with couch markers and a dummy wire for robust HDR brachytherapy source localization.
  • The developed method enhances localization accuracy relative to both room coordinates and the implant.
  • This approach offers improved precision for HDR brachytherapy treatment planning and delivery.