RPT 229 PDF

Dose Calculation for Photon-Emitting
Brachytherapy Sources
with Average Energy Higher than 50 keV:
Full Report of the AAPM and ESTRO
Report of the
High Energy Brachytherapy Source Dosimetry (HEBD)

Working Group
August 2012
DISCLAIMER: This publication is based on sources and

information believed to be reliable, but the AAPM, the
authors, and the editors disclaim any warranty or liability
based on or relating to the contents of this publication.
The AAPM does not endorse any products, manufacturers,

or suppliers. Nothing in this publication should be inter-
preted as implying such endorsement.
2012 by American Association of Physicists in Medicine

This page intentionally left blank.
Corrigenda
Errata sheet listing chronologically the changes in the report. Please, check it often to verify
that you have an updated version of the report.
Date Change Comments

September 25 Data for the IPL Cs-137 A typographical error was detected in the F(r,θ) table of the
2012 source. EPAPS Document No. E-MEDPHYSA6-3605910 in the
Tables XLVIII and XLIX EXCEL spreadsheet format. Table IV of the paper presents
have been corrected. F(r,θ) values for r = …, 1, 1.5, 2, 3, 4, .. (Correct ones) while
the spreadsheet contains data for r = …, 1, 1.25, 2, 2.5, 4, ..
Consequently, the r values in the spreadsheet have been
modified to match those given in Table IV of the original
reference. The QA table calculated using the incorrect F(r,θ)
has been updated.
Authors of the original publication have submitted an erratum
to the journal.
January 2016 Page 14 text Changed text at the bottom of the page to read “...using linear
extrapolation in r for fixed polar angle based on the last two
tabulated values, and use zeroth order (nearest neighbor)
extrapolation for r < rmin.”
Pages 38 & 39 links Updated the two hyperlinks to ESTRO and Carleton U. websites.
Page 50, Table 4, Changed the equation in column 3 heading to: CON Λ / GL (r0 ,θ0 )
column 3 heading
Page 53, Fig. 3 Updated the graphic for the Nucletron HDR.
DISCLAIMER: This publication is based on sources and information believed to be
reliable, but the AAPM, the authors, and the publisher disclaim any warranty or liability
based on or relating to the contents of this publication.
The AAPM does not endorse any products, manufacturers, or suppliers. Nothing in this
publication should be interpreted as implying such endorsement.
ISBN: 978-1-936366-17-0
ISSN: 0271-7344
© 2012 by American Association of Physicists in Medicine
All rights reserved.
Published by
American Association of Physicists in Medicine
One Physics Ellipse
College Park, MD 20740-3846
HEBD Working Group
Jose Perez-Calatayud (Chair)

Radiotherapy Department, La Fe Polythecnic and University Hospital, Valencia 46026, Spain
Facundo Ballester
Department of Atomic, Molecular and Nuclear Physics, University of Valencia, Burjassot 46100,
Spain
Rupak K. Das
Department of Human Oncology, University of Wisconsin, Madison, Wisconsin 53792
Larry A. DeWerd
Department of Medical Physics and Accredited Dosimetry and Calibration Laboratory,
University of Wisconsin, Madison, Wisconsin 53706
Geoffrey S. Ibbott
Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center,
Houston, Texas 77030
Ali S. Meigooni
Department of Radiation Oncology, Comprehensive Cancer Center of Nevada,
Las Vegas, Nevada 89169
Zoubir Ouhib
Radiation Oncology, Lynn Regional Cancer Center, Delray Beach, Florida 33484
Mark J. Rivard
Department of Radiation Oncology, Tufts University School of Medicine,
Boston, Massachusetts 02111
Ron S. Sloboda
Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta T6G 1Z2 Canada
Jeffrey F. Williamson
Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298
iii
ABSTRACT
Purpose: Recommendations of the American Association of Physicists in Medicine (AAPM) and the
European Society for Radiotherapy and Oncology (ESTRO) on dose calculations for high-energy
(average energy higher than 50 keV) photon-emitting brachytherapy sources are presented, including
the physical characteristics of specific 192Ir, 137Cs, and 60Co source models.
Methods: This report has been prepared by the High Energy Brachytherapy Source Dosimetry
(HEBD) Working Group. This report includes considerations in the application of the TG-43U1
formalism to high-energy photon-emitting sources with particular attention to phantom size effects,
interpolation accuracy dependence on dose calculation grid size, and dosimetry parameter
dependence on source active length.
Results: Consensus datasets for commercially available high-energy photon sources are provided,
along with recommended methods for evaluating these datasets. Recommendations on dosimetry
characterization methods, mainly using experimental procedures and Monte Carlo, are established
and discussed. Also included are methodological recommendations on detector choice, detector
energy response characterization and phantom materials, and measurement specification
methodology. Uncertainty analyses are discussed and recommendations for high-energy sources
without consensus datasets are given.
Conclusions: Recommended consensus datasets for high-energy sources have been derived for
sources that were commercially available as of January 2010. Data are presented according to the
AAPM TG-43U1 formalism, with modified interpolation and extrapolation techniques of the AAPM
TG-43U1S1 report for the 2D anisotropy function and radial dose function.
Keywords: brachytherapy, TG-43 formalism, high-energy brachytherapy sources, Monte Carlo,

experimental dosimetry, quality assurance.
iv
CONTENTS
I. INTRODUCTION .............................................................................................................. 1
II. PHYSICAL CHARACTERISTICS OF HIGH-ENERGY PHOTON-EMITTING

BRACHYTHERAPY SOURCES .................................................................................... 4
192
II.A. Ir............................................................................................................................... 5
137
II.B. Cs ............................................................................................................................. 6
60
II.C. Co .............................................................................................................................. 6
III. CONSIDERATIONS APPLYING THE TG-43U1 FORMALISM

TO HIGH-ENERGY PHOTON-EMITTING BRACHYTHERAPY SOURCES ... 7
III.A. Phantom size effects.................................................................................................. 8
III.B. Dose calculation grid size and interpolation accuracy............................................ 12
III.C. Dosimetry parameter dependence on active length................................................. 15
IV. CONSENSUS DATASET METHODOLOGY .............................................................. 20

IV.A. Dose rate constant ..................................................................................................... 23
IV.B. Radial dose function.................................................................................................. 23
IV.C. 2D anisotropy function ............................................................................................. 23
V. RECOMMENDATIONS ON DOSIMETRY CHARACTERIZATION

METHODS FOR HIGH-ENERGY PHOTON-EMITTING
BRACHYTHERAPY SOURCES .................................................................................... 24
V.A. Preparation of dosimetry parameters ........................................................................ 24
V.A.1. Air-kerma strength.......................................................................................... 25
V.A.2. Dose rate constant........................................................................................... 25
V.A.3. Radial dose function ....................................................................................... 25
V.A.4. 2D anisotropy function................................................................................... 26
V.B. Reference data and conditions for brachytherapy dosimetry................................... 26
V.B.1. Radionuclide data ........................................................................................... 26
V.B.2. Reference media.............................................................................................. 26
v
V.C. Methodological recommendations for experimental dosimetry .............................. 26
V.C.1. Detector choice ............................................................................................... 26
V.C.2. Phantom material and energy response characterization ............................. 28
V.C.3. Specification of measurement methods......................................................... 30
V.D. Methodological recommendations for Monte Carlo–based dosimetry................... 30
V.D.1. Specification of Monte Carlo calculation methods ...................................... 31
V.D.2. Good practice for Monte Carlo calculations ................................................. 31
V.E. Uncertainty analyses................................................................................................... 33
V.F. Publication of dosimetry results................................................................................. 34
V.G. The role of non–Monte Carlo computational tools in reference dosimetry............ 34
VI. RECOMMENDED DOSIMETRY DATASETS FOR HIGH-ENERGY

PHOTON-EMITTING BRACHYTHERAPY SOURCES .......................................... 37
VI.A. AAPM-RPC Source Registry................................................................................... 37
VI.B. Consensus datasets .................................................................................................... 39
VI.B.1. HDR 192Ir sources .......................................................................................... 39
VI.B.2. PDR 192Ir sources ........................................................................................... 39
VI.B.3. LDR 192Ir sources........................................................................................... 40
VI.B.4. LDR 137Cs sources ......................................................................................... 40
VI.B.5. HDR 60Co sources.......................................................................................... 40
VI.C. Reference overview of sources without consensus datasets................................... 40
NOMENCLATURE...................................................................................................................... 41
APPENDIX A: Detailed Recommended Dosimetry Datasets for High-Energy

Photon-Emitting Brachytherapy Sources.................................................... 45
A.1 High Dose Rate 192Ir sources ....................................................................................... 46
A.1.1 mHDR-v1 (Nucletron) ..................................................................................... 46
A.1.2 mHDR-v2 (Nucletron) ..................................................................................... 52
A.1.3 VS2000 (Varian Medical Systems) ................................................................. 57
A.1.4. Buchler (E&Z BEBIG) ................................................................................... 60
A.1.5. GammaMed HDR 12i (Varian Medical Systems)......................................... 63
A.1.6. GammaMed HDR Plus (Varian Medical Systems)....................................... 66
vi
A.1.7. GI192M11 (E&Z BEBIG) .............................................................................. 69
A.1.8. Ir2.A85-2 (E&Z BEBIG)................................................................................. 73
A.1.9. M-19 (Source Production and Equipment)..................................................... 75

A.1.10. Flexisource (Isodose Control)........................................................................ 79
A.2 Pulsed Dose Rate 192Ir sources..................................................................................... 81
A.2.1. GammaMed PDR 12i (Varian Medical Systems) ......................................... 81
A.2.2. GammaMed PDR Plus (Varian Medical Systems) ....................................... 85
A.2.3. mPDR-v1 (Nucletron) ..................................................................................... 88
A.2.4. Ir2.A85-1 (E&Z BEBIG) ................................................................................ 91
A.3. Low Dose Rate 192Ir sources ....................................................................................... 94
A.3.1. Steel clad 192Ir seed (Best Industries) ............................................................. 94
A.3.2. LDR 192Ir wires (E&Z BEBIG)....................................................................... 98
137
A.4. Cs sources ............................................................................................................... 102
A.4.1. CSM3 (E&Z BEBIG)...................................................................................... 102
A.4.2. IPL (Radiation Products Design).................................................................... 106
A.4.3. CSM11 (E&Z BEBIG).................................................................................... 109
A.5. High Dose Rate 60Co sources ..................................................................................... 112
A.5.1. GK60M21 (E&Z BEBIG)............................................................................... 112
A.5.2. Co0.A86 (E&Z BEBIG).................................................................................. 115
APPENDIX B: References for High-Energy Sources Not Commercially Available

and Without Consensus Datasets .................................................................. 119
B.1 LDR-HDR-PDR 192Ir.................................................................................................... 119
B.2 LDR 137Cs...................................................................................................................... 120
B.3 HDR 60Co ...................................................................................................................... 124
REFERENCES .............................................................................................................................. 125
vii
LIST OF FIGURES
1. Reference polar coordinate system for high-energy photon-emitting sources

adapted from the 1995 TG-43 report. ............................................................................ 45
2. Materials and dimensions (mm) of the Nucletron mHDR-v1 source.[47] ..................... 46
3. Materials and dimensions (mm) of the Nucletron mHDR-v2 source.[93] ..................... 53
4. Material and dimensions (mm) of the Varian Medical Systems VS2000 source.[170] . 58
5. Materials and dimensions (mm) of the E&Z BEBIG HDR 192Ir Buchler
model G0814 source.[64] .................................................................................................. 61
6. Materials and dimensions (mm) of the Varian Medical Systems GammaMed

HDR 12i source.[65] .......................................................................................................... 64

HDR Plus source.[65] ........................................................................................................ 67
8. Materials and dimensions (mm) of the E&Z BEBIG HDR model GI192M11
source.[71] .......................................................................................................................... 69
9. Materials and dimensions (mm) of the E&Z BEBIG HDR model Ir2.A85-2
source.[174]......................................................................................................................... 73
10. Materials and dimensions (mm) of the Source Production and Equipment M-19
source.[5] ........................................................................................................................... 75
11. Materials and dimensions (mm) of the Isodose Control Flexisource.[175] .................... 79
PDR 12i source.[69] .......................................................................................................... 82
PDR Plus source.[69] ........................................................................................................ 85
14. Materials and dimensions (mm) of the Nucletron mPDR-v1 source.[55] ..................... 88
15. Materials and dimensions (mm) of the E&Z BEBIG Ir2.A85-1 source.[174] ............... 92
16. Materials and dimensions (mm) of the Best Medical model 81-01 192Ir seed.[46]
Drawing is not to scale.................................................................................................... 95
17. Materials and dimensions (mm) of the E&Z BEBIG LDR 192Ir wire.[82]
Plot is not to scale. .......................................................................................................... 98
viii
18. Materials and dimensions (mm) of the E&Z BEBIG model CSM3 source.[141] ......... 102
19. Materials and dimensions (mm) of the Radiation Products Design model
67-6520 137Cs source.[193] The source tip is on the side of the aluminum ring. ........... 106
20. Materials and dimensions (mm) of the E&Z BEBIG CSM11 source.[62] .................... 109
21. Materials and dimensions (mm) of the E&Z BEBIG model GK60M21 source.[11] .... 112
22. Materials and dimensions (mm) of the E&Z BEBIG model Co0.A86 source.[12] ...... 116
LIST OF TABLES
I. Physical properties of radionuclides considered in this report. Data have

been taken from the NNDC.[20] Mean photon energy values are calculated
with a cutoff of = 10 keV. Data on Auger and internal conversion (IC)
electrons are not included.......................................................................................... 5
II. Polynomial coefficients of the correction factors (CF) used to quantitatively

compare bounded to unbounded radial dose functions for common phantom
shapes and sizes. CF was fitted as CF = C0 + C1 r + C2 r2 + C3 r3 + C4 r4.[29]
These coefficients have been obtained by D. Granero (private communication)
in a re-evaluation of their study which takes into account that with the
coefficients in the original publication, g(r = 1 cm) was not exactly one.............. 11
III. Interpolation and extrapolation recommendations for high-energy (low-energy)[3]

brachytherapy sources for the line-source approximation. ..................................... 12
IV. Dose rate constant for HDR 192Ir sources................................................................. 50
V. Radial dose function values for HDR sources. Interpolated/extrapolated data

are boldface/underlined. Values inside the source are in italics. In [brackets]
are the corrected values from bounded to unbounded geometry. ........................... 50
VI. F(r,) for the Nucletron mHDR-v1 source. Extrapolated data are underlined.
Values inside the source are in italics. ..................................................................... 51
VII. QA away-along data [cGy·h–1·U–1] for the Nucletron mHDR-v1 source. Values
inside the source are in italics ................................................................................... 52
VIII. F(r,) for the Nucletron mHDR-v2 source. Extrapolated data are underlined.
ix
IX. QA away-along data [cGy·h–1·U–1] for the Nucletron mHDR-v2 source. Values
inside the source are in italics................................................................................... 57
X. F(r,) for the Varian Medical Systems VS2000 source. Extrapolated data
are underlined. Values inside the source are in italics ............................................ 59
XI. QA away-along data [cGy·h–1·U–1] for the Varian Medical Systems VS2000
source. Values inside the source are in italics ......................................................... 60
XII. F(r,) for the Buchler model G0814 source. Extrapolated data are underlined.
XIII. QA away-along data [cGy·h–1·U–1] for the Buchler model G0814 source.
Values inside the source are in italics ...................................................................... 63
XIV. F(r,) for the GammaMed HDR 12i source. Extrapolated data are underlined.
XV. QA away-along data [cGy·h–1·U–1] for the GammaMed HDR 12i source.
XVI. F(r,) for the GammaMed HDR Plus source. Extrapolated data are underlined.
XVII. QA away-along data [cGy·h–1·U–1] for the GammaMed HDR Plus source.
XVIII. F(r,) for the E&Z BEBIG model GI192M11 source. Extrapolated data are
underlined. Values inside the source are in italics. ................................................. 71
XIX. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG model GI192M11
source. Values inside the source are in italics. ........................................................ 72
XX. F(r,) for the E&Z BEBIG model Ir2.A85-2 source. Extrapolated data are
XXI. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG model Ir2.A85-2 source.
XXII. F(r,) for the SPEC In. Co. model M-19 source. Extrapolated data are
underlined. Values inside the source are in italics .................................................. 77
XXIII. QA away-along data [cGy·h–1·U–1] for the SPEC In. Co. model M-19 source.
x
XXIV. F(r,) for the Isodose Control model Flexisource. Extrapolated data are
XXV. QA away-along data [cGy·h–1·U–1] for the Isodose Control model Flexisource.
XXVI. Dose rate constant for PDR sources. ........................................................................ 83
XXVII. Radial dose function values for PDR sources. Extrapolated data are
underlined. Values inside the source are in italics. In [brackets] are the
corrected values from bounded to unbounded geometry. ....................................... 83
XXVIII. F(r,) for the GammaMed PDR 12i source. Extrapolated data are underlined.
XXIX. QA away-along data [cGy·h–1·U–1] for the GammaMed PDR 12i source.
XXX. F(r,) for the GammaMed PDR Plus source. Extrapolated data are underlined.
XXXI. QA away-along data [cGy·h–1·U–1] for the GammaMed PDR Plus source.
XXXII. F(r,) for the Nucletron mPDR-v1 source. Extrapolated data are underlined.
XXXIII. QA away-along data [cGy·h–1·U–1] for the Nucletron mPDR-v1 source. Values
inside the source are in italics................................................................................... 91
XXXIV. F(r,) for the E&Z BEBIG PDR-Ir2.A85-1 model. Extrapolated data are
XXXV. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG PDR Ir2.A85-1
source. Values inside the source are in italics. ........................................................ 94
XXXVI. Dose rate constant for different LDR 192Ir sources .................................................. 96
XXXVII. Radial dose function values for LDR 192Ir sources. Extrapolated data
are underlined. Values inside the source are in italics. ........................................... 97
XXXVIII. F(r,) for the Best Industries model 81-01192Ir seed. Extrapolated data
are underlined. Values inside the source are in italics. ........................................... 97
XXXIX. QA away-along data [cGy·h–1·U–1] for the Best Industries model 81-01192Ir
seed. Values inside the source are in italics............................................................. 98
xi
XL. F(r,) for the E&Z BEBIG L = 0.5 cm wire length. Extrapolated data are
XLI. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG L = 0.5 cm wire
length. Extrapolated data are underlined. Values inside the source are in italics. 100
XLII. F(r,) for the E&Z BEBIG L = 1 cm wire length. Extrapolated data are
XLIII. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG L = 1 cm wire length.
Values inside the source are in italics. Extrapolated data are underlined. ............. 101
XLIV. Dose rate constant of 137Cs sources........................................................................... 104
XLV. Radial dose function values for 137Cs LDR sources. Interpolated/extrapolated
data are boldface/underlined. Values inside the source are in italics. ................... 104
XLVI. F(r,) for the E&Z BEBIG CSM3 source. Values inside the source are
in italics. Extrapolated data are underlined.............................................................. 105
XLVII. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG CSM3 source.
Values inside the source are in italics. Extrapolated values are underlined. ......... 106
XLVIII. F(r,) for the Radiation Products Design IPL source. Values inside the source
are in italics. Extrapolated data are underlined........................................................ 108
XLIX. QA away-along data [cGy·h–1·U–1] for the Radiation Products Design IPL
source. Extrapolated data are underlined. Values inside the source are in italics. 109
L. F(r,) for the E&Z BEBIG CSM11 source. Extrapolated data are underlined.
LI. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG CSM11 source. Values
inside the source are in italics. .................................................................................. 111
LII. Radial dose function values for 60Co HDR sources. Values inside
the source are in italics. Extrapolated data are underlined...................................... 113
LIII. Dose rate constant for HDR 60Co sources. ............................................................... 114
LIV. F(r,) for the E&Z BEBIG 60Co HDR GK60M21 source. Values inside the
source are in italics. Extrapolated data are underlined. ........................................... 114
LV. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG 60Co GK60M21
source. Values inside the source are in italics.......................................................... 115
xii
LVI. F(r,) for the E&Z BEBIG 60Co HDR Co0.A86 source. Values inside the
source are in italics. Extrapolated data are underlined. ........................................... 117
LVII. QA away-along data [cGy·h–1·U–1] for the E&Z BEBIG 60Co Co0.A86 source.
Values inside the source are in italics....................................................................... 118
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High-energy photon-emitting brachytherapy dosimetry
I. INTRODUCTION
In 1995, the American Association of Physicists in Medicine (AAPM) Task Group No. 43
(TG-43) published a clinical protocol on dosimetry for interstitial brachytherapy sources,[1]
colloquially known as the “TG-43 formalism,” and provided reference dosimetry datasets for several
designs of 192Ir, 125I, and 103Pd sources commercially available at the time. This report was instrumental
in enhancing dose calculation accuracy and uniformity of clinical dosimetry practices for low-energy
photon-emitting sources following general acceptance and implementation of the TG-43 dose
calculation formalism by the brachytherapy vendor, treatment planning systems (TPS), and user
communities. Development of the TG-43 methods in the area of low-energy brachytherapy source
dosimetry, defined as sources emitting photons of average energy less than or equal to 50 keV, was
carried out by the AAPM Low Energy Brachytherapy Source Dosimetry (LEBD) Working Group. In
response to the vastly increasing use of low-energy interstitial brachytherapy sources, especially for
permanent prostate implants, and the increasing number and variable design of commercially available
low-energy sources, LEBD continued to develop the TG-43 formalism and to prepare reference-
quality AAPM consensus dosimetry datasets from published dosimetry papers. Most of the recent
LEBD recommendations and advances in dosimetric characterization, recommended dose calculation
methodologies, and data evaluation for low-energy interstitial brachytherapy, are summarized in two
key reports: the 2004 update of the TG-43 report (TG-43U1)[2] and its 2007 supplement (TG-
43U1S1).[3,4] In the field of high-energy brachytherapy dosimetry, the TG-186 report will provide
guidance for early adopters of model-based dose calculation algorithms. The Model-Based Dose
Calculation Algorithms (MBDCA) Working Group will develop a limited number of well-defined test
case plans and perform MBDCA dose calculations and comparisons. However, there will remain for
the foreseeable future a need for reference dosimetry data obtained in liquid water phantoms to
evaluate the uniform clinical implementation and robustness of these advanced dose calculation
algorithms.
Many publications propose various dose-estimation methods and dosimetric parameters for
specific high-energy brachytherapy sources (defined as photon-emitting sources with average photon
energies exceeding 50 keV) including 192Ir, 137Cs, 60Co, and 198Au sources. Many new source designs,
especially high dose rate (HDR) and pulsed dose rate (PDR) sources, have been introduced for use in
remote-afterloading machines, while traditional low dose rate (LDR) sources such as 192Ir seeds in
ribbons, 192Ir wires, and 137Cs tubes and spheres remain a mainstay for a number of brachytherapy
applications. New brachytherapy radionuclides, such as 169Yb[5,6] and 170Tm,[7–9] are being actively
investigated for application in HDR brachytherapy and should be discussed in the forthcoming
TG-167 report. Also, new 60Co sources have been designed to be used with HDR afterloaders.[10–12]
HDR remote afterloading units are generally replacing traditional LDR 192Ir and 137Cs sources for
intracavitary and interstitial brachytherapy applications. This trend will continue as other new high-
energy brachytherapy sources are developed. It is paramount that the computational and experimental
tools used in investigations to evaluate single-source dose distributions, consensus dataset formation
processes, and calibration processes, are able to support the level of dosimetric accuracy and precision
2 HEBD report
required to safely and efficiently deliver brachytherapy to patients.[13,14] To ensure that these criteria
are met, reference dosimetry datasets obtained from these investigations must be independently
verified for accuracy and be readily available in a format accepted by commonly used planning
systems. The AAPM has made recommendations on dose calculation formalisms and the choice of
dosimetry datasets for brachytherapy sources in its TG-43,[1] TG-56,[13] and TG-59[15] reports.
Currently the number of source models in clinical use is very large, and medical physicists have few
resources to turn to for selecting the best dosimetry parameters for a given source model. The
availability in tabular form of critically evaluated and complete consensus dosimetry datasets for all
commonly used sources, for use with the updated TG-43 formalism, would be of substantial benefit to
clinical end users.
The AAPM has reviewed and published reference-quality dosimetry datasets for low-energy
brachytherapy sources in the LEBD reports (TG-43,[1] TG-43U1,[2] and TG-43U1S1[3,4]). No similar
effort has been attempted by AAPM or the European Society for Radiotherapy and Oncology
(ESTRO) for high-energy sources, nor have societal recommendations been made concerning
appropriate methods for the acquisition and formation of such datasets. To fill this void, the AAPM
Brachtherapy Subcommittee (BTSC) formed the High Energy Brachytherapy Source Dosimetry
(HEBD) Working Group to focus on photon-emitting brachytherapy sources with average energy
higher than 50 keV. This group has the following charges:
1. To compile a list of high-energy brachytherapy sources commonly used in North America and
Europe, for which the dosimetry datasets and guidelines recommended by HEBD will apply.
2. To develop dosimetric prerequisites for routine clinical use of high-energy brachytherapy
sources similar in scope to the low-energy brachytherapy dosimetry prerequisites.[16]
3. To develop an extension of the TG-43 dose-calculation formalism that is applicable to
elongated sources, i.e., with maximum linear dimensions that are large or comparable to typical
calculation distances.
4. To provide consensus datasets for the sources defined in charge 1 above, using the currently
acceptable dose calculation formalisms.
5. To perform a review of existing clinical source-strength calibration requirements and
recommendations for high-energy (LDR/HDR/PDR) sources.
6. To provide a Brachytherapy Source Registry (BSR) for web-based access to high-energy
brachytherapy source dosimetry data that satisfy the prerequisites defined in charge 2.
The objective of this report is to fulfill charges 1 and 4. Charge 2 was addressed in the first
publication of the group[7] developing a set of dosimetric prerequisites for routine clinical use of
brachytherapy sources with average energy higher than 50 keV. These broad recommendations form
the basis of the more detailed recommendations provided by this report. Charge 3 has been adopted as
the principal charge by the joint AAPM/ESTRO Task Group No. 143 on Dosimetric Evaluation of
Elongated Photon Emitting Brachytherapy Sources. Charge 5 on high-energy source calibrations is in
High-energy photon-emitting brachytherapy dosimetry 3
progress for inclusion in a complementary report. Charge 6, to expand the BSR in an analogous
manner as done for low-energy sources, is an on-going collaborative project involving the
Radiological Physics Center (RPC), the AAPM BTSC and BSR Working Group, and the ESTRO
BRAchytherapy PHYsics Quality assurance System (BRAPHYQS) subcommittee analogous to the
BTSC. Specifically, the current report addresses the following:
1. Review the construction and available published dosimetry data for high-energy 192Ir, 137Cs, and
60
Co sources that (i) continue in clinical use in North America or Europe and (ii) satisfy the
AAPM’s dosimetric prerequisites[17] (charge 1).
2. Perform a critical review of the existing TG-43U1 formalism[2] as used heretofore mainly for
low-energy brachytherapy sources. Extension of the TG-43 dose-calculation formalism was not
performed as considered in charge 3.
3. Critically review published dosimetric data for each of the prerequisite-compliant source
models listed in 1., and develop a complete consensus dataset to support clinical planning for
each source model (charge 4).
4. Develop guidelines for investigators on the use of computational and experimental dosimetry
for determination of high-energy brachytherapy source dosimetry parameters.
The recommendations included herein reflect the guidance of the AAPM and the ESTRO for
brachytherapy users, and may also be used as guidance to vendors in developing good manufacturing
practices for sources used in routine clinical treatments.
Certain materials and commercial products are identified in this report in order to facilitate
discussion and methodology description. Such identification does not imply recommendation nor
endorsement by any of the professional organizations or the authors, nor does it imply that the
materials or products identified are necessarily the best available for these purposes.
4 HEBD report
II. PHYSICAL CHARACTERISTICS OF HIGH-ENERGY PHOTON-

EMITTING BRACHYTHERAPY SOURCES
The photon-emitting brachytherapy sources included in this report have average energies
exceeding 50 keV. Only sources intended for conventional clinical interstitial and intracavitary use
were included; sources intended for intravascular brachytherapy are covered by AAPM task groups
TG-60[18] and TG-149.[19] Similarly, electronic brachytherapy sources will be addressed by the
AAPM task groups TG-167 and TG-182. The limit of 50 keV was established by the AAPM to
separate high-energy sources from those addressed by the LEBD.[16]
This report addresses brachytherapy source models that were commercially available as of
January 2010. For sources that were commercially available, the goal was to generate consensus
datasets in a format acceptable to commercial TPS. For sources that are in current clinical use but no
longer manufactured, the scientific literature was reviewed and acceptable published datasets were
identified. In a few cases, datasets were included for sources that are no longer in clinical use to
assist in the retrospective calculation of dose distributions.
The radionuclides considered in this report and described in this section are 192Ir, 137Cs, and
60
Co. Their most important physical properties are presented in Table I; see the National Nuclear
Data Center (NNDC)[20] for a more complete description. Baltas et al.[21] also provides a clear
description of these radionuclides. Detailed information on recommended photon spectra is provided
in section V.D.1.
198
Au (half-life 2.7 days) brachytherapy sources have been used extensively in the past for
treatment of various tumors including gynecological, breast, prostate, head and neck, and other soft-
tissue cancers. These sources were generally of low activity (typically mCi) and were in the form of
seeds or “grains.” 198Au emits a wide spectrum of x-rays and gamma rays with an average energy of
approximately 400 keV. The use of this radionuclide has decreased in recent years, perhaps because
of the availability of competing radionuclides. These include 125I (half-life 59.4 days) and 103Pd (half-
life 17.0 days), both of which have longer half-lives, making shipment and scheduling of treatments
more convenient, and lower photon energies, leading to more acceptable radiation safety
characteristics than 198Au. Vicini et al.[22] conducted a survey of 178 publications reporting on
prostate brachytherapy between 1985 and 1998. They found that 198Au had not been used for
monotherapy according to these studies, and had been used in combined modality therapy only in
11% of cases. Correspondingly, they found that 125I and 103Pd were used far more frequently. Yaes[23]
showed that, regardless of treatment site, the heterogeneity of the dose distributions from 198Au could
be greater than those from 125I and 103Pd. Similarly, Marsiglia et al.[24] reported that 198Au implants
more often showed significant cold spots, and generally inferior dosimetric coverage, than did
implants with other radionuclides. These reports, together with others reporting on comparisons with
other radionuclides, have resulted in relatively infrequent use of 198Au. As a result, this report will
not address 198Au brachytherapy sources.
Table I. Physical properties of radionuclides considered in this report. Data have been taken
from the NNDC.[20] Mean photon energy values are calculated with a cutoff of = 10 keV.
Data on Auger and internal conversion (IC) electrons are not included.
192 137 60
Ir Cs Co
Half-life 73.81 days 30.07 years 5.27 years
Type of disintegration – (95.1%), EC – (100%) – (100%)
(4.9%)
Maximum x-ray energy (keV) 78.6 37.5 8.3
Gamma energy-range (keV) 110.4 to 1378.2 661.6 1173.2 to 1332.5
Mean x-ray and gamma energy (keV) 350.0 613.0 1252.9
Maximum – ray energies (keV) 81.7 (0.103%) 514.0 (94.4%) 318.2 (99.88%)
258.7 (5.6%) 1175.6 (5.6%) 1491.4 (0.12%)
538.8 (41.43%)
675.1 (48.0%)
Mean – ray energy (keV) 180.7 188.4 96.5
Air kerma rate constant,
=10 keV (μGy m2 h–1 MBq–1) 0.1091 0.0771 0.3059
Specific activity (GBq mg-1) 341.0 3.202 41.91
192
II.A. Ir
The 192Ir half-life of 73.81 days allows it to be easily used for temporary implants. Its high
specific activity makes it practical to deliver sources of activities of as much as hundreds of GBq.
192
Ir decays to several excited states of 192Pt via (95%) and 192Os via electron capture (EC) (5%),
emitting on average 2.3 gamma rays per disintegration with a range of energies between 0.061 and
1.378 MeV and a mean energy of 0.355 MeV. The rays emitted have a maximum energy of
0.675 MeV and an average energy of 0.1807 MeV. 192Ir is produced from enriched 191Ir targets (37%
natural abundance) in a reactor by the (n, ) reaction, creating HDR 192Ir sources (typically 1 mm
diameter by 3.5 mm length cylinders) with activities exceeding 4.4 TBq. HDR 192Ir sources are
encapsulated in a thin titanium or stainless steel capsule and laser welded to the end of a flexible
wire. Electrons from decay are absorbed by the core and the capsule.[25–28]
6 HEBD report
137
II.B. Cs
The 137Cs half-life of 30.07 years enables use over a long period of time. Its low specific
activity makes it practical for LDR implants. 137Cs decays purely via , mainly (94.4%) to the
second excited state of 137Ba, where the de-excitation to the ground state (90%) with emission of a
gamma ray of 0.662 MeV (absolute intensity 85.1%) is in competition with IC (10%). The rays
emitted have a maximum energy of 0.514 MeV. A second decay branch (5.6% probability) to the
137
Ba ground state occurs, with maximum ray energy of 1.176 MeV. 137Cs is extracted from 235U
fission products, with the 137Cs trapped in an inert matrix material such as gold, ceramic, or
borosilicate glass. The sources are doubly encapsulated with a total of 0.5 mm thick stainless steel.
Electrons from decay are mainly absorbed by the core and the capsule.[28] Cylindrical source
models commercially available are manufactured with 3 mm diameter and external lengths up to 21
mm. Spherical sources are made for use in remote-afterloading intracavitary brachytherapy devices.
60
II.C. Co
The 60Co half-life of 5.27 years and its high specific activity make it practical for HDR
brachytherapy implants. Newly designed HDR sources have been introduced in the market. 60Co
undergoes decay to the excited states of 60Ni (94.4%). De-excitation to the ground state occurs
mainly via emission of -rays of 1.173 MeV and 1.332 MeV, each with an absolute intensity of
nearly 100%. The main rays emitted (99.88%) have a maximum energy of 0.318 MeV and an
average energy of 0.096 MeV. 60Co is produced through neutron capture by 59Co, but its long half-
life requires long irradiation times for sufficient source strength. HDR 60Co sources have dimensions
similar to those of 192Ir (section II.A). The low-energy electrons emitted by 60Co are easily absorbed
by the cobalt source material or encapsulation layers, resulting in a “pure” photon source.[10,28]
III. CONSIDERATIONS APPLYING THE TG-43U1 FORMALISM TO

HIGH-ENERGY PHOTON-EMITTING BRACHYTHERAPY SOURCES
The TG-43 formalism[1] was initially developed for use in interstitial brachytherapy including
low-energy 125I and 103Pd seeds and high-energy 192Ir seeds in ribbons. In 2004, the AAPM TG-43U1
report[2] updated the formalism and provided data for several new models of low-energy seeds. The
application of this formalism has subsequently been extended significantly by the brachytherapy
physics community, making it the international benchmark for nearly all brachytherapy sources in
brachytherapy dosimetry publications and brachytherapy TPS. The TG-43 formalism applied to low-
energy sources has the following advantages:
1. Dosimetric modeling of seeds using the point-source approximation is facilitated by averaging

dose anisotropy over all solid angles. This method of calculation is used primarily for
permanent prostate brachytherapy where seed orientation is not discernible in clinical practice
for non-stranded applications and due to the large number of seed orientations.
2. Accurate interpolation of the dose distribution is readily achieved because the geometric
dependence of dose falloff as a function of radial distance r and polar angle is accounted for.
This allows the use of a limited dataset while providing for robust dose calculation.
3. An analytic, uniform approach to brachytherapy dose calculation is readily available, thereby
promoting consistent clinical practice worldwide.
The TG-43 formalism[1,2] assumes a water medium with superposition of single source dose
distributions, no inter-source attenuation (ISA) effects, and full scatter conditions (infinite or
unbounded water medium) at dose calculation points-of-interest (POIs). Partial scatter conditions can
potentially be accommodated through the use of appropriate correction factors.[29–32] This
approximation of realistic clinical conditions is pertinent for both low-energy and high-energy
brachytherapy applications, and is discussed in detail by Rivard et al.[33,34]
Variable tissue composition has a greater influence on low-energy brachytherapy source
dosimetry than for high-energy sources due to the photoelectric effect and its high cross section at
low energies. However, the effect of scatter conditions is more important for high-energy
brachytherapy dosimetry. For low-energy brachytherapy, mostly conducted as prostate implants, the
surrounding tissue is adequate to provide full scatter conditions. In contrast, high-energy
brachytherapy implants vary from those deeply positioned (e.g., gynecological) to surface
applications (e.g., skin), with scatter significantly influencing dose calculations at clinically relevant
POIs. It is not clear whether a simple modification of the current TG-43 formalism can account for
partial radiation scatter conditions utilizing the current TG-43–based TPS. Alternatively, new dose
calculation algorithms that correct for partial radiation scatter conditions are emerging.
As for low-energy brachytherapy sources, especially those used in multi-source LDR implants,
ISA effects are also present for high-energy LDR sources such as 192Ir and 137Cs. However, the
clinical trend in the high-energy source domain is that HDR and PDR are more prevalent than the
LDR procedures.
8 HEBD report
One important limitation of current TPS dose calculation tools is the near-universal neglect of
applicator shielding. For example, doses to the rectal and bladder walls are generally not accurately
calculated for gynecological implants, and subsequently the reported doses associated with toxicities
are incorrect. Correction methods[35,36] were developed based on attenuation values that were
experimentally obtained, giving reasonable values in specific clinical applications such as shielded
cylinders.[37] Shielding is also present on some vaginal applicators to protect the healthy vagina at
variable applicator angles. Fortunately, the use of magnetic resonance imaging (MRI) is increasing
relative to computed tomography (CT) for cervical brachytherapy. With the use of MRI-compatible
applicators, imaging artifacts due to high-Z shields are mitigated. New algorithms that account for
these effects are now appearing in commercial TPS as reviewed by Rivard et al.[33,34] and are the
subject of the active AAPM Task Group 186.
The TG-43 formalism was originally applied to sources with active lengths ranging from 2
mm to 4 mm, while typical HDR/PDR sources have active lengths ranging from 0.5 mm to 5 mm,
and some high-energy LDR sources such as 137Cs tubes have active lengths >15 mm. Other LDR
sources have a variable active length and/or curved active components like 192Ir wires. An approach
to dose calculation for these sources that falls within the framework of the TG-43 formalism is
presently being developed by the AAPM Task Group 143.
In section III.C of this report the dependence of dosimetry parameters for high-energy sources
on source active length is discussed, as is the effect of phantom size used in dose calculations and/or
measurements. The latter discussion includes a methodology to convert datasets from bounded to
unbounded (full scatter) conditions to compare data from different publications. The procedure used
in this report for developing consensus datasets is based on this conversion methodology in some
cases. Adaptation of extrapolation and interpolation techniques presented in the AAPM TG-43U1[2]
and TG-43U1S1[3,4] reports was performed for high-energy sources. Finally, aspects specific to high-
energy sources such as the electronic equilibrium region close to the source and the need for higher
spatial resolution of the dose distribution close to the source are addressed.
III.A. Phantom size effects
A limitation of the TG-43 formalism when applied to high-energy sources is the assumption of
fixed scatter conditions at calculation points, without consideration of the tissue boundaries. The TG-
43 dose calculation formalism assumes an infinite scattering medium and can result in
overestimation of absorbed dose at a low-density interface. In many clinical settings, the actual
scatter conditions may significantly deviate from these reference conditions, leading to significant
dose overestimates, e.g., when the source is near the surface of the patient. This is often the case for
breast implants. For example, some breast protocols [e.g., Radiation Therapy Oncology Group
(RTOG) protocol 0413] require that the dose homogeneity index include the skin dose calculations.
Errors/limitations in calculating dose at shallow depths affect the dose calculation.
Serago et al.[38] showed a dose reduction at points close to low-density interfaces of up to 8%
for HDR 192Ir brachytherapy as typical for breast implants performed as a boost. Mangold et al.[39]
showed deviations of up to 14% with measurements close to the tissue-air interface, whereas Wallner
and colleagues[40] found the TPS to overestimate dose by no more than 5% at points close to the skin
and lung for partial breast irradiation. However, Raffi et al.[41] found TPS dose overestimations of up
to 15%.
Lymperopoulou et al.[42] reported that the skin dose overestimation can increase from 15% to
25% when 169Yb is used in place of 192Ir. Pantelis et al.[43] showed for breast implants at 2 to 5 cm
depths with Monte Carlo (MC) radiation transport methods that the TPS overestimates by 5% to 10%
the isodose contours lower than 60% of the prescribed dose. Other extreme clinical situations are
superficial implants involving shallow clinical target volume (CTV) irradiations, or intraoperative
brachytherapy for which specialized applicators have been designed. In the latter situation Raina et
al.[44] showed differences of up to 13% between the dose calculated for actual and full scatter
conditions in the surface tissue layer. In practice, this difference can be minimized by adding bolus,
but this may not be clinically beneficial.
TPS calculations are based on interpolation over stored two-dimensional (2D) water dose rate
tables which assume cylindrically symmetric sources and applicators, a uniform water-equivalent
medium, and negligible ISA effects. Usually, these dose rate tables consist of TG-43 parameter
values or away-along dose rate tables. In principle, it seems logical that the tables include larger
distances to avoid extrapolation. Although these larger distance values are not often clinically
significant, accurate data are useful for dose calculations to radiosensitive anatomical structures
outside the CTV, especially when the patient has undergone external beam radiotherapy. For low-
energy brachytherapy dosimetry, the TG-43U1 report[2] recommended that the radial dose function
g(r) extend to 7 cm for 125I and to 5 cm for 103Pd, which correspond to values of approximately 0.5%
and 0.3% of the dose rate at 1 cm, respectively. Also in the TG-43U1 report, recommendations for
good practice for MC dosimetry included determination of the dose distribution for r 10 cm, with
at least 5 cm of backscatter material for 125I and 103Pd. As will be justified below for high-energy
sources, the recommended range for g(r) is r 10 cm.
Another issue is whether the TG-43 dosimetry parameters and the dose rate tables used by the
TPS should be obtained with full scatter conditions for the complete range of distances. This issue is
related to the appropriate phantom size to be used in MC calculations (henceforth labeled with “MC”
subscript) or experimental purposes (henceforth labeled with “EXP” subscript), in order to establish
the reference dose rate distributions used as input and benchmark data for TPS clinical dosimetry.
For high-energy sources, an effectively unbounded spherical phantom radius R of 40 cm is
recommended to promote uniformity of dose calculations for r < 20 cm, since it is not possible to
cover all applications that move from superficial to deeper implants by selecting a smaller phantom
size. Another issue to consider is the promise of new TPS algorithms to solve traditional calculation
limitations such as tissue heterogeneities, patient and applicator scatter of radiation, intersource
effects, and shielding corrections. These new algorithms will be discussed in section V.
Phantom size is well known to be an important consideration in brachytherapy dosimetry.
[45]
Ellet studied boundary effects for photon source energies ranging from 0.03 to 2.75 MeV by
comparing the dose in water spheres of radius R = 10, 20, 30, and 40 cm with the dose in an
unbounded medium. Doses were observed to be within 5% of the values in an unbounded medium at
distances of more than one mean free path from the interface (citing a mean free path of 2.19 cm for
an energy of 0.03 MeV, 9.10 cm for 0.364 MeV, 11.7 cm for 0.662 MeV, and 17.3 cm for 1.46
10 HEBD report
MeV). Williamson[46] compared MC calculations for 192Ir assuming an unbounded water phantom
and a R = 15 cm spherical phantom with measured data from the Interstitial Collaborative Working
Group for a cubic phantom of approximate size (20 20 20) cm3. Agreement within 5% was
observed up to 5 cm from the source, but differences of 5% to 10% were noted for r > 5 cm.
Williamson and Li[47] found a difference of 12% at r = 12 cm from a microSelectron PDR 192Ir source
between the dose calculated in an unbounded water phantom and that obtained with a spherical
phantom (R = 15 cm). Venselaar et al.[48] measured the influence of phantom size on dose by
changing the water level in a cubic water tank for 192Ir, 137Cs, and 60Co sources. Significant dose
differences were observed between experiments with different phantom sizes. Karaiskos et al.[49]
performed MC and thermoluminescent dosimetry (TLD) studies of the microSelectron HDR 192Ir
source using spherical water phantoms with R = 10–50 cm. They ascertained that phantom
dimensions significantly affect g(r) near-phantom boundaries where deviations of up to 25% were
observed. They did not observe significant differences in the anisotropy function F(r,) for the
different values of R. Other investigators have found a dose dependence on R due to the different
scatter conditions.[50–56]
Pérez-Calatayud et al.[29] presented a study where MCg(r) was obtained for water phantoms with
5 cm R 30 cm (125I and 103Pd) and 10 cm R 50 cm (192Ir and 137Cs). They showed that dose
differences with respect to full scatter conditions for 192Ir and 137Cs sources, in the case of the most
popular phantom size cited in the literature (R = 15 cm), reached 7% (192Ir) and 4.5% (137Cs) at
r = 10 cm, but were only 1.5% (192Ir) and 1% (137Cs) at r = 5 cm. For R = 40 cm and 192Ir or 137Cs, the
dose rate was equivalent to an unbounded phantom for r 20 cm, since this size ensured full scatter
conditions. For 125I and 103Pd, R = 15 cm was necessary to ensure full scatter conditions within 1%
for r 10 cm.[29] These results agree with the subsequent study by Melhus and Rivard,[30] who in
addition showed that for 169
Yb a radius of R 40 cm is required to obtain data in full scatter
conditions for r 20 cm. Pérez-Calatayud et al.[29] developed a simple expression relating values of
g(r) for various phantom sizes based on fits to the dose distributions for 192Ir and 137Cs. This
expression is useful to compare published dose rate distributions for different phantom sizes, and to
correct g(r) values for bounded media of radius 10 cm R 40 cm to unbounded phantom values.
Differences between corrected dose rate distributions and the corresponding MC results for a given
phantom size were less than 1% for r < R – 2 cm if R < 17 cm, and for r < 15 cm if R 17 cm. At
larger distances r, the fitted dose rate distribution values did not lie within the 1% tolerance. These
relations were based on the previous result that for R = 40 cm the dose rate was equivalent to an
unbounded phantom for r 20 cm. Some dosimetry investigators have used a 40-cm-high cylindrical
phantom with a 20-cm radius in their MC studies. It has been shown that this phantom is equivalent
to a spherical phantom with a 21-cm radius.[29] The expression developed by Pérez-Calatayud et al.[29]
is not applicable to the outer 2 cm of this phantom. To date, most published MC high-energy
brachytherapy dosimetry studies have been performed in a water sphere with R = 15 cm,[10,46,55,57–61] a
cylindrical phantom of size 40 cm 40 cm,[62–69] or a sphere with R = 40 cm.[70–72] Granero et al.[31]
developed correction factors expressed as fourth-degree polynomials to transform g(r) data for 192Ir
and 137Cs obtained using commonly published phantom sizes into approximate g(r) values for
unbounded phantom conditions, with agreement within 1%.[29–31] These correction factors are given
in Table II.
Table II. Polynomial coefficients of the correction factors (CF) used to quantitatively compare bounded
to unbounded radial dose functions for common phantom shapes and sizes.
CF was fitted as CF = C0 + C1 r + C2 r2 + C3 r3 + C4 r4.[29] These coefficients have been obtained
by D. Granero (private communication) in a re-evaluation of their study which takes into account
that with the coefficients in the original publication, g(r = 1 cm) was not exactly one.
Sphere Cylinder Cube
CF =
(
g Rsph = 40 cm, r ) CF =
(
g Rsph = 40 cm, r ) CF =
(
g Rsph = 40 cm, r )
g(R sph = 15 cm, r ) g(R cyl = 20 cm, r ) g ( Rcube = 15 cm, r )
1 cm r 15 cm 1 cm r 20 cm 1 cm r 15 cm
192 137 192 137 192 137
CF parameter Ir Cs Ir Cs Ir Cs
C0 [dimensionless] 1.002 1.001 1.001 1.001 1.002 1.001
–3 –3 –3 –3 –3
–1
C1 [cm ] –3.52 × 10 –2.28 × 10 –1.23 × 10 –1.09 × 10 –3.27 × 10 –1.85 × 10–3
C2 [cm–2] 2.06 × 10–3 1.24 × 10–3 3.00 × 10–4 4.02 × 10–4 1.31 × 10–3 8.89 × 10–4
C3 [cm–3] –2.39 × 10–4 –1.35 × 10–4 –2.40 × 10–5 –3.93 × 10–5 –2.46 × 10–4 –9.45 × 10–5
C4 [cm–4] 1.38 × 10–5 7.78 × 10–6 1.90 × 10–6 2.08 × 10–6 8.50 × 10–6 5.23 × 10–6
In this joint AAPM/ESTRO report, g(r) values from published studies obtained under bounded
conditions have been transformed to full scatter conditions with the correction factors in Table II. So,
with these relationships, TPS users can transform data from the literature obtained in a bounded
medium to input data in full scatter conditions for r 15 cm.
When different datasets obtained with different phantom sizes are compared, the boundary
scatter defect must be taken into account. At r = 1 cm, full scatter exists within 0.5% for all studies,
hence the dose rate constant is directly comparable in all cases. As noted in the literature,[49] F(r,)
has been shown to be nearly independent of phantom size. Consequently, research has focused on
g(r). Anagnostopoulos et al.[54] proposed a calculation algorithm based on the scatter-to-primary ratio
to relate g(r) for one spherical phantom size to g(r) for other R values. Russell et al.[73] proposed
another dose calculation algorithm based on primary and scatter dose separation involving
parameterization functions which could also be used to correct the scatter defect. Melchert et al.[74]
developed a novel approach inspired by field theory to calculating the dose decrease in a finite
phantom for 192Ir point source(s).
12 HEBD report
III.B. Dose calculation grid size and interpolation accuracy
Traditionally, brachytherapy TPS utilized analytical methods such as the Sievert integral[75] to
generate dose rate tables for conventional LDR brachytherapy sources such as 137Cs tubes and 192Ir
wires. These systems then utilized the same method for data interpolation to calculate dose for
clinical implants. However, current TPS used for HDR, PDR, and LDR brachytherapy allow direct
introduction of tabulated dosimetry parameters from the literature. Some of this information is
included in the TPS default dosimetric data supplied by the TPS manufacturer. In some systems,
values of the dosimetry parameters are manipulated from one format to another in order to match the
dose calculation algorithm used by the system. Examples include changing from rectangular to polar
coordinates, using different mathematical functions to fit and smooth tabulated data, and
extrapolating data outside of the available data range. Therefore, it is desirable that TG-43 consensus
data be presented with adequate range and spatial resolution in order to facilitate input and
verification of the accuracy of the TPS dose calculation algorithm.
A review of the published data on dosimetry parameters for various high-energy
brachytherapy sources indicates that different authors have used a variety of spatial and angular
increments and ranges in their dosimetric procedures. Therefore, a clear methodology for
interpolation or extrapolation of the published data may be required to determine dose rate
distributions at spatial locations not explicitly included in the published data. The AAPM TG-43U1
report[2] provided guidelines for interpolation and extrapolation of one-dimensional (1D) and 2D
dosimetry parameters. The 2007 supplement (i.e., TG-43U1S1)[3,4] included further clarification and
modifications of the interpolation and extrapolation techniques in order to make these procedures
more accurate. Unlike for low-energy sources, the 1D approximation for high-energy brachytherapy
source dosimetry is not recommended, based on the smaller number of sources generally used,
known source orientation(s), and the method used for source localization. In this section, the
parameter range and spatial resolution, as well as interpolation and extrapolation recommendations
are provided. The interpolation and extrapolation recommendations for high-energy (and low-energy
from TG-43U1S1) brachytherapy sources of 2D dosimetry are summarized in Table III.
Table III. Interpolation and extrapolation recommendations for high-energy (low-energy)[3]

brachytherapy sources for the line-source approximation.
Parameter r < rmin rmin < r rmax r > rmax

Extrapolation Interpolation Extrapolation
Linear (log-linear) using Linear using data of last two tabulated
Nearest neighbor or
datapoints immediately radii (single exponential function based
gL(r) zeroth-order
extrapolation (Ditto) adjacent to the radius of on fitting gL(r) datapoints for the
interest furthest three r values).
Nearest neighbor or Bilinear (bilinear)
Nearest neighbor or zeroth-order r-
F(r,) zeroth-order interpolation method for
extrapolation (Ditto)
extrapolation (Ditto) F(r,)
With respect to the angular resolution for F(r,), 10° steps were generally recommended by
the TG-43U1[2] report, although 1° steps near the source long axes may be needed to have 2%
interpolation accuracy over the range of angles. For radial resolution, TG-43U1 recommended F(r,)
be tabulated at 0.5, 1, 2, 3, and 5 cm for 103Pd and also at 7 cm for 125I. For gL(r), the recommended
range was the same as the F(r,) radial range, but no specifics were provided concerning radial
resolution. However, both the TG-43U1 and TG-43U1S1[3,4] reports required that the gL(r) radial
resolution permit log-linear interpolation and fitting with ±2% accuracy. The radial coordinate mesh
recommended by HEBD is similar to that recommended by LEBD for low-energy sources. However,
a maximum range of 10 cm is indicated since the dose rate here is about 1% of the value at r0 due to
the more uniform g(r) behavior for high-energy sources. The minimum r value for the high-energy
consensus datasets will also differ based on consideration of radiological interactions. Some
differences between low-energy and high-energy source dosimetry include the following:
1. From a clinical perspective, there is more concern with dose accuracy along the longitudinal
axis region of the source for high-energy sources as there is a larger proportion of treatments
in which the dose along this axis is included in the prescription (e.g., dome applicators for
hysterectomyzed patients, endometrial applicators) than for low-energy brachytherapy. In
contrast, permanent prostate implants use many seeds, and the longitudinal axis region is less
relevant because of volume averaging and the contribution of many seeds with variable axis
orientation.[76–78]
2. For high-energy sources, MC-based dosimetry is the predominant method in part due to its
robustness at these energies. When measurement conditions are subject to challenges
(associated with detector energy response, detector radiation sensitivity, positioning
uncertainty, detector volume averaging, influence of radiation scatter conditions on results,
etc.), the role of experimental dosimetry for high-energy brachytherapy may be more limited
than MC-based dosimetry. Experiment may primarily serve to validate MC, and to obtain
for averaging with MC-derived values since MC is primarily used to determine F(r,) and
gL(r) for high-energy sources. Consequently, range and spatial resolution limitations are not of
concern for MC methods and high-energy brachytherapy source dosimetry. However, caution
must be taken at close distances if electron transport and electron emissions are not
considered.
A study by Pujades-Claumarchirant et al.[79] has been performed for high-energy sources to

check methods of interpolation/extrapolation that allow accurate reproduction of gL(r) and F(r,)
from tabulated values, including the minimum number of entries for gL(r) and F(r,) that allow
accurate reproduction of dose distributions. Four sources were studied: 192Ir, 137Cs, 60Co, and a
hypothetical 169Yb source. The r mesh was that typically used in the literature: 0.25, 0.5, 0.75, 1, and
1.5 cm, and for 2 to 10 cm in 1 cm steps, adding the point rgmax = 0.33 cm for 60Co and rgmax = 0.35 cm
for 137Cs near the maximum value g(rgmax). For F(r,), the entries for polar angles close to the source
14 HEBD report
long axis were evaluated at four different step sizes: 1°, 2°, 5°, and 10°. For gL(r), linear
interpolations agreed within 0.5% compared with MC results. The same agreement was observed for
F(r,) bilinear interpolations using 1° and 2° step sizes.
Based on the Pujades-Claumarchirant et al. study,[79] minimum polar angle resolutions of 2°
(0° to 10° interval), 5° (10° to 30° interval), and 10° (30° to 90° interval) with the addition of
corresponding supplementary angles as applicable if dosimetric asymmetry about the transverse
plane is >2% are recommended. Further, use of bilinear and linear interpolation for F(r,) and gL(r),
respectively, is recommended since log-linear interpolation is not a significant improvement over
linear g(r) interpolation for high-energy sources.[79]
F(r,) and gL(r) extrapolation for r > 10 cm could be performed by linear extrapolation from
the last two tabulated values. However, because of the inverse square law, the dose rate is very low
and not clinically relevant. If dosimetric accuracy is required for r > 10 cm, for example to calculate
organ-at-risk dose, users must refer to the original MC publication.
In contrast with low-energy brachytherapy dosimetry, extrapolation for high-energy sources
for r rmin is complicated. Electronic equilibrium is reached within a distance of 0.1 mm from the
capsule for a low-energy source due to the short electron range. Thus, it can be assumed that
collisional kerma is equal to absorbed dose everywhere. For high-energy brachytherapy dosimetry,
the region of electronic disequilibrium near the source and the contribution from emitted electrons
can be important issues, and are not considered in most MC publications.
In a recent study of Ballester et al.[28] MC calculations scoring dose and taking into account
electronic emission are compared with MC calculations scoring collisional kerma at short distances
for spherical sources with active and capsule materials mimicking those of actual sources. Electronic
equilibrium is reached to within 1% for 192Ir, 137Cs, 60Co, and 169Yb at distances greater than 2, 3.5, 7,
and 1 mm from the source center, respectively. Electron emissions are important (i.e., >0.5% of the
total dose) within 3.3 mm of 60Co and 1.7 mm of 192Ir source centers but are negligible over all
distances for 137Cs and 169Yb. Ballester et al.[28] concluded that electronic equilibrium conditions
obtained for spherical sources could be generalized to actual sources, while electron contributions to
total dose depend strongly on source dimensions, material composition, and electron spectra.
Consequently, no extrapolation method can accurately predict near-source dose rate distributions
because they depend on both the extent of electronic disequilibrium and the electron dose at
distances closer than the minimum tabulated results.
However, tabular data containing voids close to and inside the source should not be presented,
and adoption of the TG-43U1S1 extrapolation method for r < rmin using the nearest neighbor data for
gL(r) is recommended until such time as future studies generate data for this region. For F(r,),
HEBD decided to take advantage of partial data and proposed the following approach as a
compromise to maintain consistency with the TG-43U1S1 report: fill in missing data for partially
complete F(r,) tables using linear extrapolation in r for fixed polar angle based on the last two
tabulated values, and use zeroth order (nearest neighbor) extrapolation for r < rmin. It is emphasized
that extrapolated values are only included for the purpose of providing complete data tables as re-
quired by some TPS. Dose data outside the source obtained from these extrapolated values could be
subject to large errors due to beta (electron) contribution, kerma versus dose differences, and
linear extrapolation limitations. Data inside the source are only provided for TPS requirements and
they do not have any physical meaning. These extrapolated values should be used with caution in
clinical dosimetry because potentially large errors exist; this scenario is different from the low-energy
case of TG-43U1S1 where differences between MC calculated and extrapolated doses are generally
minimal.
The formalisms of the 1995[1] and 2004[2] TG-43 reports were based on dosimetric
characteristics of seed models for brachytherapy sources containing 125I, 103Pd, and 192Ir having nearly
spherical dose distributions, given their relatively large ratios of radial distance to active source
length. Therefore, it is appropriate to use the polar coordinate system to describe dosimetric
parameters around these sources. However, several investigators have shown that this approach fails
when the active length is greater than the distance to the POI.[80–83] Alternatively, the advantage of
using the cylindrical coordinate system (Y, Z)–based TG-43 formalism has been demonstrated for
dose calculations around elongated brachytherapy sources by Patel et al.[84] and Awan et al.[85]
Detailed comparisons between the polar and cylindrical coordinate–based formalisms are given by
Awan et al.[85] and the forthcoming AAPM TG-143 report. In these comparisons, it has been
demonstrated that the basic dosimetry parameters in the two coordinate systems are very similar. The
main difference is in the F(r,) definition:
g (Y )
Fpol ( r, ) = Fcyl ( Y, Z ) . (1)
g (r )
However, the cylindrical coordinate system–based formalism provides a more accurate tool for
interpolation and extrapolation of dosimetry parameters for a given source, since the spatial sampling
better approximates the cylindrical radiation dose distribution. For the high-energy sources
considered in this report, the active length up to 1.5 cm, the TG-43 approach using polar coordinates
also applies well if adequate mesh resolution is utilized, and then it is recommended here. Dosimetric
considerations (source calibration, TG-43 parameter derivation, TPS implementation, etc.) for
sources with larger active lengths and curved lengths are being evaluated by AAPM TG-143.
III.C. Dosimetry parameter dependence on active length

The dosimetric properties of a brachytherapy source depend upon the geometry and material
composition of the source core and its encapsulation. For high-energy photon emitters such as 192Ir,
the material composition dependence is much less pronounced than that for low-energy emitters such
as 125I.[1,2] This leads to a greater similarity of TG-43 dosimetry parameters for high-energy sources
containing the same radionuclide and having comparable dimensions than for low-energy sources.
For example, a study by Williamson and Li[47] comparing the original microSelectron Classic HDR
192
Ir source (Nucletron B.V., The Netherlands) with the PDR source and the old VariSource HDR
192
Ir source revealed that they have nearly identical values, and their gL(r) data agreed within ~1%
16 HEBD report
for r > 0.5 cm. Selected reports from the literature describing such similarities for 192Ir, 137Cs, and
60
Co brachytherapy sources are summarized below.
Wang and Sloboda[86] compared the transverse plane dose distributions for four 192Ir
brachytherapy sources (Best Medical model 81-01, Nucletron microSelectron HDR and PDR 192Ir
sources, Varian VariSource HDR) and five hypothetical 192Ir cylindrical source designs using the
EGS4 MC code. The transverse-plane dose rate and air-kerma strength sK per unit contained activity
were calculated in a spherical water phantom of R = 15 cm and a dry air sphere of 5 m diameter,
respectively, to study the influence of the active length L and R on these quantities. For r 4L, the
transverse-plane dose rate and sK depended on R but not on L, and were proportional to the
corresponding quantities for an unencapsulated point source to within 1%. When the transverse-
plane dose rate was normalized to sK, differences in the dose rate profiles between the various
sources disappeared for r 4L. For r < 4L, the transverse-plane dose rate and sK were dependent on
both R and L, and the geometry function G(r,) was the principal determinant of the shape of the
normalized dose rate profile. Photon absorption and scattering in the source had a considerably
smaller influence and partly compensated one another, whereas differences in the photon energy
fluence exiting the source were not of sufficient magnitude to influence absorption and scattering
fractions for the dose rate in water. Upon calculating and gL(r) for the four real sources using
GL(r,) (except for the microSelectron PDR source for which the particle streaming function SL(r,)
was used),[87] observed differences in were explained on the basis of differences in GL(r,) and
source core diameter d. For r 1 cm, gL(r) were similarly identical within 1%, and small differences
for r < 1 cm were caused by varying degrees of photon absorption and scattering in the sources.
Karaiskos and colleagues[88] obtained TG-43 dosimetry parameters for 192Ir wire of active
lengths 0.5 cm L 12 cm and internal diameters d = 0.1, 0.3, and 0.4 cm using an in-house MC
code and a modified Sievert-integral method. They employed GL(r,), as they had previously shown
it to introduce differences of <1% compared with SL(r,) for r > L/2 and similarly small differences
for clinically relevant wire lengths of 4 to 6 cm for r L/2.[89] With the line source approximation, a
scaling relation holds between geometry functions for sources of different active lengths L and L
GL ( r, ) L r sin ( ) L r L
= = = , (2)
GL ( r , ) L r sin ( ) Lr L
where is the angle subtended by the active length with respect to the calculation point P(r,) and
r L
= due to similar triangles. Karaiskos et al. subsequently determined that for wires of equal
r L
length was only weakly dependent on d, differences being <3%. Based on this observation, they
showed that for any 192Ir source of active length L can be related to that of a reference source of
active length LREF using:
L LREF
= . (3)
GL ( r0 , 0 ) GLREF ( r0 , 0 )
This relation was found to hold to within 2% for LREF 5 cm, and to <3% when realistic HDR 192
Ir
brachytherapy sources were considered. Thus, this relation can be used to calculate for 192
Ir wires
of arbitrary length, and may also be useful to check the consistency of EXP- or MC-derived values
for other source models. The investigators also determined that gL(r) for 0.2 cm r 10 cm was
independent of L to <2% and of d to <3%. They concluded that MC-calculated values of gL(r) for L
set to 5 cm were adequate for most any length. Sievert-integral[75] calculated F(r,) values decreased
as d increased, but by no more than 3% over all radial distances examined. MC-calculated F(r,)
values were nearly unity for polar angles 30° 90° for all r and L. However, a strong
dependence on both r and L was observed for < 30°. This was due in part to the fact that the main
dose contributor to a point close to the source is the source segment closest to that point; whereas for
points further away from the source, the entire source length contributes and F(r,) decreases for
polar angles close to the long axis due to oblique filtration within the source structure. Then, van der
Laarse et al.[82] developed these ideas to create a new method, named the Two Length Segmented
(TLS) method, which models brachytherapy dose parameters for 192Ir wires of any length and shape
using dose parameters for straight wire segments 0.5 and 1.0 cm in length. The resultant dose rate
distributions around straight and U-shaped wires agreed better with MC calculations than those
obtained with the Point Segmented Source method, Line Segmented Source method, or Karaiskos et
al.[88] dose calculation models.
Papagiannis et al.[90] performed a dosimetry comparison of five HDR 192Ir sources (old and
new Nucletron microSelectron, old and new Varian VariSource, and the Buchler source), the LDR
192
Ir seed (Best Medical model 81-01), and the LDR 192Ir wire source (Eckert & Ziegler BEBIG
GmbH) in an R = 15 cm liquid water sphere using their own MC code. They tested the validity of
equation (3) relating using the reference geometry function GL(r0,0), with a point 192Ir source
serving as the reference, and found that the ensuing expression,
= 1.12 GL ( r0 , 0 ) cGy h 1U 1 (4)
yielded with differences <2% at reference radial distances of 1 and 2 cm for any of the 192Ir source
designs. The value 1.12 cGycm2h–1U–1 corresponds to for an 192Ir point source.[91] These
investigators also found that g(r) for all sources except the Buchler source were in close agreement
for distances 0.1 cm r 5 cm, and lay within 2% of g(r) for a point 192Ir source. The Buchler
18 HEBD report
source presented a slight increase at radial distances r < 0.5 cm, possibly arising from hardening of
the emerging photon spectrum due to its larger source core diameter. All sources were observed to
exhibit non-negligible anisotropy, with F(r,) values being strongly dependent on source geometry.
F(r = 0.2 cm,) did not significantly differ from unity over all polar angles for all sources since the
main contributor to the dose rate at P(r,) is the source segment closest to that point.
Using their established MC code, Karaiskos et al.[55] compared the dosimetry of the old and
new Nucletron microSelectron PDR 192Ir source designs in an R = 15 cm liquid water sphere. They
found the to be identical to each other and to that for a point source to within statistical
uncertainties of ~0.5% and explained the result in terms of equation (3) on the basis of the short L of
0.6 and 1.0 mm for the sources. Using SL(r,),[87,89] the gL(r) values were found to be identical within
1% to those obtained using the linear source approximation GL(r, ) over the distance interval 0.1 cm
r 14 cm. When the point source geometry function r2 was used, differences >1% were observed
only for r < 0.3 mm. The F(r,) for both source designs was found to be significant only at polar
angles close to the longitudinal source axis ( < 30° and > 150°) and to be greatest within these
angular intervals at intermediate radial distances for reasons discussed previously.[90] The new design
presented increased F(r,) up to 10% at polar angles near = 0° (distal end of the source) as a result
of its longer active core.
Casal et al.[63,67] and Pérez-Calatayud et al.[63,67] calculated the dose rate distributions around
three different LDR 137Cs sources (Amersham models CDCS-M, CDC-1, and CDC-3) in a 40 cm
high, 40 cm diameter water cylinder using the GEANT3 MC code. TG-43 dosimetry parameters
were obtained using GL(r,). For the model CDCS-M source they found /GL(r0,0) constancy, 1.05
cGy cm2/(h U), within 0.9% for the corresponding ratio of the model CDC-J source, which had the
same encapsulation but a 1.5 mm shorter active length. The latter ratio was determined from MC
data published by Williamson.[57] For the CDC-1 and CDC-3 sources, the values of /GL(r0,0)
differed by only 0.1%. For all three sources, gL(r) was no more than 1% different from the
normalized Meisberger polynomial for 0.5 cm r 10 cm.[92] The F(r,) results corresponded to the
varying self-attenuation associated with the different source designs.
Papagiannis et al.[10] compared the dosimetry of three HDR 60Co sources containing two active
pellets in contact or spaced 9 or 11 mm apart, used in the Ralstron remote afterloader. MC
calculations for an R = 15 cm water sphere were done with the group’s own simulation code and
included electron transport for r < 0.5 cm. The dose rate distribution around the source having the
pellets in contact closely resembled that for an unencapsulated 60Co point source. As r increased
sufficiently for the point-source approximation to apply, the dose rate distributions for the other two
designs also conformed to that of a point source, presenting only minor spatial dose anisotropy close
to the source long axis. The main influence on once again proved to be the spatial distribution of
activity, represented by GL(r,), for reasons similar to those cited for commercial 192Ir source designs.
Consequently, the relation
= 1.094 GL ( r0 , 0 ) cGy h 1U 1 , (5)
where = 1.094 cGycm2h–1U–1 for a 60Co point source,[91] was used to obtain values for realistic
Co sources within ±2%. Using the GL(r,), gL(r) also agreed within 2% for 0.5 cm r 15 cm.
60
However, using GP(r), differences of up to 28% were noted. F(r,) for all three source designs
calculated using GL(r,) indicated that dose anisotropy was negligible for r 1 cm, and was only
evident for r > 1 cm at points close to the source drive wire ( ~ 180°).
In summary, the dosimetry for r < 2 cm is primarily determined by the contained activity
distribution for high-energy photon-emitting brachytherapy sources. The influence of photon
attenuation and scattering in the source core and capsule is comparatively smaller in magnitude, and
is further diminished when D ( r, ) SK is calculated. As a consequence, for commercially
available 192Ir, 137Cs, and 60Co brachytherapy sources containing the same radionuclide are equal
(within a few percent) to the product of for an unencapsulated point source and GL(r,).
Corresponding gL(r) values for sources containing the same radionuclide that have been extracted
from dose distribution data using GL(r,) also agree to within a few percent over the radial interval
0.3 cm r 10 cm. Self-attenuation in the active core and surrounding encapsulation characterizing
each source design influences F(r,).
20 HEBD report
IV. CONSENSUS DATASET METHODOLOGY

The source models reviewed in this report satisfy the AAPM/ESTRO recommendations
published by the HEBD in Li et al.[17] The consensus methodology for these high-energy sources is
similar to that recommended for low-energy sources by LEBD[2] but has been adapted for high-
energy sources. According to these HEBD recommendations,[17] there are two source categories:
1. For conventional encapsulated sources similar in design to existing or previously existing

ones, a single dosimetric study published in a peer-reviewed journal is sufficient. MC or EXP
dosimetry (or both) methods may be used.
2. For all other high-energy sources, at least two dosimetric studies published in peer-reviewed
journals by researchers independent of the vendor, one theoretical (i.e., MC-based) and one
experimental, are required.
In the present report, all 192Ir and 137Cs sources are categorized as “conventional encapsulated
sources.” While not commercially available at the time of publication of the current
recommendations, HDR 60Co sources are also included in this first category. The remaining
radionuclides, 169Yb and 170Tm, fall into the second category.
Similarly to the AAPM TG-43U1 report, appropriate publications reporting single source
dosimetry were evaluated. For each source model, a single TG-43U1 consensus dataset (CONL, CON,
g (r), CONF(r,) including data up to r = 10 cm) was derived from multiple published datasets as
CON L
detailed below. If items essential to critical evaluation were omitted from a publication, the authors
were contacted for information or clarification.
The methodology followed to derive a consensus dataset was as follows:
1. The peer-reviewed literature was examined to identify candidate datasets for each source
model that were derived either from measurements or MC studies and that followed the
guidelines of the TG-43U1[2] and HEBD report.[17] The quality of each dataset was then
examined, taking into consideration salient factors such as data consistency, MC code
benchmarking, etc.
2. The value of CON was obtained from MC data for the following reasons: MC results’
uncertainties were always less than the measured uncertainties. Frequently, only MC results
were available without measured results, and the variations of MC were typically less than the
MC uncertainties for high-energy sources. The EXP have been in good agreement with MC.
For example, Daskalov et al.[93] showed that EXP for the mHDR-v2 source agreed with MC to
within 2%. The value from Meisberger et al.[92] agreed to within 0.3%.
3. In most cases, CONgL(r) and CONF(r,) were taken from a single MC study. When available,
experimental studies were used to validate MCgL(r) and MCF(r,). Data selection was based on
highest spatial resolution (r and ), largest radial range, and highest degree of smoothness.
Even though some selected published data used the point-source approximation or the particle
streaming function,[87,89] those data were transformed for use with the linear geometry function.
4. Values of CONgL(r) were determined for full scatter conditions as described in section III.A and
for values of r 10 cm.
5. As described in section III.B, a candidate publication’s gL(r) and F(r,) data were examined to
determine whether the values at short distances took into account a possible lack of electronic
equilibrium (if collisional kerma was simulated instead of absorbed dose) and included any
non-negligible beta component. This issue should be addressed in the publication because of
the dependence of gL(r) at short distances on capsule material and thickness. If it was not, data
at affected small r were removed. Future publications need to explicitly consider these
electronic dose effects.
6. If the liquid water phantom used in a selected MC calculation did not generate gL(r) under full
scatter conditions for r 10 cm, the data were corrected to unbounded conditions as justified
in section III.A according to the polynomial corrections in Table II. These modified values are
indicated using [brackets] in the consensus dataset tables.
7. Data inside the source are only provided for TPS requirements and they do not have any
physical meaning. These data are italicized.
8. For sources included in this report, AAPM/ESTRO recommends the 2D brachytherapy
dosimetry formalism and 2D tables: F(r,), GL(r,), and gL(r). Source orientation is considered
in all currently available TPS for nonpermanent implants. From the clinical point of view,
source orientation is more relevant along and near the source long axis for high-energy
dosimetry. There are a significant number of treatments in which the long-axis dose close to
the first source position is included in the target prescription (i.e., gynecological applications).
In contrast, it is less relevant for low-energy permanent implants with many seeds, where
source orientation averaging is adequate.
9. Data interpolation of gL(r) and F(r,) is needed for dataset comparison and within consensus
tables. In the TG-43U1 report,[2] interpolations were required to yield 2% error. For the high-
energy regime, this should be reduced to 1%. Interpolated data are indicated by boldface and
follow the methodology described in section III.B.
10. Similar to TG-43U1S1, CONgL(r) values were tabulated on a common mesh for all source
models of the same radionuclide. In contrast, the mesh used for CONF(r,) follows the one(s)
included in the selected publication(s). CONgL(r) starts from the minimum available distance,
and continues with the common mesh [0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 5, 6, 8, 10] cm, according
to section III.B, to ensure linear-linear interpolation accuracy within 1%. Further, for the case
of 60Co, high-resolution radial distance data are required in the vicinity of the source. The
minimum r-value in the consensus dataset may be different as a function of the source model
22 HEBD report
considered, physical processes in play based on photon energy, and the method used to
simulate or measure dose in this region.
11. According to section III.B, the recommended angular mesh for CONF(r,) is: 0° to 10°
(1° increments), 10° to 20° (5° increments), 20° to 160° (10° increments), 160° to 170°
(5° increments), 170° to 180° (1° increments). Consensus data were selected based on having
an angular mesh closest to the recommended one.
12. Extrapolation of consensus datasets was performed following the methodology described in
section III.B. Extrapolated values are underlined in dataset tables.
13. Upon derivation of the consensus TG-43 dataset, an away-along dose rate table was obtained
(cGyh–1U–1) for TPS quality assurance purposes. Range and resolution of this table are: away
[0, 0.25, 0.5, 0.75, 1, 1.5, 2–7 (1 cm increment)] cm and along [0, 0.5, 1, 1.5, 2–7 (1 cm
increments)] cm.
14. To provide a consistent convention for all brachytherapy sources, the angle origin is selected
to be the source tip, i.e., is defined such that 0° is in the direction of the source tip. For the
case of asymmetric LDR sources (without driven cable) the angle origin will be clearly
identified for each source model. The origin of coodinates is selected to be the center of the
active volume for all sources. Published data with a different angle/coordinate origin were
transformed accordingly. This convention is recommended for future studies.
The criteria used to evaluate dosimetry parameters for each source were similar to those of the
TG-43U1 report and are as follows:
1. Internal geometry and description of the source.

2. Review of pertinent literature for the source.
3. Measurement medium to liquid water medium corrections (if applicable).
4. Experimental method used.
5. Geometry function used; active length assumed for the line source approximation.
6. Name and version of MC code.
7. MC cross-section library.
8. Variance reduction techniques used (for sK and dose in water).
9. Electron emission inclusion.
10. Photon emission spectrum.
11. MC benchmarking according to the HEBD prerequisites.[17]
12. Phantom shape and size used in MC and EXP.
13. Agreement between MC and experimental dosimetry (if applicable, according to the
HEBD prerequisites).[17]
IV.A. Dose rate constant
As pointed out in TG-43U1,[2] MC and experimental studies complement one another, and
when combined can average out possible biases of each individual methodology. In contrast to the
low-energy case, the high-energy CON is obtained from the average of MC values alone, while
available EXP are used to validate MC. For the sources considered in this report, the EXP agrees with
MC to within 2%.[93] This approach is justified because unlike for lower energy sources, the
influence of source geometry on the dose distribution is less important at higher energies. It also has
the advantage of utilizing the smaller uncertainties of the MC method, thus providing reduced
uncertainty in the value of CON. In the case of sources within the category of “conventional
encapsulated, similar to existing ones” for which just one study was available, the value was
compared with those for sources of similar design, first removing the geometrical dependence by
forming the ratio /GL(r0,0), as discussed in section III.C. Based on trends observed during the
compilation of this report, the agreement between MC- and EXP-derived values should be 1%.
IV.B. Radial dose function
For each source, MC and experimental gL(r) results were graphically compared. When a
published study used a geometry function that was different from the simple linear geometry
function, gL(r) was recomputed. Based on trends observed during the compilation of this report, the
agreement between MC and EXP gL(r) values should be 3%. The most complete and smooth MC
dataset was selected that also considered electronic disequilibrium and the dose from electron
emissions.
IV.C. 2D anisotropy function
For each source, published F(r,) values from MC and EXP results were graphically
compared. If a geometry function different from the simple linear geometry function was used,
F(r,) was recomputed. Based on trends observed during the compilation of this report, the
agreement between MC and EXP F(r,) values, when available, should be 5%.
24 HEBD report
V. RECOMMENDATIONS ON DOSIMETRY CHARACTERIZATION

METHODS FOR HIGH-ENERGY PHOTON-EMITTING
BRACHYTHERAPY SOURCES
The TG-43U1 report[2] on low-energy brachytherapy contains many methodological
recommendations and suggestions that should be followed by investigators who would like their
published work, whether based upon experimental or computational methods, to be considered as a
reference-quality dataset for inclusion in the consensus dose-distribution formation process. In
general, all TG-43U1 guidelines and recommendations are also applicable to high-energy source
dosimetry, unless otherwise specified in the sections below. Thus, the present recommendations
emphasize mainly variances from the TG-43U1 LEBD-recommended methodology for obtaining
brachytherapy dosimetry parameters.
In 2007, AAPM/ESTRO recommendations on dosimetric prerequisites for routine clinical use
of photon-emitting brachytherapy sources with average energies higher than 50 keV were
published.[17] These recommendations, similar to the AAPM LEBD recommendations[16] apply to
brachytherapy sources that are intended for routine clinical use, and were intended to define
minimum requirements for future source dosimetry studies so that the accuracy and consistency of
the consensus datasets may be improved.
In the current report, only the deviations from the TG-43U1 recommendations[2] (section V,
p. 650) necessitated by the higher photon energies or different physical configurations of the sources
are noted. These are categorized as (A) preparation of dosimetry parameters, (B) reference data and
conditions for brachytherapy dosimetry, (C) and (D) methodological recommendations, (E)
uncertainty analyses, (F) publication of dosimetry results, and (G) non-MC computational methods.
V.A. Preparation of dosimetry parameters
For the high-energy sources, e.g., HDR 192Ir sources, dosimetric parameters should be
tabulated for 2D formalisms. Exceptions include spherical pellets (e.g., 137Cs Selectron from
Nucletron) where a 2D model cannot be formulated. Regardless of the dimensionality of the
formalism adopted, the line-source approximation should always be used for computing the
geometry function (with the obvious exception of spherically symmetric sources), GL(r,), and gL(r).
For reader convenience, we include the following alternative expression for GL(r,):

L L
r cos r cos +
1 2 cos
1 2
cos
2 2
L
r + Lr cos
2 L
r + + Lr cos
2
2 2
GL ( r, ) = . (6)
Lr sin
This expression of GL(r,) has been included in which cos and cos–1 are used as alternatives to tan
and tan–1. The practical reason is that a negative argument of tan–1 results in a negative angle, instead
of an angle between 90° and 180° as required by the TG-43 formalism polar coordinate system.
For F(r,) and gL(r), the minimum-maximum range for r and , and the resolution within this
range where dose rate shall be calculated or measured, has been discussed in section IV. If
polynomial fits are presented, care should be taken to assure agreement within 0.5% between the
polynomial fit prediction and the original tabulated data over the whole range. Special care must be
taken rounding-off parameters from the fit. To assure that g(r0 = 1 cm) = 1 with enough precision, the
summation of all the parameters must be “1.0000.” Further, the range over which the fit is applicable
should be stated. In addition to the TG-43 dosimetry parameters, a derived away-along table should
be included for TPS QA testing purposes as described in section IV.
V.A.1. Air-kerma strength
As similarly recommended in the TG-43U1 report,[2] source strength for high-energy sources should
be expressed in terms of air-kerma strength or reference air-kerma rate (RAKR), not apparent
activity, mg-Ra-eq, or other antiquated units. Exceptions may result in patient harm.
V.A.2. Dose rate constant
All TG-43U1 recommendations are applicable to high-energy sources, with the exception that
for conventionally encapsulated 192Ir, 137Cs, and 60Co sources, only a single source is required for
experimental purposes. To ensure validity of the source model used by MC simulations, pinhole
autoradiography,[94] multi-slit techniques,[95] and transmission radiography should be utilized to
confirm the manufacturer’s specifications for active length, uniform activity distribution, and
physical-to-active source-tip offset. Experimental determinations of absolute dose rates to water from
high-energy sources should have direct traceability of SK to a primary or secondary standard
dosimetry laboratory such as the National Institute of Standards and Technology (NIST) or an
Accredited Dosimetry Calibration Laboratory (ADCL). Experimentally, is evaluated by taking the
ratio D ( r , ) S .
0 0 K
V.A.3. Radial dose function
In addition to the TG-43U1 recommendations, investigators must consider using coupled

photon-electron MC codes for short distances where secondary charged particle equilibrium failures
imply a deviation of dose from collisional kerma in excess of 2%. As discussed in section III.B,
deviations greater than 1% may occur at distances less than 7, 3.5, 2, and 1 mm from the center of
60
Co, 137Cs, 192Ir, and 169Yb sources, respectively. Similarly, -ray transport must be simulated at
distances where dose-to-kerma ratio deviations exceeding 1% are possible.
26 HEBD report
V.A.4. 2D Anisotropy function
The recommendations of the AAPM TG-43U1 report[2] are to be followed.
V.B. Reference data and conditions for brachytherapy dosimetry
V.B.1. Radionuclide data
The influence of photon spectrum choice on brachytherapy dosimetry parameters such as

and g(r) has been studied by Rivard et al.[96] For 192Ir sources, they found that the uncertainties
propagated to these parameters by photon-spectrum uncertainties were much less than 1% (k = 1).
Given the standardization of radionuclide data available from the NNDC and the rigorous
infrastructure for performing and maintaining the dataset evaluations, the AAPM and ESTRO
recommend that NNDC data be used for clinically related applications of all brachytherapy.[20]
V.B.2. Reference media
As recommended by TG-43U1, pure degassed liquid water (H2O) with a mass density of 0.998
3
g/cm at 22.0 °C should be used for MC as the medium for both specification of absorbed dose and
dose distributions. As clarified in the TG-43U1S1 report,[3] dry air (0% humidity) is recommended
for SK in contrast to the TG-43U1 report, which recommended air at 40% relative humidity. The
composition of dry air is given in Table XIV of the TG-43U1 report.
V.C. Methodological recommendations for experimental dosimetry

Historical reviews of experimental dosimetry for interstitial brachytherapy sources, including
high-energy sources, appear in Williamson[97] and, for 192Ir only, in the original TG-43 report.[1]
Starting from the earliest work of Meredith et al.,[98] who used a cylindrical perspex ion chamber to
measure exposure in air and water for 192Ir interstitial sources, and progressing to dose measurements
using lithium fluoride (LiF) TLDs in solid phantoms, these papers and their associated references
give an excellent perspective on experimental dosimetry methodologies in this field. A more detailed
and contemporary review of experimental brachytherapy dosimetry methods, including emerging
detector technologies such as radiochromic film, gels, and liquid-filled ionization chambers, has been
given by Williamson and Rivard.[99]
V.C.1. Detector choice
Experimental determination of dose distributions around high-energy brachytherapy sources

face the same challenges as their low-energy counterparts: high-dose gradients near the source and
low-dose rates further away. Moreover, at close distances to the brachytherapy source, detector size
can significantly influence dose measurement accuracy due to averaging in the presence of high dose
gradients and source self-attenuation. Thus, a suitable detector should possess a wide dynamic range,
high sensitivity, flat energy response, and small geometric dimensions. A number of detectors (e.g.,
diodes, radiochromic films, and TLDs) satisfy the above criteria and therefore have commonly been
used. Dosimeters used for reference data should satisfy the following criteria:
1. A relatively small active volume such that effects resulting from averaging of high-gradient
dose fields over this volume are negligible or are accurately accounted for by correction
factors.
2. A well-characterized energy-response function such that differences between the calibration
energy and experimentally measured energy are either negligible or may be quantitatively
accounted for.
3. Sufficient precision and reproducibility to permit estimation of dose rate in medium with k = 1
Type A (statistical) uncertainties 3% and k = 1 Type B uncertainties 6%.
While no practical detector system perfectly fulfills the three requirements above, among the
established dosimetry techniques, LiF TLD-100 detectors provide a good trade-off between flat
energy dependence, small size, and detector dynamic range for both high- and low-energy
brachytherapy sources and thus has been used most frequently.[99,100] For example, silicon diodes,
which have smaller active detector volumes and larger sensitivities (reading per unit dose in water),
violate requirement 2 above. They have sensitivities that vary by as much as 60% with respect to
source-detector distance[101,102] for 169Yb and 192Ir sources due to the variation in photon spectra. Thus,
the AAPM and ESTRO currently do not recommend silicon diode detectors for reference-quality
dose measurement for sources with mean energies exceeding 50 keV. Among validated and fully
developed dosimeter technologies, TLD dosimetry has the least position-dependent sensitivity for
high-energy sources. TLD energy response has been reported to vary 10% to 15% over the 1 to 10
cm distance range for 192Ir sources.[103] Similar magnitude but opposite direction variations have been
reported for older (MD-55-2 and earlier) radiochromic film models.[104,105] Newer models of
radiochromic film [EBT[106–108] and EBT2[109–112] include small concentrations of a medium atomic
number loading compound designed to compensate for the absorbed dose under-response of the
diacetylene monomer active sensor medium. EBT film type has a nearly energy-independent dose
response.[113,114] MD-55-2 radiochromic film has been used successfully to measure high-resolution
(<0.25 mm) absolute dose distributions around HDR 192Ir sources[115] and LDR 137Cs sources[116] with
k = 1 total uncertainties of 4% to 4.6%, among the lowest ever reported for such measurements
around a brachytherapy source using a secondary detector. However, these detectors must be
considered under development at this time because of numerous artifacts (non-uniformity, dose rate
dependence, film darkening kinetics, scanner artifacts) which require rigorous correction. TLD
dosimetry techniques for both general radiotherapy applications[100,117] and reference-quality
brachytherapy dosimetry[99,100] have been reviewed extensively.
28 HEBD report
V.C.2. Phantom material and energy response characterization
For low-energy brachytherapy dosimetry, accurate knowledge of the atomic composition of

the phantom is critical for proper results.[100] The TG-43U1 report allows use of either single-
component high-purity industrial plastics or polyamine-based epoxy resin mixtures (e.g., commercial
solid water), which can have somewhat variable atomic compositions in their makeup. Therefore, it
is suggested that the composition be independently determined by elemental composition assays of
representative samples. In all cases, phantom-to-liquid-water corrections (based upon MC
calculations) must be applied to the measurements.
For 192Ir and other high-energy sources, absorbed-dose water equivalence is less dependent on
phantom composition,[103] so that commercial plastics such as polymethylmethacrylate (PMMA) as
well as single-component resin mixtures can be used with lower correction uncertainties due to
knowledge of their composition. Experimentally, Meli et al.[103] found that PMMA, polystyrene, and
Solid WaterTM introduced corrections ranging from –4% to +2% relative to liquid water at distances
of 3 to 6 cm. MC calculations, simulating mono-energetic point sources embedded in 1 m radius
phantoms composed of liquid or Solid Water, demonstrated that the latter introduced corrections of
less than 5% at 10 cm distance for photon energies greater than 100 keV. A more recent MC
study[118] of 192Ir phantom correction factors for cylindrical phantoms of PMMA, polystyrene, and
Solid Water found that corrections depended on phantom dimensions as well as phantom media. For
a phantom size of 20 cm diameter and height (typical for experimental purposes), correction factors
were <4% at distances for r 10 cm. For larger 40 cm phantoms, larger corrections (up to 6% at 10
cm for PMMA) were noted.
Industrial plastic phantoms (PMMA, polystyrene, or polycarbonate) for high-energy
brachytherapy dosimetry are recommended. Single-component resin phantoms are recommended and
should be accompanied by the appropriate phantom to water correction factors or should include an
estimate of the uncertainties associated with the non-water equivalence of the phantom for sources
with average photon energies greater than 0.2 MeV, but should be avoided for average energies
between 0.05 and 0.2 MeV unless validated by elemental composition assays. While atomic
composition measurements are mostly unnecessary in this energy range, density measurements
should be performed. MC-based medium corrections (phantom–to–liquid water conversion factors
based upon the assumed composition and actual geometry and density of the experimental phantom)
should be used. However, the dosimetry investigator should also consider the dependence of detector
response as a function of source distance within the phantom due to differences in response between
the phantom and reference medium, i.e., liquid water.
The TG-43U1 report recommended the experimental dosimetry formalism introduced by
Williamson and Meigooni,[119] which has been updated[100] and whose notation is used below. An
important correction factor is the relative energy response correction, E(Q0, G0 Qref, Gref, r;Gexp),
which accounts for the difference in detector sensitivity between the megavoltage photon beam used
to calibrate the detector and the brachytherapy source irradiation geometry. G0, Gref, and Gexp are
vectors corresponding to the energy-response correction factors associated with measurements taken
during the calibration setup, the reference geometry (Gref = unbounded water phantom with point
detectors) and the source irradiation setup (e.g., Gexp = (25 cm)3 PMMA phantom, (1 × 1 × 1) mm3
TLD-100 detectors), respectively. Q0, Qexp, and Qref denote the corresponding spectra in these
irradiation geometries. The relative energy response correction can be factored into three separate
corrections:[100]
(
rel
) (
Q0 Qexp ; M0 f rel Q0 ,G 0 Qexp ,G exp , r ),
( )
kbq
E Q0 ,G 0 Qref ,G ref , r;G exp =
( )
(7)
pphant,wat Qexp ,G exp Qref ,G ref ;r
where the intrinsic relative energy response correction is given by:
kbq ( M, Q0 ) ( M D ) ( r, Q ,G ) ,
(
rel
Q0 Qexp ; M ) =
0 det exp exp
( ) ( M D ) ( Q ,G )
kbq (8)
kbq M, Qexp 0 det 0 0
where M is the detector reading and Ddet is the mean absorbed dose to the active detector volume.
(
rel
kbq )
Q0 Qexp ; M describes the efficiency with which the detector-response mechanism transforms
energy imparted to its active collection volume by the brachytherapy radiation field into an
observable response, relative to its efficiency in the calibration beam. The relative absorbed-dose
energy dependence is given by
f ( r, Q0 ,G 0 ) (D )( ).
( ) det Dwat r, Qexp ,G exp
f rel Q0 ,G 0 Qexp ,G exp , r =
( ) (D ) ( Q ,G )
(9)
f r, Qexp ,G exp det Dmed0 0 0
f rel is that component of relative detector response which is due only to the efficiency with which the
brachytherapy spectrum imparts energy to the active detector volume relative to the corresponding
efficiency in the calibration beam, when both efficiencies are normalized to dose in medium in the
absence of the detector. f rel includes the displacement and volume-averaging corrections. The dose-
measurement phantom correction factor, pphant,wat (Qexp, Gexp Qref, Gref;r), corrects for differences
between the irradiation geometry used to perform the measurements and the reference geometry in
which the final dose distribution is to be specified. As a ratio of geometric point doses in
homogeneous media, it is independent of the detector geometry, composition, and underlying
mechanism, and depends only on the reference and experimental phantom dimensions, composition,
and positioning relative to other sources of scattered radiation near the measurement phantom.
rel
The controversies surrounding the choice of kbq Q0 Qexp ; M ( ) corrections for TLD
dosimetry of low-energy brachytherapy sources, where recent experiments suggest energy response
correction factors ranging from 1.05 to 1.10, have been reviewed by Williamson and Rivard.[100]
rel
While kbq values are closer to unity for high-energy brachytherapy sources, two recent publications
30 HEBD report
rel
found anomalously high values of kbq = 1.018–1.038 for 137Cs relative to 60Co.[120,121] Overall energy-
response corrections for HDR 192Ir brachytherapy sources have been measured, but without result
comparisons to MC calculated absorbed-dose energy-dependent factors. Because definitive factors
rel
are not yet available, it is recommended that kbq be taken as unity for high-energy photon dosimetry,
while pphant,wat and f rel should be carefully calculated for the experimental geometry used. Without
additional information, a k = 1 uncertainty of 3% may be assigned to the overall energy response
correction factor.
For radiochromic film, it is not clear whether or not dosimetrically significant energy response
corrections exist. Based on a study of Model MD-55-2, Bohm et al.[104] concluded that f rel MC
accounted for measured E(Q0 Qref) values within 5%. On the other hand, Sutherland and
Rogers[122] found relatively poor agreement between their MC calculations and previously reported
measurements.[123,124] Since radiochromic film response is highly dependent upon film composition,
and depends on a host of other factors, including temporal history and temperature,[125,126] it is
recommended that this detector be used cautiously.
V.C.3. Specification of measurement methods
Recommended methodologies for using TLD dosimetry in brachytherapy have been reviewed
elsewhere.[99,100] All recommendations in section V.D.3 of the 2004 AAPM TG-43U1 report[2] should
be followed for high-energy brachytherapy dosimetry. Careful correction for volume averaging,
source and/or detector displacements, and phantom composition/size should be applied so that the
final dose rates represent absorbed dose rates to water per unit SK at geometric points in an
unbounded liquid water medium. The location of dose measurement points should be referenced to
the geometric center of the active source core.
V.D. Methodological recommendations for Monte Carlo–based dosimetry
Codes that have been widely used for high-energy source dosimetry include PTRAN, MCNP,
GEANT4, PENELOPE, and EGSnrc. At the time of publication of this report, all these codes are
based upon modern cross-section libraries and complex and accurate physics models to simulate
transport of electrons and photons through complex media. All these codes have been benchmarked
against experimental measurements or by code intercomparisons. For high-energy sources,
collisional kerma approximates dose at distances from the source surface where electronic
equilibrium is reached. However, electronic equilibrium at close distances from 192Ir, 137Cs, and 60Co
sources is not reached, and beta and internal conversion electrons emerging from the source capsule
require detailed electron transport if accurate dose rate estimates near the sources are required
(section III.B). Errors exceeding 2% will occur if photon-only MC transport simulation is used to
estimate dose for distances at or below 1.6, 3, and 7 mm for 192Ir, 137Cs, and 60Co sources,
respectively.[28]
In general, the AAPM and ESTRO recommend that MC investigators utilize well-
benchmarked codes for brachytherapy dosimetry studies intended to produce reference-quality dose
rate distributions for clinical use. A benchmarked code is able to reproduce MC simulations
comparable to those obtained by other codes validated experimentally or a code whose results have
been validated experimentally. However, all investigators should assure themselves that they are able
to reproduce previously published dose distributions for at least one widely used brachytherapy
source model. The 2007 HEBD prerequisites[17] stated that MC transport codes should be able to
support dose rate estimation with expanded uncertainties (k = 2) no greater than the 3% to 5%
characteristic of the MC transport codes currently used for low-energy source dosimetry. Also, the
2007 report included methods to benchmark the MC calculation method. Agreement between the
MC results and the benchmark data should be within 2% for , 5% for gL(r), and 10% for F(r,)
within 5° from the source long axis.[17] Unlike for low-energy sources, the range of secondary
electrons from high-energy sources will require electron transport at short distances.[28]
V.D.1. Specification of Monte Carlo calculation methods
The nine points in the list in section V.E.1 of the TG-43U1 report[2] are applicable to high-
energy sources with the following changes:
1. Limit consideration to emitted photon energies above 10 keV (for simulations in both water
and in-air or in vacuo). Based on typical PDR/HDR source encapsulations, 10 keV should be
an adequate cutoff and is commonly used in publications. A lower energy cutoff does not
produce more accurate results for most dosimetry applications, but prolongs the calculation
time required to achieve a fixed Type A uncertainty level (or prevents finer spatial resolution
with associated volume averaging).
2. All photons emitted with an energy above the 10 keV cutoff must be included in dosimetry
calculations. At least one publication has reported that high-energy photons with low emission
probabilities can influence results significantly.[96] Therefore, reference spectra must be used in
their entirety in MC simulations, i.e., NNDC reference spectra[20] must not have low-intensity
lines removed.
3. If charged particle transport is simulated, the underlying transport algorithm should be
described clearly, if only by reference. The quantity used to approximate dose (e.g., collisional
kerma) or any variance reduction techniques should be clearly specified. Whether beta-ray and
internal conversion electron transport is included, along with the initial beta spectrum used,
should be specified.
V.D.2. Good practice for Monte Carlo calculations
1. Reference-quality absorbed dose rate to water distributions should be computed in liquid water
in a phantom which approximates full scatter conditions characteristic of an unbounded
phantom. For 192Ir, 137Cs, and 169Yb sources, a spherical phantom with radius R = 40 cm (or the
32 HEBD report
equivalent cylindrical phantom dimensions) should be used, while R = 80 cm is required for

60
Co[29–31] sources.
2. A sufficient number of histories should be calculated to ensure that the dose rate per simulated
history d ( r0 , 0 ) and kair ( d, 0 ) calculations for derivation of sK have Type A uncertainties (k
= 1) < 0.1% for distances 5 cm and Type A uncertainties (k = 1) < 0.2% for distances 10
cm. In evaluating sK, the confounding influence of contaminant low-energy photons below 10
keV (and contaminant electrons as well if charged-particle transport is simulated) should be
assessed and corrected for if necessary. By convention, kair ( d, 0 ) and sK must be specified in
dry air.
3. The influence of photon cross-section uncertainties on dose estimation accuracy has not been
comprehensively studied in the high-energy brachytherapy regime. Until careful studies
demonstrate otherwise, TG-43U1 recommendations should be followed. This includes use of
post-1980 cross-section libraries, preferably those equivalent to the current NIST XCOM
database such as DLC-146 or EPDL97. Older cross-section libraries based on Storm and Israel
data[127,128] must be avoided. Electron binding effects on coherent and incoherent scattering
should be simulated using the form factor approximation. In the presence of high atomic
number absorbers, atomic relaxation processes resulting in characteristic x-rays exceeding
10 keV should be simulated. Mass-energy absorption coefficients used to convert energy
fluence into collisional kerma must be consistent with the interaction physics models and
photon cross sections used for transport.
4. Collisional kerma and dose estimators (scoring tally)[129] and detector volumes should be
chosen to limit volume-averaging artifacts to <0.1%. To minimize the impact of voxel size
effects[130-132] while maintaining reasonable efficiency for track-length and analog estimators,
maximum voxel sizes in Cartesian coordinates could be chosen in the following way: (0.1
mm)3 voxels for distances in the range of rsource < r 1 cm, (0.5 0.5 0.5) mm3 voxels for 1
cm < r 5 cm, (1 1 1) mm3 voxels for 5 cm < r 10 cm, and (2 2 2) mm3 voxels for
10 cm < r 20 cm, where r is defined as the distance from the center of the source. Rectilinear
or toroidal voxels of similar radial dimensions should have similar volume-averaging effects.
5. Especially for photon sources in the 50 to 300 keV energy range, the manufacturer-reported
dimensions of encapsulation and internal components should be verified through the use of
physical measurements, transmission radiography, and autoradiography. For all sources,
transmission radiography and pinhole radiography should be used to verify the active source
dimensions and location relative to the physical source dimensions, and that the radioactivity
is approximately uniformly distributed. The impact of internal source component mobility[133]
on the dose distribution should be assessed.
6. Some MC studies consider the effect of electronic non-equilibrium conditions near a
brachytherapy source, or the beta-ray contribution to the dose distribution near the source. In
these cases, secondary electron transport should be simulated. To avoid inconsistencies and
systematic errors in the results, the following precautions should be heeded. Because
brachytherapy simulations involve rather extreme conditions (very small detector thicknesses,
low energies, etc.) that may invalidate the approximations upon which the charged particle
transport algorithms are based, they may produce artifacts that are evident only in extreme
cases but that are masked in other situations. The following precautions cover different aspects
including physics models implemented in the codes and electron tracking techniques, among
others:
a. Usually, the simplest strategy is to perform test simulations starting with standard
simulation parameters recommended for the code under consideration, followed by other
test runs that vary these parameters to study their influence on the final results.
b. Electron step size is a critical parameter that influences deposited doses in small geometry
regions. It should be handled with care in each simulation and, if adjustable, parametric
studies should be performed to demonstrate that the dosimetric results are not sensitive to
this parameter choice.
c. Some multiple scattering (MS) theories place limits on the minimum number of mean
collisions that must occur in each condensed history step for validity to be maintained. The
existence of steep dose gradients at the distances of interest necessitates high spatial
resolution for dose computation. Consequently, shells to score dose are very thin close to
the source. The Molière MS minimum step size imposes a restriction on the spatial
resolution of MC simulation. Care must be taken to maintain the dimension of the scoring
region above this limit.[134] This limitation affects mainly codes derived from EGS4.
d. The user must be sure that the number of interactions in a voxel is large enough (a
minimum of 10) for the result to be statistically well behaved.
e. Some codes handle boundary crossing algorithm corrections poorly while others generate
artifact-free corrections. Switching to single-scattering mode near boundaries is the
preferred solution. For example, Type-1 transport algorithms (MCNP, ITS, ETRAN),
which use Goudsmit-Saunderson multiple-scattering formalism parameters, stopping
powers, and energy-straggling corrections precalculated on a fixed logarithmically spaced
energy-loss grid, are particularly subject to boundary crossing algorithm artifacts as media
and detector interfaces truncate condensed history steps at arbitrary intermediate values.
The influence of such partial steps cannot be recovered by interpolation of precalculated
data. Chibani and Li[135] demonstrate that pre-2000 versions of MCNP-determined low-
energy electron dose distributions were sensitive to choice of energy-indexing (boundary
crossing algorithm interpolation scheme).
f. Variance reduction techniques are often implemented in the codes and although they are
generally robust they should be used with care. In particular, the user is advised to check
that results are unbiased.
V.E. Uncertainty analyses
Both experimental and MC determinations of reference-quality single-source dose rate

distributions should include formal uncertainty analyses that adhere to the methodology of NIST
Technical Note 1297.[136] While a number of publications,[100,137] including the TG-43U1[2] and TG-
34 HEBD report
138[14] reports give detailed guidance on applying this methodology to low-energy brachytherapy,
complete and rigorous uncertainty analyses for high-energy brachytherapy are generally lacking.
However, extensive uncertainty analyses are given by Raffi et al.[41] for HDR 192Ir experimental and
MC and Granero et al.[138] for HDR 192Ir MC simulations. These papers include both Type A and
Type B uncertainties. These uncertainties are in agreement with those in the AAPM TG-138 report,
and are over a factor of two lower than those in Table XII of the TG-43U1 report for low- and high-
energy sources. While 169Yb has been considered by some manufacturers, the SK calibration
uncertainties are still a matter of study and are of the order of 3% (k = 1). As similarly recommended
in section V.D.3(10) and section V.E.1(9) of the AAPM TG-43U1 report for measurements and
simulations of low-energy photon-emitting brachytherapy dosimetry studies, respectively, the
AAPM recommends that high-energy brachytherapy source dosimetry investigators perform detailed
uncertainty analyses in a manner similar to Raffi et al., and Granero et al., yet specific to the source
model and conditions examined in their investigation.
V.F. Publication of dosimetry results
As recommended by TG-43U1[2] and the HEBD prerequisites,[17] commercially distributed

high-energy sources used in routine clinical practice should be supported by two independent
dosimetry studies that adhere to the methodological recommendations of this report. As defined by
TG-43U1, “independence” requires (a) that dosimetry investigators be free of affiliations or other
conflicts of interest with the source vendor and (b) the two studies be scientifically independent of
one another. The Li et al.[17] recommendations require that one study be experimental (usually TLD-
based) and that the other be theoretical (MC). The studies must be published in the peer-reviewed
literature. A technical note format is acceptable as is publishing the two independent studies in the
same publication. Given publication length limitations, AAPM committees do not require that all
expected or needed documentation and method description be included in the published paper.
However, it must be either posted electronically with the online version of the paper or made
available by the authors via a personal communication upon request. Conventionally encapsulated
192
Ir, 137Cs, and 60Co sources require only a single MC-based study for comprehensive dose
characterization.
Some TPS algorithms correct the dose from full scatter to the clinical specific conditions, and
require dosimetry parameter data based on full scatter conditions. For some of these TPS algorithms,
it has been proposed that the primary- and scatter-component functions be obtained from TG-43–
based dose rate tables and will need to be handled independently by the TPS dose calculation
algorithm.[139]
V.G. The role of non–Monte Carlo computational tools in reference dosimetry
Over the years, a variety of computational tools, in addition to MC simulation, have been
proposed or even widely used for the determination of single-source dose distributions in the high-
energy photon regime.
Heuristic analytical model algorithms were not introduced as dosimetry or dose-estimation

tools, but as treatment-planning tools for computing more realistic and accurate dose distributions for
clinical multi-source implants in the presence of tissue-composition and density heterogeneities,
applicator shielding and attenuation, and inter-seed attenuation. Accelerated MC simulation codes[140]
have also been adapted for clinical dose computation. The potential for these innovations in clinical
dose computation has been reviewed by Rivard et al.[33] and is the subject of the active AAPM Task
Group 186.
Prior to community-wide acceptance of the 1995 AAPM TG-43 report, nearly every general-
purpose brachytherapy planning system utilized the 1D path-length or Sievert model to generate
single-source dose distributions around encapsulated line sources such as intracavitary brachytherapy
tubes. Comparisons with MC simulation demonstrate that with properly selected input parameters
and realistic modeling of the source geometry, accurate results (2% transverse axis and 5%
longitudinal axis differences) can be achieved for 137Cs tubes and needles.[57,141] However, for lower
energy sources, including LDR 192Ir seed and HDR 192Ir sources, accurate modeling of 2D anisotropy
corrections cannot be achieved.[142] Simple extensions of the Sievert model can restore accuracy in
many cases, such as by separating primary and scatter components and modeling the latter as an
isotropic distribution.[142,143] However, comparisons between benchmark calculations from MC or
analytical methods such as the Sievert integral are required to ensure dose prediction accuracy for
new source designs. Hence, 1D path-length models are not endorsed by this report for estimation of
reference-quality dose distributions for any category of high-energy sources.
A number of more sophisticated scatter separation algorithms, which involve one-, two-, or
even three-dimensional integration of the scatter dose distribution over the implant geometry have
been proposed.[73,144–147] Closely related are superposition/convolution algorithms[148] of which the
most fully developed is Carlsson-Tedgren’s[149,150] brachytherapy adaptation of the external-beam
collapsed cone approach. As with the simpler Sievert-style algorithms, these approaches require
significant fine tuning and validation against more definitive MC simulations to avoid excessive
systematic dose computation errors, and thus are not acceptable as substitutes for MC simulation for
estimation of reference-quality single-source dose distributions.
A more empirical scatter-separation method was introduced[151] for CT-based planning for
HDR 192Ir brachytherapy; the primary and scatter dose distributions for each dwell position are
calculated first as if the patient is an infinite water phantom. Corrections for photon attenuation,
scatter, and spectral variations along medium- or low-Z heterogeneities are made according to the
radiological paths determined by ray tracing. The scatter dose is then scaled by a correction factor
that depends on the distances between the points of interest, the body contour, and the source
position. Dose calculations were evaluated for phantoms with tissue and lead (Pb) inserts, as well as
patient plans for head-and-neck, esophagus, and balloon breast brachytherapy treatments.
PTRAN_CT-based MC calculations were used as the reference dose distributions. For the breast
patient plan, the TG-43 formalism overestimated the target volume receiving the prescribed dose by
about 4% and skinD0.1cc by 9%, whereas the analytical and MC results agreed within 0.4%.
36 HEBD report
Deterministic transport equation solvers, most commonly discrete ordinates methods

simulations, have also been investigated for their potential use in brachytherapy planning
applications.[152,153] A Grid-Based Boltzmann Solver (GBBS) was introduced as a supported option in
a commercially available brachytherapy planning system.[154,155] In contrast to the more sophisticated
heuristic algorithms [class 1(b) above], GBBS directly solves the underlying Boltzmann transport
equation on a systematically discretized seven-dimensional phase-space mesh. Because GBBS
algorithms use random sampling on a very limited basis if at all, GBBS results do not suffer from
statistical noise and very slow convergence rates. However, many application-specific parameters
need to be optimized, including density of the angular mesh, energy group structure and weighting
functions, as well as spatial mesh geometry and angular-flux interpolation technique. Inadequate
optimization can lead to substantial systematic errors and artifacts, e.g., ray effects. While very
promising tools for radiotherapy planning purposes, inherently more accurate MC benchmarks are
required for GBBS tuning and validation. Hence, GBBS and related techniques[156] are not suitable
reference-quality dosimetry tools.
In summary, of the computational tools developed to date, only MC simulation is an
acceptable method for estimating reference-quality dosimetry parameters. This is a consequence of
the fundamental mathematical nature of MC simulation, which yields a statistically imprecise, but
exact first-principles solution of the transport equation. While statistical noise in some settings can
be a limiting problem, in the context of brachytherapy reference dosimetry it can be eliminated as a
practical issue through long run times, efficient sampling techniques, or proper selection of variance-
reduction strategies.[100] Although approximations are often used within MC codes, the ideal of
convergence to an unbiased solution of the Boltzmann equation is approximated to a high degree of
accuracy in practice. Residual errors, e.g., volume averaging, are straightforward to correct or
eliminate using modern codes. In contrast, both deterministic heuristic and transport-solution
algorithms, while free of statistical uncertainty, are always subject to complex, geometry-dependent
patterns of systematic error.
VI. RECOMMENDED DOSIMETRY DATASETS FOR HIGH-ENERGY

PHOTON-EMITTING BRACHYTHERAPY SOURCES
Recommended consensus datasets for high-energy sources have been obtained for sources that
were commercially available as of January 2010. Data are presented according to the AAPM TG-
43U1 formalism, with upgraded interpolation and extrapolation techniques in Table III for F(r,) and
g(r). Additionally, the radial and angular ranges of the datasets are chosen to accurately represent the
dosimetric characteristics given linear interpolation by TPS. A common mesh was introduced for
gL(r), and the mesh of the selected publication has been kept for F(r, ). For each source model the
source is described and consensus datasets are presented (Appendix A).
For TPS that use the TG-43 dose-calculation formalism and permit user input of dosimetry
parameters, the medical physicist should enter the dosimetry parameters and check the accuracy of
the dose calculation.[13] These tasks should be well documented. For some TPS, dosimetry
parameters are entered by the manufacturer, without the possibility of user modification. In these
cases, users should verify the correct entry and document these commissioning findings before
releasing the TPS for clinical use.
Clinical implementation of these datasets should follow the recommendations included in
section VI of the TG-43U1 report.[2] A medical physicist should implement the dose calculation data
and techniques recommended by this report on the TPS and quantitatively assess the influence of this
action on dose delivery. In cases where data are introduced as coefficients in an equation, [e.g., a
polynomial function for gL(r)], it is necessary to evaluate the quality of the fit over the intended
calculation range. Users must verify that the TPS follows the TG-43U1 formalism, and should also
document the TPS methods for interpolation and extrapolation (applying the recommendations
introduced in TG-43U1S1[3] and also more specifically in this report) of dose calculations within and
beyond the range provided dosimetry. The dose rates calculated by the TPS from a single source
should be compared with the dose rate distribution derived from the tabulated consensus values
presented in this report. To facilitate this comparison, dose rate tables in a Cartesian coordinate
system have been included as has been recommended previously by the AAPM (TG-40,[157] TG-
53,[158] TG-56,[13] and TG-43U1.[2]) This comparison should yield agreement within ±2% over all
angles and over the range of radial distances commissioned. Discrepancies exceeding 2% should be
documented and critically examined since better agreement is expected.
VI.A. AAPM-RPC Source Registry
In 2001, the RTOG approached the RPC with the request to make available a list of
brachytherapy sources that met appropriate criteria and could be considered usable for clinical trials.
The RPC collaborated with the AAPM, which had issued a report entitled “Dosimetric prerequisites
for routine clinical use of new low-energy photon interstitial brachytherapy sources” by Williamson
et al.[16] Sources that met these dosimetric prerequisites were judged to be sufficiently well
characterized, have adequate traceability to national standards, and be manufactured under processes
38 HEBD report
subjected to appropriate quality control standards. Shortly afterwards, the joint AAPM/RPC Source
Registry was established on the RPC web page and has been maintained ever since. Institutions
considering enrolling patients in clinical trials sponsored by the U.S. National Cancer Institute (NCI)
that involve low-energy seeds must use sources that are listed on the Registry. The Registry includes
tables of dosimetry parameters that have been compiled from peer-reviewed publications and issued
as consensus data deemed suitable by the AAPM for clinical use.
Development of a new RTOG protocol requiring use of high-energy photon-emitting
brachytherapy sources prompted expansion of the Registry in 2009 to include such sources. For
high-energy sources to be included in the Registry, there must be compliance with the HEBD
prerequisites.[17] The BTSC and BSR have identified a number of high-energy sources that meet
these prerequisites. In response, the RPC has added these sources to the Registry.
The differences in radionuclide characteristics stimulated some changes in the requirements
between low- and high-energy photon-emitting brachytherapy sources. Whereas source manu-
facturers must submit low-energy sources at least annually to NIST or other primary standards labs
for SK calibration consistency, a calibration comparison frequency of 2 years for 60Co, 137Cs, and 192Ir
sources is recommended. Vendors of sources containing these high-energy radionuclides should
comply with this comparison frequency, and are monitored for compliance by the AAPM and
ESTRO. For 192Ir, 137Cs, and 60Co sources of conventional design, the Registry only requires a single
published dataset. This must be a MC study of dose to water in water medium as stated in section IV.
A special case exists for orphaned sources: those no longer commercially available, but still in
regular use in hospitals. These must be sources with long half-lives and suitable dose rates that
consequently comprise only certain models of 137Cs and 60Co sources. In the case of these sources,
there is no manufacturer available to submit the Registry application forms. For these orphaned
sources, the AAPM and RPC have developed an approved alternative procedure for Registry
application: a hospital that wishes to participate in a clinical trial that involves brachytherapy sources
not currently posted on the Registry may submit the application, listing the dosimetric studies
available and the dosimetry parameters to be used for treatment planning. The hospital must also
describe their method of source strength traceability for review by the RPC to assure the correct
calibration of the sources. In the special case of source trains, in which individual sources cannot be
removed for calibration with a well chamber, the hospital may describe a method of calibration at a
distance in a phantom, in accordance with calibration procedures described in the peer-reviewed
literature.
As extensively described by Rivard et al.,[159] while posting of a source model on the Registry
does not imply existence of an AAPM-endorsed consensus dataset, clinical use of Registry-posted
data represents a reasonable choice for medical physicists, the source vendor, and clinical trial
investigators for implementing newly marketed seed products. AAPM consensus datasets are
typically issued within 3 years after posting on the Registry, and then included on the RPC website.
In the absence of AAPM-issued consensus datasets, ESTRO manages a database for brachytherapy
dosimetry parameters and other related data http://www.estro.org/about/governance-organisation/com
mittees-activities/tg43. For low-energy LDR brachytherapy sources for which AAPM-endorsed con-
sensus datasets are available, ESTRO recommends adopting these datasets and the ESTRO website
includes a link to the Registry website. A similar policy isIMPLEMENTEDFORHIGH ENERGYSOURCES

once consensus data are published.
Another online venue for brachytherapy dosimetry parameter data is at Carleton University:
http://www.physics.carleton.ca/clrp/seed_database/. Data for this website includes results of MC
simulations for 125I, 103Pd, 192Ir, and 169Yb sources. A key difference between this site and the other
three venues is that the data were derived from a common MC radiation transport code, Brachy-
Dose.[132] In addition to the TG-43 dosimetry parameters, dose rate tables for high-energy sources
are also presented separately for primary, single-scattered, and multiple-scattered photons. For the
192
Ir sources, these datasets have been evaluated in this report.
VI.B. Consensus datasets
Sources meeting the 2007 AAPM prerequisites[17] are considered in this section. The
publications pertaining to each source have been evaluated following the guidelines described in
section IV. Details about source characteristics including source schematic diagram, criteria for
selecting consensus data among those published, and a brief discussion about the publications related
to each source are available in Appendix A. This section presents a list of sources.
VI.B.1. HDR 192Ir sources
The HDR 192Ir brachytherapy sources for which consensus datasets have been obtained are as
follows:
a. Nucletron model mHDR-v1 (classic) source
b. Nucletron model mHDR-v2 source
c. Varian Medical Systems model VS2000 source
d. Eckert & Ziegler BEBIG GmbH model Buchler source
e. Varian Medical Systems model GammaMed HDR 12i source
f. Varian Medical Systems GammaMed HDR Plus source
g. Eckert & Ziegler BEBIG GmbH model GI192M11 source
h. Eckert & Ziegler BEBIG GmbH model Ir2.A85-2 source
i. SPEC Inc. model M-19 source
j. Isodose Control model Flexisource.
VI.B.2. PDR 192Ir sources
The PDR 192Ir brachytherapy sources for which consensus datasets have been obtained are as
follows:
a. Varian Medical Systems model GammaMed PDR 12i source
b. Varian Medical Systems model GammaMed PDR Plus source
c. Nucletron model mPDR-v1 source
40 HEBD report
d. Eckert & Ziegler BEBIG GmbH model Ir2.A85-1 source.
VI.B.3. LDR 192Ir sources

The LDR 192Ir brachytherapy sources for which consensus datasets have been obtained are as
follows:
a. Best Industries model 81-01 seed
b. Eckert & Ziegler BEBIG GmbH 0.5 and 1.0 cm long wires.
VI.B.4. LDR 137Cs sources

The LDR 137Cs brachytherapy sources for which consensus datasets have been obtained are as
follows:
a. Eckert & Ziegler BEBIG GmbH model CSM3 source
b. Isotope Product Laboratories model IPL source
c. Eckert & Ziegler BEBIG GmbH model CSM11 source.
VI.B.5. HDR 60Co sources
The HDR 60Co brachytherapy sources for which consensus datasets have been obtained are as
follows:
a. Eckert & Ziegler BEBIG GmbH model GK60M21 source
b. Eckert & Ziegler BEBIG GmbH model Co0.a86 source.
VI.C. Reference overview of sources without consensus datasets
In addition to the sources enumerated in section VI.B for which consensus data have been
produced, there are other sources that have been used in the past in clinical practice or are even still
being used at the time of publication of this report. However, these sources were no longer
commercially available as of January 2010, and consensus datasets are not issued. However, since
there may be retrospective dosimetry trials involving these sources, and also to guide medical
physicists still using them clinically, references are provided from which dosimetry data can be
obtained (these are justified in Appendix B of the online report). Any manipulation of these datasets
is the responsibility of the individual user or company.
These sources are as follows:
a. LDR 137Cs: pellet, CSM2, CSM3-a, CDCS-J, 6500/6D6C, Gold-matrix series 67-800,
CSM1, CDCS-M, CDC.K1-K3, CDC.K4, CDC 12015 to CDC 12035, and CDC.G and
CDC.H
b. LDR 192Ir: Platinum-clad seed
c. HDR 192Ir: Varian classic
d. PDR 192Ir: Nucletron
e. HDR 60Co: Ralstron Type-1, Type-2, and Type-3.
NOMENCLATURE
1D one-dimensional
2D two-dimensional
AAPM American Association of Physicists in Medicine
ADCL Accredited Dosimetry Calibration Laboratory
BRAPHYQS ESTRO BRAchytherapy PHYsics Quality assurance System
BSR Brachytherapy Source Registry (AAPM Working Group)
BTSC Brachytherapy Subcommittee (AAPM)
CF correction factor
CSDA continuous slowing down approximation
CT computed tomography
CTV clinical target volume
EC electron capture
ESTRO European Society for Radiotherapy and Oncology
EXP experimental measurement
GBBS Grid-Based Boltzmann Solver
GBq gigabecquerel
HDR high dose rate
HEBD AAPM High Energy Brachytherapy Source Dosimetry Working Group
IC internal conversion
ICWG Interstitial Collaborative Working Group
ISA inter-source attenuation
keV kiloelectron volt
LDR low dose rate
LEBD AAPM Low Energy Brachytherapy Source Dosimetry Working Group
LiF lithium fluoride
MBDCA Model-Based Dose Calculation Algorithms (working group)
42 HEBD report
MC Monte Carlo
mCi millicurie
MCPT Monte Carlo Photon Transport
MeV megaelectronvolt
MRI magnetic resonance imaging
MS multiple scattering
NCI Natonal Cancer Institute
NIST U.S. National Institute of Standards and Technology
NNDC National Nuclear Data Center
PDR pulsed dose rate
PMMA polymethyl methacrylate
POI points-of-interest
PSS primary and scatter dose separation
RAKR reference air-kerma rate
RPC Radiological Physics Center
RTOG Radiation Therapy Oncology Group (U.S.)
STP standard temperature pressure
TG-43 AAPM Task Group No. 43 brachytherapy dose calculation formalism
TG-43U1 2004 update to the TG-43 report
TG-43U1S1 2007 supplement to the 2004 AAPM TG-43U1 report
TLD thermoluminescent dosimeter, generally composed of LiF (TLD-100)
TLS two length segmented method
TPS treatment planning system(s)
QA quality assurance
U The unit of air-kerma strength, equivalent to μGy m2 h–1 or cGycm2h–1.
Angle subtended by P(r,) and the two ends of the brachytherapy source active
length. As used in the line-source approximation, has units of radians.
d Distance to the point of measurement from the source center in its transverse-
plane. Typically measured in air or in vacuo. Units of cm.
d ( r0 , 0 ) The dose rate per history estimated using Monte Carlo methods at the reference
position.
D ( r, ) Dose rate in water at P(r,). The dose rate is generally specified with units
cGyh–1 and the reference dose rate, D ( r0 , 0 ) , is specified at P(r0, 0) with units
of cGyh–1.
Energy cutoff parameter used for air-kerma rate evaluation, with units of keV.
F(r,) 2D anisotropy function describing the ratio of dose rate at radius r and angle
around the source, relative to the dose rate at r0 = 1 cm and 0 = 90° when
removing geometry function effects. Dimensionless units.
GX(r,) Geometry function approximating the influence of the radionuclide physical

distribution on the dose distribution. GX(r,) is calculated by the following:
GP ( r, ) = r 2 point-source approximation

if 0
G L ( r, ) = Lr sin line-source approximation
( r 2 L2 4 )
1
if = 0
with units of cm–2.
g(r) Radial dose function describing the dose rate at distance r from the source in
the transverse plane relative to the dose rate at r0 = 1 cm. Dimensionless units.
gL(r) Radial dose function, determined under the assumption that the source can be
represented as a line segment. Dimensionless units.
gP(r) Radial dose function, determined under the assumption that the source can be
represented as a point. Dimensionless units.
CON g(r) radial dose function derived from consensus dataset. Dimensionless units.
k ( d ) Air-kerma rate in vacuo, per history as estimated using Monte Carlo methods,
due to photons of energy greater than .
K ( d ) Air-kerma rate in vacuo on the source transverse plane due to photons of

energy greater than , with units of cGyh–1.
44 HEBD report
Dose rate constant in water, with units of μGyh–1U–1. is defined as the dose
rate at P(r0,0) per unit SK.
CON Notation indicating that the reported value of is the consensus value
determined by the AAPM from published data, with units of cGyh-1U-1.
EXP Notation indicating that the reported value of was determined by

experimental measurement.
MC Notation indicating that the reported value of was determined using Monte
Carlo calculations.
L Active length of the source (length of the radioactive portion of the source)
with units of cm.
Leff The effective active length of the source. Leff is used for brachytherapy sources
containing uniformly spaced multiple radioactive components. Leff = SN,
where N represents the number of discrete pellets contained in the source with
center-to-center spacing S.
P(r,) Point-of-interest, positioned at distance r and angle from the geometric center
of the radionuclide distribution.
r The distance from the source center to P(r,), with units of cm.
r0 The reference distance, generally 1 cm.
sK The air-kerma strength per history estimated using Monte Carlo methods.
SK Air-kerma strength: the product of the air-kerma rate and the square of the
distance d to the point of specification from the center of the source in its
transverse-plane. SK is expressed in units of μGy m2 h–1, a unit also identified
by U.

The polar angle between the longitudinal axis of the source and the ray from
the active source center to the calculation point, P(r,).
0
The reference polar angle, generally 90° or /2 radians.
APPENDIX A
DETAILED DOSIMETRY DATASETS FOR HIGH-ENERGY

PHOTON-EMITTING BRACHYTHERAPY SOURCES
The general 2D dose rate equation from the 1995 TG-43 formalism is retained:
G ( r, )
D ( r, ) = SK L gL ( r ) F ( r, ) , (10)
GL ( r0 , 0 )
where r denotes the distance from the center of the active source to the point of interest, r0 denotes
the reference distance which is specified to be r0 = 1 cm in that protocol, and denotes the polar
angle specifying the point of interest, P(r,), relative to the source longitudinal axis. The reference
angle, 0, defines the source transverse plane, and is specified to be 0 = 90° (Figure 1). In clinical
practice, an HDR-PDR source is fixed to a cable, such that its position and orientation are easily
identified. So, we have chosen as Z- and Y-axis the longitudinal and transverse axes, respectively.
The origin is taken as the center of the active part, with the positive Z-axis directed through the
source tip. In the case of LDR 137Cs sources, the source tip must be defined for each source model.
Figure 1. Reference polar coordinate system for high-energy

photon-emitting sources adapted from the 1995 TG-43 report.[1]
The TG-43 formalism applies to sources with cylindrically symmetric dose distributions with
respect to the source longitudinal axis. HDR-PDR sources discussed in this report can be accurately
represented by a capsule and a cable, and consequently are asymmetric with respect to the transverse
plane. In the case of LDR sources, 137Cs sources are asymmetric while 192Ir seeds and wires are
symmetric with respect to the transverse axis. In the latter case, consensus datasets presented in this
section assume that dose distributions are symmetric with respect to the transverse plane, i.e., that
radioactivity distributions to either side of the transverse plane are mirror images of one another. For
46 HEBD report
the sources included in this report, only the line-source approximation used for the geometry
function applies.
Before using data in this section, please read section III.B to be aware of extrapolation
methods used for some datapoints in the tables.
A.1. High Dose Rate 192Ir sources
A.1.1. mHDR-v1 (Nucletron)
Source Description
This microSelectron HDR source was introduced in 1991 by Nucletron (Veenendaal, The
Netherlands). The radioactive source (10 Ci or 41103 U) consists of a 0.60 mm diameter by 3.5 mm
long cylinder of pure iridium, which is encapsulated in an AISI 316L stainless steel capsule with an
outer diameter of 1.1 mm and a spherical distal end with a 0.55 mm radius of curvature. The distance
from the physical source tip to the distal face of the active core tip is 0.35 mm. A schematic of the
source is shown in Figure 2.
Figure 2. Materials and dimensions (mm) of the Nucletron mHDR-v1 source.[47]
Publications
Muller-Runkel and Cho[160] performed anisotropy measurements in polystyrene and air using
TLDs at radial distances r = 1 cm to 10 cm at polar angles restricted, however, to ±45° with respect
to the long axis of the source.
Williamson and Li[47] used the Monte Carlo Photon-Transport (MCPT) code to calculate 2D
dose rate distributions and also tabulated their published data in the Interstitial Collaborative
Working Group (ICWG) and TG-43 formalism formats. This code simulates photoelectric
absorption, followed by K-shell and L-shell characteristic x-ray emission, pair production, and
coherent and incoherent scattering. The photon cross-section library DLC-99 (HUGO)[161] was used.
The primary photon spectrum for 192Ir was that of Glasgow and Dillman.[162] The photon cutoff
energy was not indicated. Since their code did not model transport and scattering of secondary
electrons, they calculated the collisional kerma rate (using either the next-flight or exponential track-
length estimator) and converted to dose rate by normalizing the data to air-kerma strength per unit
contained activity. Air-kerma rates were calculated for distances ranging from 5 to 100 cm along the
transverse source bisector with the source inmersed in a 5 m sphere of dry air. The 2D dose rate was
calculated at approximately 500 points in a 30 cm water sphere. For transverse axis data, dose rates
were calculated at distances ranging from 0.1 cm to 14 cm. To obtain the 2D anisotropy function,
they used a variable grid of 70 polar angles at 6 distances from 0.25 cm up to 5 cm. The standard
deviation of the mean (k = 1) for total dose ranged from 0.5% (near the source) to 2% (far from the
source). They deduced a MC estimate of 1.115 cGyh–lU–l ± 0.5%. Observe that in this paper polar
angle is defined as 180° – (Fig. 1).
TLD, diode, and MC dosimetry of this source was published by Kirov et al.[94] They measured
the 2D dose rate distribution around the source and used the results to validate MC simulations by
Williamson and Li.[47] TLDs in a solid-water phantom were used to measure the transverse-axis dose
rates for 0.5 r 10 cm and the polar dose rate profiles at 1.5 cm, 3 cm, and 5 cm distances from the
source. At close distances, 7 mm to 40 mm from the HDR source, they performed transverse axis
dose rate measurements with an Si diode in water. Agreement between MC photon transport absolute
dose rate calculations[47] and measurements was, on average, within 5%. From the transverse-axis
experimental data, they deduced a value for the dose rate constant of 1.14 cGyh–lU–1 ± 5%.
Anctil et al.[163] made TLD measurements in a polystyrene phantom of size (30 30 16.5)
cm3 using 1.0 mm 6 mm LiF rods calibrated in a 6 MV linac beam and having a measurement
precision of 3%. Approximately 7 cGy was delivered to each TLD position in the phantom.
Measurements were repeated 5 times except at the reference position, where they were repeated
24 times using bilateral TLD placement to minimize source positioning error in the transverse
direction. A distance-dependent photon energy response correction was made using factors taken
from Meigooni et al.[164] TG-43 parameters were obtained using a line source approximation for the
geometry function, with L = 0.35 cm. was (1.13 ± 0.03) cGyh–1U–1. The radial dose function was
obtained over the distance range 1.0 cm to 10.0 cm in 1.0 cm steps, and the 2D anisotropy function
was obtained on a polar grid sampling the same radial points and an angular range from 0° to 170° in
10° steps.
Karaiskos et al.[49] performed MC and TLD studies of the source using spherical water
phantoms with R = 10 cm to 50 cm. Analytical tracking was performed for every primary photon
initiated in a random position and emitted in a random direction within the source. Primary and
secondary photons were sampled individually in direct analogy to the main processes, namely
photoabsorption and coherent and incoherent scattering. The tracking and interactions of photons
were based on up-to-date and self-consistent total, partial, and differential cross sections and the
procedure outlined by Chan and Doi[165] for the sampling of coherent and incoherent scattering. The
photon spectrum and cutoff energies used were not indicated. The electron binding energy of the
scattering atom was taken into account in the incoherent scattering process. For electrons, the
continuous slowing down approximation (CSDA) was followed. The calculation of energy
48 HEBD report
deposition was performed either directly from the electron energy deposition within the voxel
volume or from the photon energy fluence. For the energies considered, both methods gave results
within statistical uncertainties. The results presented were generated using the second method
yielding statistical uncertainties <1%. The 30 cm diameter phantom was divided into discrete
concentric spherical shells of 1 mm thickness, each split into angular intervals of up to 2°. In these
voxels, quantities such as the number and kind of interactions, the energy transferred to electrons by
primary and/or secondary interactions, photon spectra, as well as the primary, scattered and total
energy deposition were scored. Using these quantities, absorbed dose, air kerma, water kerma, dose
anisotropy function, and radial dose function can be calculated for all voxels in a single run. They
ascertained that phantom dimensions significantly affected g(r) near phantom boundaries where
deviations of up to 25% were observed. They also did not observe significant differences in the 2D
anisotropy function F(r,) for the different values of R. Radial dose functions, dose rate constant, and
2D anisotropy functions, utilized in the TG-43 dose estimation formalism, were calculated. In
addition, measurements of anisotropy functions using LiF TLD-100 rods were performed in a
polystyrene (30 30 30) cm3 phantom to support their MC calculations using the same phantom
size. The energy dependence of LiF TLD response was investigated over the whole range of
measurement distances and angles. TLD measurements and MC calculations are in agreement with
each other and agree with published data. They deduced a value of = (1.116 ± 0.006) cGyh–1U–1.
They provided gL(r) (L = 0.35 cm) and F(r,) for a spherical phantom with R = 15 cm. Observe that
in this paper polar angle is defined as 180° – (Fig. 1)
Papagiannis et al.[90] used their own MC simulation (the same code used by Karaiskos et al.[49])
to calculate the gamma dose rate distribution in water around this source. The 192Ir source photon
spectrum from Glasgow and Dillman[162] was used. The dose component due to the beta spectrum of
192
Ir was evaluated. The water kerma approximation was utilized and results were presented for
points at transverse distances greater than 1 mm from the source. The source was centrally positioned
in a 30 cm diameter spherical water phantom. The phantom sphere was divided into discrete
concentric spherical shells of 0.025 cm thickness up to r = 0.5 cm and 0.1 cm thickness thereafter,
each split into angular intervals of 1° with respect only to . The particle streaming function as
described in Karaiskos et al.[89] was used. They reported = 1.108 cGyh–1U–1±0.13%. Numerical
values of the radial dose function and anisotropy functions were not provided.
Taylor and Rogers[139] used BrachyDose,[132] a brachytherapy user code for EGSnrc,[166] to
perform an exhaustive dosimetric study of all HDR and PDR 192Ir and 169Yb sources available at the
time of publication. For the transport of photons, Rayleigh scattering, bound Compton scattering,
photoelectric absorption, and fluorescent emission of characteristic x-rays were all simulated. Photon
cross sections from the XCOM database were used and mass-energy absorption coefficients were
calculated using the EGSnrc user-code “g.” The incident 192Ir spectrum used was taken from work by
Duchemin and Coursol,[167] while the 169Yb spectrum was the simplified spectrum presented by
Medich et al.[5] The photon cutoff energy was set to 1 keV for all dose-to-water calculations. Dose
calculations were performed scoring kerma using a track-length estimator in a water cube of side
80 cm surrounding the source and considering a length of cable equal to those used previously by
other authors for the same source. To minimize the impact of voxel size effects while maintaining
reasonable efficiency, voxel sizes were chosen in the following way: (0.1 0.1 0.1) mm3 voxels
for distances in the range of rsource < r 1 cm, (0.5 0.5 0.5) mm3 voxels for 1 cm < r 5 cm,
(1 × 1 1) mm3 voxels for 5 cm < r 10 cm, and (2 2 2) mm3 voxels for 10 cm < r 20 cm,
where r is defined as the distance from the center of the source. The magnitude of uncertainty
introduced by voxel size effects is typically less than 0.25%.[132] Calculations of the air kerma per
history were made in vacuo, thereby avoiding the need to correct for attenuation by air. The mass
energy absorption coefficients for air used in this calculation were calculated with the composition
recommended by TG-43U1. Air kerma times d 2 per history was calculated in a (10 10 0.05) cm3
voxel located 100 cm from the source along the transverse axis and then corrected to give the air
kerma times d 2 per history at a point (assuming an isotropic point source).[132] Low-energy photons
emitted from the source encapsulation were suppressed in the air-kerma calculations by discarding
all photons with energies less than 10 keV. The radial dose function was obtained using a line source
geometry function over a radial range r = [0.2 to 1(0.1), 1 to 2 (0.25), 2 to 5(0.5), 5 to 20(1)] cm. It
was fit with a 5th order polynomial, and alternatively with a modified polynomial, over the full range.
The 2D anisotropy function was obtained over the same radial range and an angular range = 0° to
3°(1°), 3° to 7°(2°), 10°, 12°, 15° to 165°(5°), 168°, 170°, 173°, 177° to 180°(1°). Datasets for all
sources studied are avalaible online (http://www.physics.carleton.ca/clrp/seed_database/). For the
mHDR-v2 source they provided = (1.117 ± 0.002) cGyh–1U–1.
Consensus Data
The four MC studies mentioned above[47,49,90,168] derived very close values of and their
average value was taken as the consensus value: CON = 1.116 cGyh–1U–1 (Table IV). The TLD
measurements[163] and the MC results[47,49] for the 30 cm diameter phantom agreed within
uncertainites. The MC radial dose function data from Karaiskos et al.[49] and Williamson and Li[47]
were converted to unbounded ones as explained in section III.A to be compared with the
corresponding data of Taylor and Rogers.[168] Unbounded radial dose data by Williamson and Li and
Taylor and Rogers are very close to each other, while the correponding data from Karaiskos et al.,
are slightly higher. Because the Taylor and Rogers data present a step at r = 1 cm, the data from
Williamson and Li (unbounded) are selected as CONgL(r) (Table V), removing the published data at r
= 0.1 cm because electronic disequilibrium exists and kerma was scored instead of absorbed dose.
The comparison of the anisotropy results from the three MC studies[47,49,168] shows good agreement
(differences of less than 1% except at r = 0.25 cm and at small angles where differences are up to
6%). Moreover, they agree within uncertainities with the TLD data of Anctil et al.[163] Because the
data of Taylor and Rogers present the best mesh in both r and , these data are recommended as
CONF(r,) (TableVI).
50 HEBD report
Derived from the consensus TG-43 dataset, an away-along dose rate table is presented
(cGyh–1U–1) for TPS quality assurance purposes (Table VII).
Table IV. Dose rate constant for HDR 192Ir sources.
Statistical
CON uncertainty CON/GL(r0 ,0)
Source Name (Manufacturer) [cGyh U–1]–1
(k = 1) [cGycm2h–1U–1]
mHDR-v1 (Nucletron) 1.116 0.9% 1.127
mHDR-v2 (Nucletron) 1.109 1.1% 1.121
VS2000 (Varian) 1.100 0.6% 1.123
Buchler (E&Z BEBIG) 1.117 0.4% 1.119
GammaMed HDR 12i (Varian) 1.118 0.4% 1.129
GammaMed HDR Plus (Varian) 1.117 0.4% 1.128
GI192M11 (E&Z BEBIG) 1.110 0.4% 1.121
Ir2.A85-2 (E&Z BEBIG) 1.109 1.2% 1.120
M-19 (SPEC) 1.114 0.2% 1.125
Flexisource (Isodose Control) 1.113 1.0% 1.124
Table V. Radial dose function values for HDR sources. Interpolated/extrapolated data are
boldface/underlined. Values inside the source are in italics. In [brackets] are the corrected
values from bounded to unbounded geometry.
gL(r)
Nucletron Nucletron Varian E&Z BEBIG Varian Varian E&Z BEBIG E&Z BEBIG SPEC Isodore Control
mHDR-v1 mHDR-v2 VS2000 Buchler GammaMed HDR 12i GammaMed HDR Plus GI192M11 Ir2.A85-2 M-19 Flexisource
r [cm] L = 0.35 cm L = 0.35 cm L = 0.5 cm L = 0.13 cm L = 0.35 cm L = 0.35 cm L = 0.35 cm L = 0.35 cm L = 0.35 cm L = 0.35 cm
0.00 [0.991] 1.276 0.986 1.023 0.992 0.998 0.990 0.990 0.993 0.991
0.06 1,276
0.08 1,199
0.10 1,110
0.15 1,018
0.20 [0.991] 1,001 0.986 1.023 0.992 0.998
0.25 [0.992] 0.995 0.991 1.018 0.992 0.997 0.990 0.990 0.993 0.991
0.50 [0.997] 0.997 0.997 1.002 0.994 0.996 0.996 0.996 0.995 0.997
0.75 [0.999] 0.998 0.999 0.999 0.997 0.998 0.998 0.998 0.998 0.998
1 1 1 1 1 1 1 1 1 1 1
1.5 [1.002] 1,003 1.005 1.003 1.004 1.003 1.003 1.002 1.001 1.002
2 [1.004] 1,005 1.010 1.004 1.006 1.006 1.004 1.004 1.005 1.004
3 [1.006] 1,008 1.012 1.008 1.008 1.006 1.005 1.005 1.008 1.005
4 [1.006] 1,007 1.013 1.007 1.005 1.004 1.004 1.003 1.003 1.003
5 [1.001] 1,003 1.011 1.002 0.999 0.999 0.999 0.999 0.999 0.999
6 [0.993] 0.996 1.003 0.995 0.991 0.993 0.992 0.991 0.994 0.991
8 [0.970] 0.972 0.982 0.971 0.968 0.968 0.968 0.968 0.969 0.968
10 [0.934] 0.939 0.949 0.941 0.936 0.935 0.935 0.935 0.939 0.935
Table VI. F(r,) for the Nucletron mHDR-v1 source. Extrapolated data are underlined.
Values inside the source are in italics.
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
0 0.683 0.683 0.664 0.626 0.634 0.655 0.677 0.697 0.743 0.776
1 0.683 0.683 0.664 0.624 0.638 0.661 0.683 0.704 0.746 0.779
2 0.682 0.682 0.663 0.625 0.646 0.669 0.691 0.713 0.754 0.784
3 0.677 0.677 0.664 0.637 0.656 0.681 0.701 0.722 0.762 0.791
5 0.683 0.683 0.675 0.658 0.679 0.701 0.719 0.738 0.775 0.799
7 0.704 0.704 0.697 0.684 0.702 0.724 0.740 0.760 0.790 0.814
10 0.738 0.738 0.733 0.722 0.739 0.759 0.773 0.789 0.816 0.835
12 0.762 0.762 0.758 0.748 0.764 0.780 0.792 0.807 0.830 0.849
15 0.798 0.798 0.793 0.783 0.796 0.811 0.821 0.833 0.851 0.865
20 0.845 0.845 0.842 0.836 0.844 0.855 0.862 0.871 0.884 0.894
25 0.885 0.885 0.880 0.871 0.880 0.888 0.891 0.897 0.908 0.915
30 0.910 0.910 0.906 0.898 0.906 0.912 0.915 0.918 0.928 0.930
35 0.931 0.931 0.928 0.921 0.927 0.932 0.936 0.941 0.945 0.948
40 0.952 0.952 0.947 0.936 0.943 0.948 0.948 0.953 0.955 0.956
45 0.962 0.962 0.959 0.953 0.958 0.962 0.962 0.966 0.968 0.968
50 0.971 0.971 0.969 0.965 0.968 0.971 0.972 0.975 0.977 0.975
55 0.984 0.984 0.976 0.971 0.977 0.980 0.979 0.980 0.982 0.983
60 0.989 0.989 0.983 0.978 0.984 0.988 0.988 0.989 0.989 0.990
65 0.992 0.992 0.988 0.986 0.989 0.991 0.989 0.993 0.996 0.993
70 0.995 0.995 0.994 0.991 0.993 0.996 0.994 0.995 0.997 0.995
75 0.997 0.997 0.995 0.993 0.996 0.997 0.996 0.997 0.999 0.996
80 0.998 0.998 1.000 0.995 0.999 1.000 0.999 1.003 1.000 0.999
85 0.999 0.999 1.000 0.995 0.998 0.999 1.001 1.003 1.002 1.000
90 1 1 1 1 1 1 1 1 1 1
95 0.999 0.999 1.000 0.994 0.999 1.003 1.001 1.002 1.001 1.001
100 0.999 0.999 0.998 0.993 0.998 1.001 1.001 1.002 0.999 0.999
105 0.998 0.998 0.996 0.991 0.996 0.999 0.999 1.001 1.000 0.999
110 0.995 0.995 0.993 0.990 0.993 0.994 0.993 0.993 0.994 0.993
115 0.993 0.993 0.990 0.985 0.988 0.991 0.992 0.993 0.992 0.991
120 0.989 0.989 0.986 0.979 0.983 0.983 0.984 0.988 0.988 0.986
125 0.984 0.984 0.978 0.973 0.978 0.981 0.981 0.983 0.983 0.984
130 0.970 0.970 0.969 0.967 0.969 0.973 0.971 0.975 0.975 0.975
135 0.962 0.962 0.959 0.954 0.958 0.963 0.962 0.964 0.965 0.965
140 0.950 0.950 0.946 0.939 0.945 0.949 0.950 0.954 0.956 0.958
145 0.934 0.934 0.930 0.922 0.927 0.932 0.934 0.937 0.942 0.946
150 0.913 0.913 0.908 0.898 0.905 0.911 0.914 0.920 0.926 0.931
155 0.884 0.884 0.878 0.867 0.875 0.883 0.887 0.894 0.902 0.908
160 0.820 0.820 0.822 0.827 0.836 0.846 0.853 0.863 0.876 0.886
165 0.758 0.758 0.761 0.767 0.780 0.795 0.806 0.816 0.839 0.854
168 0.708 0.708 0.712 0.720 0.736 0.755 0.769 0.785 0.811 0.832
170 0.661 0.661 0.666 0.678 0.701 0.723 0.740 0.757 0.789 0.810
173 0.592 0.592 0.599 0.614 0.643 0.670 0.690 0.712 0.753 0.782
175 0.556 0.556 0.563 0.578 0.609 0.638 0.660 0.685 0.731 0.762
177 0.538 0.538 0.545 0.558 0.586 0.616 0.642 0.666 0.714 0.750
178 0.531 0.531 0.538 0.551 0.576 0.606 0.632 0.659 0.707 0.744
179 0.536 0.536 0.541 0.550 0.570 0.597 0.624 0.649 0.700 0.739
180 0.534 0.534 0.539 0.548 0.567 0.595 0.621 0.647 0.700 0.738
52 HEBD report
Table VII. QA away-along data [cGyh–1U–1] for the Nucletron mHDR-v1 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01662 0.01688 0.01716 0.01740 0.01763 0.01787 0.01784 0.01706 0.01558 0.01384 0.01204 0.01041
6 0.0223 0.0228 0.0232 0.0237 0.0241 0.0244 0.0242 0.0225 0.0200 0.01717 0.01457 0.01225
5 0.0315 0.0325 0.0334 0.0343 0.0348 0.0351 0.0343 0.0305 0.0259 0.0215 0.01756 0.01435
4 0.0481 0.0500 0.0519 0.0535 0.0543 0.0539 0.0510 0.0427 0.0339 0.0266 0.0209 0.01663
3 0.0829 0.0877 0.0926 0.0954 0.0958 0.0906 0.0812 0.0606 0.0442 0.0326 0.0245 0.01888
2 0.1809 0.1977 0.211 0.212 0.202 0.1699 0.1364 0.0857 0.0560 0.0386 0.0278 0.0208
1.5 0.321 0.358 0.377 0.359 0.322 0.242 0.1768 0.0998 0.0616 0.0412 0.0292 0.0216
1 0.728 0.842 0.809 0.677 0.542 0.340 0.224 0.1129 0.0664 0.0434 0.0303 0.0222
0.5 3.40 3.43 2.19 1.354 0.886 0.448 0.265 0.1225 0.0697 0.0448 0.0309 0.0225
0 3.92×108 15.61 4.33 1.966 1.116 0.500 0.282 0.1259 0.0708 0.0451 0.0311 0.0226
–0.5 2.76 3.43 2.20 1.357 0.886 0.448 0.265 0.1226 0.0698 0.0448 0.0309 0.0225
–1 0.637 0.820 0.806 0.678 0.542 0.341 0.223 0.1129 0.0666 0.0434 0.0303 0.0222
–1.5 0.284 0.336 0.372 0.357 0.322 0.242 0.1770 0.0997 0.0616 0.0413 0.0292 0.0216
–2 0.1617 0.1812 0.206 0.210 0.202 0.1700 0.1365 0.0857 0.0560 0.0385 0.0278 0.0208
–3 0.0753 0.0798 0.0878 0.0932 0.0945 0.0902 0.0810 0.0606 0.0442 0.0325 0.0245 0.01882
–4 0.0441 0.0458 0.0484 0.0514 0.0531 0.0534 0.0509 0.0426 0.0338 0.0266 0.0209 0.01660
–5 0.0293 0.0300 0.0311 0.0325 0.0337 0.0345 0.0340 0.0305 0.0259 0.0214 0.01754 0.01436
–6 0.0208 0.0212 0.0217 0.0224 0.0231 0.0239 0.0239 0.0224 0.01994 0.01718 0.01453 0.01225
–7 0.01561 0.01579 0.01609 0.01646 0.01686 0.01746 0.01760 0.01693 0.01556 0.01382 0.01205 0.01038
A.1.2. mHDR-v2 (Nucletron)
Source Description
This microSelectron HDR source from Nucletron (up to 12 Ci or 4.9104 U), also known as
the mHDR-v2, consists of a pure iridium metal cylinder which is 3.6 mm long with a diameter of
0.65 mm. The outer capsule diameter and the capsule length are 0.90 mm and 4.5 mm, respectively.
It is welded to a 200 mm long and 0.70 mm diameter woven steel cable. It was developed to allow
the source to pass through smaller diameter (and curved) catheters than the v1 model. The
mechanical design of this source is shown in Figure 3.
Publications
The MC study data published by Daskalov et al.[93,169] have been distributed by Nucletron in its
TPS. As in the mHDR-v1 model (Appendix A.1.1), these data were generated by the MCPT code
with the DLC-99 (HUGO)[161] photon cross-sections library; 192Ir source photon spectrum from
Glasgow and Dillman[162] with no electron emissions; photon-only transport (no electron transport
was performed) with kerma rate at a geometric point calculated using either exponential track-length
estimator or once-more collided flux estimator; air-kerma rate per unit contained activity was
calculated in a dry air sphere 5 m in diameter, and linear corrections were used due to the buildup of
scattered photons in air; the source was centrally positioned in a 30 cm diameter spherical water
phantom. Water-kerma rate was estimated at 600 positions from 0.1 cm r 14 cm; radial dose
function was generated from 1 mm to 14 cm from the source; anisotropy functions were generated
with 67 polar angles at distances of r = 0.25 cm, 0.5 cm, 1.0 cm, 2.0 cm, 3.0 cm, and 5.0 cm.They
reported = 1.108 cGyh–1U–1 ± 0.13%.
Figure 3. Materials and dimensions (mm) of the Nucletron mHDR-v2 source.[93]
Papagiannis et al.[90] (Appendix A.1.1) reported = (1.109 ± 0.005) cGyh–1U–1. Wang and
Li[27] studied the dose rate distribution with MC methods up to radial distances of 1 cm, accounting
for the charged particle nonequilibrium and beta particle contribution, for intravascular treatment
planning applications. They deduced = (1.108 ± 0.002) cGyh–1U–1. Taylor and Rogers[139]
(Appendix A.1.1) obtained = (1.109 ± 0.002) cGyh–1U–1.
Granero et al.[138] studied again this source because Nucletron reported some minor changes
that are within the manufacturing tolerances: the source core diameter has been reduced to 0.60 mm,
the length has been reduced to 3.5 mm, and 0.4 mm of the cable attached to the source capsule has
been replaced with stainless steel. Encapsulation thicknesses and the materials and composition by
weight remain unchanged. Granero et al., have used three different MC codes: MCNP5,
Penelope2008, and GEANT4 (version 9.3). They have reproduced the calculation as in Daskalov et
al. (including the same geometry) using the three codes. Comparisons of the Daskalov et al. results
with their results indicate that the TG-43 dosimetry parameters agree within k = 1 statistical
uncertainties (<0.2%). Therefore, they concluded that any statistically significant dosimetric
differences between the mHDR-v2 before and after the changes reported by the manufacturer can be
attributed to source design differences and are not due to choice of MC code and related differences
in radiological physics modeling. They repeated the MC simulations introducing the changes in the
source geometry and adhered to the HEBD prerequisites. Moreover, they have considered –
contribution to the dose distribution and the lake of electronic equilibrium was taken into account.
They have calculated dose to water using cells 0.01 cm in thickness for r 1 cm from the source, and
factors of five and ten thicker for 1 cm < r 3 cm and 3 cm < r 20 cm, respectively. Angular
54 HEBD report
sampling was taken every 2°. Energy cutoff for both electrons and photons was taken as 10 keV. The
source was located at the geometric center of a spherical liquid water phantom with 40 cm in radius
to estimate dose to water and simulate unbounded phantom conditions for r 20 cm. Air-kerma
strength was simulated in vacuo. Upon averaging results from the three MC codes, = (1.1121 ±
0.0008) cGyh–1U–1 was obtained. This value is comparable with the results of Daskalov et al.,
Papagiannis et al., Wang and Li, and Taylor and Rogers for this source. For r 0.25 cm, gL(r) was
obtained using kerma estimation, while absorbed dose due to photons and source electrons was used
for smaller distances. The gL(r) they obtained agree well (typically < 0.2% differences) with Taylor
and Rogers data for r 0.25 cm as well as with their own study of the unmodified mHDR-v2 source.
F(r,) is provided with high resolution for radial distances r < 0.4 cm in 2° increments. In general,
F(r,) agreement with published data on the unchanged mHDR-v2 source is within a few percent
except for r < 0.25 cm, where electron dose contributions and the lack of electronic equilibrium
become significant.
Consensus Data
The MC studies[27,90,93,138,139,169] derived very close values of and their average value was
taken as the consensus value: CON = (1.109±0.012) cGyh–1U–1 (Table IV). The radial dose function
and anisotropy function from Granero et al.[138] were selected as CONgL(r) (Table V) and CONF(r,)
(Table VIII and Table VIII (cont.)) because they provide data at short distances from the source capsule.
(cGyh–1U–1) for TPS quality assurance purposes (Table IX).
Table VIII. F(r,) for the Nucletron mHDR-v2 source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.06 0.08 0.10 0.15 0.20 0.25 0.30 0.35 0.40
0 0.951 0.951 0.934 0.917 0.874 0.831 0.787 0.744 0.714 0.692
2 0.947 0.947 0.930 0.914 0.871 0.829 0.786 0.744 0.714 0.693
4 0.944 0.944 0.927 0.910 0.869 0.827 0.785 0.744 0.714 0.694
6 1.059 1.059 1.033 1.008 0.944 0.881 0.817 0.754 0.721 0.707
8 0.999 0.999 0.980 0.961 0.914 0.866 0.819 0.772 0.744 0.730
10 1.007 1.007 0.989 0.971 0.927 0.882 0.837 0.793 0.766 0.755
12 1.007 1.007 0.991 0.975 0.936 0.897 0.858 0.819 0.791 0.780
14 1.158 1.158 1.129 1.100 1.027 0.954 0.881 0.830 0.811 0.804
16 1.269 1.269 1.230 1.192 1.094 0.997 0.900 0.851 0.832 0.825
18 1.378 1.378 1.330 1.281 1.159 1.037 0.915 0.867 0.850 0.844
20 1.784 1.784 1.678 1.572 1.306 1.041 0.933 0.885 0.868 0.861
22 1.784 1.784 1.679 1.575 1.313 1.050 0.942 0.893 0.881 0.875
26 1.704 1.704 1.610 1.516 1.281 1.046 0.953 0.920 0.906 0.900
30 1.089 1.089 1.119 1.149 1.225 1.049 0.961 0.932 0.923 0.919
32 1.157 1.157 1.167 1.178 1.203 1.039 0.966 0.939 0.931 0.927
36 1.181 1.181 1.176 1.170 1.156 1.023 0.971 0.949 0.944 0.941
40 0.954 0.954 1.053 1.152 1.109 1.016 0.974 0.961 0.955 0.953
50 1.037 1.037 1.071 1.104 1.047 0.999 0.981 0.976 0.974 0.973
60 1.008 1.008 1.041 1.062 1.013 0.998 0.993 0.987 0.986 0.985
70 1.078 1.078 1.023 1.026 1.001 0.997 0.996 0.995 0.994 0.994
80 1.020 1.020 1.005 1.007 1.000 1.002 1.003 0.998 0.998 0.998
90 1 1 1 1 1 1 1 1 1 1
100 1.012 1.012 1.002 1.008 0.996 0.995 0.999 0.999 0.999 0.999
110 1.069 1.069 1.029 1.025 1.006 0.994 0.996 0.995 0.994 0.994
120 1.004 1.004 1.049 1.060 1.020 0.999 0.992 0.988 0.986 0.986
130 1.056 1.056 1.080 1.105 1.047 1.003 0.985 0.976 0.975 0.974
132 1.043 1.043 1.077 1.111 1.058 1.002 0.982 0.974 0.972 0.970
134 1.021 1.021 1.078 1.135 1.068 1.007 0.982 0.971 0.968 0.967
136 1.011 1.011 1.075 1.138 1.076 1.014 0.979 0.967 0.964 0.963
138 1.080 1.080 1.113 1.146 1.098 1.016 0.977 0.963 0.961 0.958
140 0.983 0.983 1.068 1.153 1.113 1.020 0.982 0.961 0.956 0.954
144 1.184 1.184 1.176 1.169 1.151 1.033 0.978 0.951 0.945 0.942
148 1.140 1.140 1.155 1.169 1.204 1.031 0.976 0.942 0.932 0.928
150 1.099 1.099 1.128 1.158 1.232 1.052 0.967 0.930 0.923 0.920
154 1.631 1.631 1.554 1.477 1.285 1.093 0.959 0.914 0.904 0.899
158 1.725 1.725 1.636 1.547 1.324 1.101 0.947 0.896 0.879 0.873
160 1.741 1.741 1.649 1.558 1.329 1.099 0.937 0.880 0.863 0.858
162 1.515 1.515 1.452 1.389 1.230 1.072 0.914 0.862 0.846 0.840
164 1.382 1.382 1.331 1.280 1.153 1.025 0.898 0.843 0.826 0.820
166 1.961 1.961 1.845 1.729 1.439 1.150 0.860 0.819 0.804 0.797
168 1.036 1.036 1.016 0.996 0.946 0.895 0.845 0.794 0.779 0.770
170 0.894 0.894 0.884 0.874 0.850 0.825 0.801 0.776 0.752 0.741
172 0.880 0.880 0.870 0.860 0.835 0.810 0.786 0.761 0.736 0.711
174 0.626 0.626 0.627 0.627 0.628 0.629 0.630 0.631 0.632 0.633
176 0.575 0.575 0.575 0.576 0.577 0.579 0.580 0.582 0.583 0.585
178 0.536 0.536 0.537 0.537 0.539 0.540 0.542 0.543 0.545 0.546
180 0.497 0.497 0.498 0.499 0.500 0.502 0.503 0.504 0.506 0.507
56 HEBD report
Table VIII (cont). F(r,) for the Nucletron mHDR-v2 source. Extrapolated data are underlined.
r (cm)
(deg) 0.75 1 1.5 2 3 4 5 6 8 10
0 0.619 0.610 0.614 0.625 0.650 0.689 0.711 0.733 0.768 0.798
2 0.639 0.634 0.640 0.651 0.675 0.704 0.725 0.744 0.775 0.801
4 0.659 0.658 0.667 0.677 0.699 0.720 0.738 0.755 0.782 0.804
6 0.684 0.685 0.693 0.703 0.722 0.741 0.757 0.772 0.796 0.816
8 0.710 0.712 0.719 0.729 0.746 0.763 0.777 0.790 0.812 0.830
10 0.739 0.739 0.746 0.754 0.770 0.785 0.797 0.809 0.829 0.844
12 0.765 0.766 0.772 0.779 0.792 0.805 0.816 0.826 0.844 0.857
14 0.790 0.790 0.795 0.801 0.813 0.825 0.835 0.844 0.859 0.871
16 0.812 0.812 0.816 0.822 0.832 0.842 0.850 0.858 0.871 0.881
18 0.831 0.832 0.835 0.840 0.849 0.857 0.865 0.871 0.882 0.892
20 0.849 0.849 0.852 0.856 0.864 0.871 0.878 0.883 0.893 0.901
22 0.864 0.864 0.867 0.871 0.877 0.884 0.890 0.894 0.903 0.910
26 0.891 0.890 0.892 0.895 0.900 0.905 0.909 0.913 0.920 0.925
30 0.911 0.911 0.913 0.915 0.919 0.922 0.926 0.929 0.934 0.938
32 0.921 0.920 0.921 0.923 0.927 0.930 0.933 0.935 0.940 0.944
36 0.935 0.935 0.936 0.937 0.940 0.943 0.945 0.947 0.950 0.953
40 0.948 0.948 0.949 0.950 0.952 0.954 0.956 0.958 0.960 0.962
50 0.971 0.970 0.971 0.972 0.973 0.974 0.974 0.975 0.977 0.978
60 0.984 0.985 0.985 0.986 0.986 0.987 0.987 0.988 0.988 0.989
70 0.993 0.994 0.994 0.994 0.995 0.995 0.995 0.995 0.995 0.995
80 0.998 0.998 0.999 0.999 0.999 0.999 0.999 1.000 1.000 1.000
90 1 1 1 1 1 1 1 1 1 1
100 0.998 0.998 0.998 0.999 0.999 0.999 0.999 0.999 0.999 0.999
110 0.994 0.994 0.994 0.995 0.995 0.995 0.995 0.995 0.995 0.995
120 0.985 0.985 0.985 0.986 0.987 0.987 0.987 0.988 0.988 0.989
130 0.971 0.971 0.971 0.972 0.973 0.974 0.975 0.975 0.977 0.978
132 0.967 0.967 0.968 0.968 0.969 0.970 0.972 0.972 0.974 0.975
134 0.963 0.963 0.963 0.964 0.965 0.967 0.968 0.969 0.970 0.972
136 0.959 0.958 0.959 0.960 0.961 0.962 0.964 0.965 0.967 0.968
138 0.954 0.953 0.954 0.955 0.956 0.958 0.960 0.961 0.963 0.965
140 0.948 0.947 0.948 0.949 0.951 0.953 0.955 0.957 0.959 0.961
144 0.936 0.935 0.936 0.937 0.940 0.942 0.944 0.946 0.949 0.952
148 0.919 0.919 0.920 0.922 0.925 0.929 0.931 0.934 0.938 0.942
150 0.911 0.910 0.912 0.913 0.917 0.921 0.924 0.927 0.932 0.936
154 0.889 0.888 0.890 0.893 0.898 0.903 0.907 0.911 0.918 0.923
158 0.861 0.861 0.864 0.867 0.873 0.880 0.886 0.891 0.900 0.907
160 0.845 0.845 0.848 0.852 0.860 0.867 0.874 0.879 0.890 0.898
162 0.827 0.826 0.830 0.835 0.844 0.852 0.860 0.867 0.878 0.887
164 0.806 0.805 0.810 0.815 0.825 0.835 0.844 0.852 0.866 0.876
166 0.781 0.781 0.786 0.792 0.804 0.816 0.826 0.835 0.851 0.863
168 0.753 0.754 0.760 0.767 0.782 0.794 0.806 0.816 0.835 0.849
170 0.721 0.722 0.729 0.737 0.754 0.769 0.783 0.796 0.817 0.834
172 0.686 0.686 0.695 0.705 0.725 0.742 0.758 0.772 0.796 0.815
174 0.641 0.646 0.656 0.669 0.692 0.711 0.730 0.747 0.774 0.797
176 0.595 0.602 0.616 0.630 0.658 0.678 0.699 0.718 0.749 0.773
178 0.556 0.563 0.578 0.595 0.625 0.638 0.660 0.682 0.717 0.746
180 0.518 0.525 0.540 0.559 0.591 0.598 0.621 0.646 0.685 0.718
Table IX. QA away-along data [cGyh–1U–1] for the Nucletron mHDR-v2 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01690 0.01709 0.01724 0.01749 0.01772 0.01800 0.01797 0.01713 0.01564 0.01385 0.01209 0.01044
6 0.0227 0.0231 0.0235 0.0239 0.0243 0.0246 0.0244 0.0226 0.01996 0.01719 0.01455 0.01226
5 0.0320 0.0328 0.0337 0.0345 0.0351 0.0353 0.0345 0.0306 0.0259 0.0213 0.01750 0.01432
4 0.0487 0.0505 0.0524 0.0540 0.0549 0.0542 0.0513 0.0426 0.0338 0.0265 0.0208 0.01656
3 0.0819 0.0886 0.0936 0.0965 0.0967 0.0910 0.0813 0.0604 0.0440 0.0324 0.0244 0.01875
2 0.1776 0.2006 0.214 0.214 0.204 0.1704 0.1360 0.0853 0.0557 0.0384 0.0277 0.0207
1.5 0.311 0.364 0.382 0.362 0.324 0.241 0.176 0.0993 0.0614 0.0410 0.0290 0.0215
1 0.707 0.859 0.818 0.682 0.542 0.340 0.223 0.1124 0.0662 0.0431 0.0301 0.0220
0.5 3.45 3.47 2.19 1.354 0.885 0.446 0.264 0.1219 0.0694 0.0445 0.0308 0.0224
0 6.80×108 15.5 4.29 1.953 1.109 0.497 0.281 0.1254 0.0705 0.0449 0.0310 0.0225
–0.5 2.62 3.47 2.20 1.355 0.885 0.447 0.264 0.1219 0.0694 0.0445 0.0308 0.0224
–1 0.608 0.849 0.816 0.681 0.543 0.340 0.223 0.1124 0.0662 0.0431 0.0301 0.0220
–1.5 0.274 0.355 0.380 0.361 0.323 0.242 0.1764 0.0993 0.0614 0.0410 0.0290 0.0215
–2 0.1587 0.1927 0.212 0.213 0.203 0.1703 0.1361 0.0853 0.0558 0.0384 0.0277 0.0207
–3 0.0745 0.0840 0.0915 0.0955 0.0962 0.0907 0.0812 0.0605 0.0440 0.0324 0.0244 0.01875
–4 0.0422 0.0472 0.0507 0.0531 0.0543 0.0540 0.0512 0.0426 0.0338 0.0265 0.0208 0.01656
–5 0.0279 0.0304 0.0324 0.0337 0.0346 0.0351 0.0343 0.0306 0.0259 0.0213 0.01750 0.01432
–6 0.0200 0.0213 0.0225 0.0233 0.0238 0.0244 0.0242 0.0225 0.01994 0.01717 0.01455 0.01226
–7 0.01500 0.01576 0.01647 0.01697 0.01735 0.01780 0.01786 0.01708 0.01561 0.01384 0.01207 0.01044
A.1.3. VS2000 (Varian Medical Systems)
Source Description
The VS2000 is an HDR 192Ir source model brought to the market in the year 2000 by Varian
Medical Systems (Palo Alto, CA) designed to be used in their remote afterloading system. The active
core length (5.0 mm), in comparison to their previous VariSource source (10.0 mm), was reduced in
length to provide better flexibility for clinical cases. The source design and encapsulation details
remained similar. A schematic diagram is provided in Figure 4. The active source consists of two,
0.34 mm diameter, 2.5 mm long cylinders with semispherical ends. The radioactive material, pure
iridium metal (22.42 g/cm³), is uniformly distributed in these two pellets. The source is encapsulated
at the end of a 0.59 mm outer diameter nitinol cable consisting of two parts: one flexible part close to
the source and a stiffer one in the proximal part of the cable. The composition is 44.4% Ti and 55.6%
Ni by weight (density 6.5 g/cm³). The encapsulation extends 1 mm beyond the distal end of the
active core and can be approximated by a 0.59 mm diameter, 0.705 mm long cylinder with a
hemispherical end of 0.295 mm radius.
58 HEBD report
Figure 4. Material and dimensions (mm) of the Varian Medical Systems VS2000 source.[170]
Publications
The VS2000 model has been evaluated by Angelopoulos et al.[170] using a custom yet well-
benchmarked MC simulation code (Karaiskos et al.[49] in Appendix A.1.1). The MC code used the
detailed active core, encapsulation geometry and materials of the source design. Water-kerma
approximation was utilized and results were presented for points at transverse distances greater than
1 mm from the source.192Ir source photon spectrum from Glasgow and Dillman[162] was considered.
The source was centrally positioned in a 30 cm diameter spherical water phantom. The phantom
sphere was divided into discrete concentric spherical shells of 0.1 cm thickness up to 15 cm, each
split into angular intervals of 1° with respect only to . Air-kerma strength was derived using both
simulation in free space and dry air. The data from Angelopoulos et al.[170] were cross-checked by the
same authors against other sources such as the VariSource and the microSelectron and to a point
source to validate their findings. Percentage differences between the values of these three sources
follow the percentage differences detected between their geometry functions, GL(r = 1 cm, /2),
where is defined. When compared to the point source and using the same phantom dimensions,
gL(r) was not significantly affected by the source and the encapsulation geometry (3% at distance
close to the source 2 mm and less than 1% for all other radial distances). They reported = (1.101
± 0.006) cGyh–1U–1. Observe that in this paper polar angle is defined as 180° – (Fig. 1).
Taylor and Rogers[139] (see Appendix A.1.1) obtained = (1.099 ± 0.002) cGyh–1U–1.
Consensus Data
The average value of the MC studies[139] was taken as the consensus value: = (1.100 ±
CON
0.006) cGyh–1U–1 (Table IV). The radial dose function and anisotropy function from Taylor and
Rogers were selected as CONgL(r) (Table V) and CONF(r,) (Table X) because these were obtained in
an unbounded phantom, although both studies provided close results for the anisotropy function.
(cGyh–1U–1) for TPS quality assurance purposes (Table XI).
Table X. F(r,) for the Varian Medical Systems VS2000 source. Extrapolated data
are underlined. Values inside the source are in italics.
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
0 0.598 0.598 0.573 0.524 0.536 0.568 0.599 0.627 0.688 0.734
1 0.508 0.508 0.514 0.527 0.551 0.580 0.612 0.638 0.698 0.743
2 0.526 0.526 0.533 0.546 0.573 0.606 0.635 0.661 0.715 0.757
3 0.556 0.556 0.563 0.576 0.601 0.631 0.658 0.684 0.733 0.771
5 0.626 0.626 0.631 0.642 0.663 0.690 0.712 0.732 0.772 0.804
7 0.691 0.691 0.695 0.703 0.718 0.739 0.756 0.771 0.804 0.829
10 0.770 0.770 0.772 0.775 0.781 0.797 0.811 0.821 0.844 0.864
12 0.801 0.801 0.803 0.806 0.812 0.825 0.835 0.843 0.863 0.878
15 0.842 0.842 0.843 0.845 0.848 0.858 0.865 0.871 0.886 0.898
20 0.889 0.889 0.889 0.890 0.892 0.898 0.902 0.904 0.915 0.924
25 0.929 0.929 0.926 0.920 0.918 0.922 0.925 0.926 0.934 0.938
30 0.945 0.945 0.943 0.940 0.938 0.942 0.944 0.946 0.949 0.953
35 0.959 0.959 0.958 0.957 0.952 0.955 0.956 0.959 0.961 0.965
40 0.969 0.969 0.968 0.966 0.963 0.967 0.968 0.969 0.970 0.971
45 0.976 0.976 0.975 0.974 0.973 0.975 0.975 0.976 0.977 0.978
50 0.993 0.993 0.983 0.982 0.979 0.981 0.981 0.980 0.983 0.984
55 0.996 0.996 0.987 0.986 0.986 0.987 0.985 0.985 0.985 0.986
60 0.997 0.997 0.991 0.991 0.988 0.992 0.991 0.990 0.991 0.991
65 0.997 0.997 0.994 0.997 0.993 0.994 0.994 0.996 0.995 0.995
70 0.998 0.998 0.997 0.997 0.995 0.995 0.996 0.997 0.996 0.996
75 0.998 0.998 0.998 1.000 0.997 0.998 0.998 0.998 0.997 0.999
80 0.999 0.999 0.998 1.002 0.998 0.998 0.997 0.997 0.999 0.998
85 0.999 0.999 1.000 1.001 0.998 0.999 0.999 1.000 0.999 1.000
90 1 1 1 1 1 1 1 1 1 1
95 0.999 0.999 1.001 1.000 0.998 0.999 0.998 1.000 0.999 0.999
100 0.999 0.999 0.998 1.005 0.997 0.999 0.999 0.998 0.999 1.000
105 0.999 0.999 0.998 1.000 0.997 1.000 0.998 0.998 0.996 0.997
110 0.999 0.999 0.997 0.999 0.995 0.995 0.995 0.995 0.997 0.997
115 0.998 0.998 0.994 0.995 0.992 0.994 0.995 0.994 0.994 0.993
120 0.997 0.997 0.991 0.996 0.990 0.990 0.990 0.990 0.991 0.993
125 0.995 0.995 0.987 0.988 0.984 0.987 0.985 0.985 0.984 0.988
130 0.993 0.993 0.981 0.979 0.978 0.981 0.981 0.980 0.981 0.983
135 0.976 0.976 0.976 0.977 0.974 0.975 0.976 0.975 0.976 0.977
140 0.971 0.971 0.969 0.967 0.964 0.967 0.968 0.969 0.970 0.971
145 0.960 0.960 0.958 0.955 0.953 0.956 0.958 0.958 0.961 0.963
150 0.947 0.947 0.945 0.941 0.940 0.944 0.944 0.945 0.951 0.954
155 0.931 0.931 0.927 0.918 0.919 0.923 0.927 0.931 0.935 0.942
160 0.892 0.892 0.892 0.892 0.891 0.896 0.899 0.904 0.914 0.921
165 0.845 0.845 0.845 0.846 0.848 0.858 0.865 0.872 0.886 0.899
168 0.799 0.799 0.801 0.804 0.812 0.825 0.834 0.845 0.863 0.878
170 0.755 0.755 0.758 0.765 0.779 0.794 0.806 0.820 0.843 0.861
173 0.676 0.676 0.681 0.691 0.712 0.732 0.750 0.767 0.799 0.826
175 0.608 0.608 0.613 0.625 0.648 0.671 0.695 0.717 0.760 0.793
177 0.511 0.511 0.518 0.533 0.561 0.590 0.619 0.648 0.704 0.749
178 0.514 0.514 0.519 0.529 0.550 0.570 0.591 0.611 0.662 0.714
179 0.402 0.402 0.409 0.422 0.449 0.475 0.501 0.528 0.594 0.660
180 0.291 0.291 0.299 0.315 0.348 0.380 0.412 0.444 0.525 0.606
60 HEBD report
Table XI. QA away-along data [cGyh–1U–1] for the Varian Medical Systems VS2000 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01537 0.01603 0.01688 0.01762 0.01815 0.01871 0.01867 0.01772 0.01610 0.01422 0.01235 0.01066
6 0.0204 0.0216 0.0231 0.0243 0.0251 0.0256 0.0253 0.0233 0.0205 0.01757 0.01485 0.01249
5 0.0285 0.0309 0.0336 0.0354 0.0365 0.0368 0.0357 0.0315 0.0265 0.0218 0.01781 0.01453
4 0.0428 0.0479 0.0533 0.0564 0.0574 0.0565 0.0530 0.0437 0.0345 0.0269 0.0211 0.01679
3 0.0722 0.0863 0.0973 0.1014 0.1013 0.0943 0.0835 0.0616 0.0446 0.0328 0.0247 0.01899
2 0.1543 0.204 0.226 0.225 0.212 0.1749 0.1388 0.0864 0.0564 0.0388 0.0279 0.0209
1.5 0.273 0.384 0.405 0.378 0.334 0.247 0.1790 0.1003 0.0620 0.0414 0.0293 0.0217
1 0.627 0.930 0.864 0.705 0.555 0.344 0.225 0.1131 0.0667 0.0435 0.0303 0.0222
0.5 3.42 3.87 2.27 1.370 0.891 0.448 0.265 0.1224 0.0698 0.0449 0.0310 0.0226
8
0 2.38×10 13.98 4.15 1.924 1.100 0.497 0.282 0.1260 0.0710 0.0453 0.0313 0.0227
–0.5 1.79 3.87 2.27 1.373 0.891 0.448 0.265 0.1225 0.0698 0.0448 0.0310 0.0226
–1 0.378 0.930 0.863 0.705 0.556 0.344 0.225 0.1131 0.0667 0.0435 0.0303 0.0222
–1.5 0.171 0.381 0.405 0.378 0.334 0.247 0.1788 0.1003 0.0619 0.0414 0.0293 0.0216
–2 0.1001 0.203 0.226 0.225 0.212 0.1750 0.1388 0.0863 0.0564 0.0388 0.0279 0.0209
–3 0.0483 0.0836 0.0968 0.1013 0.1011 0.0944 0.0837 0.0617 0.0446 0.0328 0.0247 0.01898
–4 0.0294 0.0455 0.0529 0.0562 0.0574 0.0564 0.0531 0.0437 0.0344 0.0268 0.0211 0.01680
–5 0.0202 0.0292 0.0331 0.0353 0.0366 0.0368 0.0357 0.0315 0.0265 0.0217 0.01777 0.01453
–6 0.01493 0.0202 0.0226 0.0241 0.0250 0.0256 0.0253 0.0233 0.0205 0.01757 0.01484 0.01247
–7 0.01158 0.01487 0.01642 0.01743 0.01807 0.01871 0.01868 0.01772 0.01612 0.01421 0.01234 0.01064
A.1.4. Buchler (E&Z BEBIG)

Source Description
This source is the HDR 192Ir source from Amersham (Product code ICCB2113, Source G0814,
described in the Technical Information and Operation Instructions of the Unit). The 192Ir Buchler HDR
source consists of a cylindrical active iridium core ( = 22.42 g/cm3) of 1 mm diameter and 1.3 mm
length (Figure 5). The active iridium is assumed to be uniformly distributed in this core, which is
encapsulated in a stainless steel wire (No 1.4541) of 1.6 mm outer diameter and 1.2 mm inner diameter.
The upper rounded end of the source is a stainless steel hemisphere of radius 0.8 mm.
Publications
This source has been studied by Ballester et al.[64] using the GEANT3 code.[171] Photon
interactions simulated in this code include photoelectric effect (followed by characteristics x-rays),
Compton scattering, pair production, and Rayleigh scattering. They used the spectrum from
Shirley.[172] The cutoff energy for photons was taken as 10 keV. The electron transport was done in
order to account for the small differences between kerma and absorbed dose at positions close to the
Figure 5. Materials and dimensions (mm) of the E&Z BEBIG

HDR 192Ir Buchler model G0814 source.[64]
source due to the lack of charged-particle equilibrium near the source (r < 1 cm). A cutoff energy of
10 keV was taken for electrons. A cylinder of water of 80 cm height and 40 cm in radius was
assumed with the source in its center. Ballester et al. [private communication] have reported a
misprint in ref. [64] where the phantom dimensions given (40 cm height and 40 cm diameter) are
incorrect. The extension of the proximal end of the wire was modeled as 6 cm long with effective
density of = 5.6 g/cm3 in both cases. The dose analog estimator was used to calculate absorbed dose.
The dose was calculated up to 20 cm away from the source in 0.5 mm steps and for angles from 0° to
180° in 1° steps. Next, the dose was stored in Cartesian coordinates as a 400800 matrix from y = 0
to y = 20 cm and from z = –20 cm to z = +20 cm, and in polar coordinates as a 400180 matrix from
r = 0 to r = 20 cm and from = 0° to = 180°. The standard deviation (k = 1) of the absorbed dose
in cells at distances less than 5 cm from the origin ranged from 0.1% to 1.5%, increasing to 5% at 20
cm. To evaluate SK, the source was positioned in a (6 6 6) m3 dry air cube and cells to score air
kerma were defined for transverse axis distances ranging from 5 cm to 150 cm. The air kerma has been
scored at distances from the source large enough to treat the source as a mathematical point. y = z
=1 cm cell sizes were taken. The active length L = 0.15 cm was used to calculate gL(r) and F(r,) from
0.2 cm up to 20 cm. They reported a = (1.115 ± 0.003) cGyh–1U–1.
Taylor and Rogers[139] (Appendix A.1.1) studied this source with the same geometry and source
cable as in Ballester et al., obtaining = (1.119 ± 0.003) cGyh–1U–1.
Consensus Data
The average of the two published values was used for CON = (1.117 ± 0.004) cGyh–1U–1 and
is recommended (Table IV). For CONgL(r), data from Ballester et al.[64] reproduced in Table V are
recommended, because electron transport was included and Taylors and Rogers data present a step at
62 HEBD report
r = 1 cm. For CONF(r,), data from Ballester et al.[64] reproduced in Table XII are recommended,
because of the step at 1 cm in Taylor and Rogers data and the dose was reported close to the source
by Ballester et al.
(cGyh–1U–1) for TPS quality assurance purposes (Table XIII).
Table XII. F(r,) for the Buchler model G0814 source. Extrapolated data
are underlined. Values inside the source are in italics.
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 2 3 4 6 8 10
0 0.864 0.864 0.873 0.882 0.881 0.880 0.884 0.887 0.891 0.893 0.896 0.915 0.920 0.940
1 0.863 0.863 0.871 0.879 0.878 0.878 0.881 0.885 0.889 0.892 0.895 0.915 0.920 0.938
2 0.871 0.871 0.878 0.885 0.884 0.883 0.885 0.888 0.891 0.894 0.897 0.916 0.922 0.937
3 0.873 0.873 0.880 0.887 0.886 0.885 0.888 0.890 0.893 0.897 0.901 0.918 0.925 0.937
4 0.876 0.876 0.882 0.888 0.888 0.887 0.889 0.892 0.895 0.899 0.903 0.920 0.927 0.937
5 0.876 0.876 0.882 0.888 0.889 0.889 0.891 0.894 0.897 0.902 0.906 0.921 0.927 0.935
6 0.877 0.877 0.883 0.889 0.890 0.890 0.893 0.895 0.898 0.904 0.909 0.923 0.929 0.935
7 0.878 0.878 0.884 0.890 0.891 0.891 0.893 0.895 0.899 0.905 0.910 0.924 0.930 0.935
8 0.880 0.880 0.886 0.892 0.894 0.893 0.896 0.898 0.901 0.908 0.912 0.925 0.931 0.935
9 0.882 0.882 0.888 0.894 0.896 0.897 0.899 0.901 0.905 0.911 0.916 0.927 0.932 0.935
10 0.883 0.883 0.889 0.895 0.898 0.899 0.902 0.904 0.907 0.914 0.918 0.928 0.933 0.935
15 0.896 0.896 0.901 0.906 0.909 0.910 0.912 0.913 0.916 0.923 0.927 0.936 0.940 0.940
20 0.905 0.905 0.911 0.917 0.919 0.921 0.923 0.924 0.927 0.933 0.937 0.945 0.948 0.948
30 0.910 0.910 0.934 0.940 0.942 0.942 0.944 0.946 0.947 0.951 0.954 0.959 0.962 0.964
40 0.939 0.939 0.955 0.962 0.964 0.963 0.964 0.967 0.967 0.968 0.970 0.973 0.975 0.977
50 0.964 0.964 0.977 0.980 0.981 0.981 0.980 0.983 0.982 0.982 0.983 0.986 0.987 0.987
60 0.976 0.976 0.991 0.993 0.994 0.995 0.992 0.995 0.993 0.992 0.993 0.996 0.995 0.993
70 0.989 0.989 0.997 1.000 1.001 1.001 0.998 1.000 0.999 0.999 0.999 1.000 0.998 0.997
80 0.997 0.997 0.997 1.000 1.001 1.001 1.000 1.001 1.002 1.002 1.002 1.002 1.000 0.999
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 0.998 0.998 0.998 1.000 1.000 1.001 1.001 1.002 1.001 1.001 1.001 1.001 1.000 1.000
110 0.980 0.980 0.996 1.000 1.001 1.002 0.999 1.002 0.999 0.998 0.998 1.000 0.998 0.998
120 0.980 0.980 0.989 0.993 0.995 0.995 0.993 0.996 0.994 0.993 0.993 0.996 0.994 0.991
130 0.957 0.957 0.978 0.983 0.983 0.983 0.982 0.984 0.983 0.983 0.984 0.987 0.987 0.982
140 0.950 0.950 0.957 0.964 0.964 0.965 0.965 0.966 0.967 0.968 0.970 0.971 0.971 0.970
150 0.921 0.921 0.928 0.935 0.937 0.940 0.939 0.939 0.942 0.944 0.947 0.948 0.950 0.954
160 0.867 0.867 0.880 0.893 0.893 0.894 0.894 0.896 0.897 0.901 0.907 0.919 0.922 0.929
165 0.854 0.854 0.855 0.856 0.855 0.858 0.861 0.865 0.865 0.870 0.878 0.895 0.903 0.908
170 0.803 0.803 0.807 0.811 0.815 0.820 0.823 0.824 0.825 0.827 0.838 0.859 0.875 0.878
171 0.796 0.796 0.799 0.802 0.805 0.808 0.812 0.813 0.815 0.818 0.830 0.851 0.868 0.869
172 0.785 0.785 0.786 0.787 0.788 0.789 0.796 0.799 0.804 0.806 0.820 0.839 0.857 0.860
173 0.750 0.750 0.755 0.760 0.765 0.770 0.775 0.783 0.790 0.791 0.805 0.825 0.845 0.849
174 0.692 0.692 0.703 0.715 0.726 0.737 0.751 0.758 0.766 0.775 0.791 0.810 0.831 0.837
Table XII (continued).
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 2 3 4 6 8 10
175 0.696 0.696 0.701 0.705 0.710 0.715 0.721 0.727 0.738 0.754 0.773 0.792 0.814 0.824
176 0.642 0.642 0.648 0.655 0.661 0.667 0.675 0.683 0.698 0.729 0.750 0.767 0.791 0.806
177 0.509 0.509 0.520 0.532 0.543 0.554 0.568 0.582 0.610 0.666 0.696 0.732 0.763 0.784
178 0.466 0.466 0.472 0.479 0.485 0.492 0.500 0.509 0.525 0.558 0.591 0.659 0.720 0.750
179 0.414 0.414 0.419 0.424 0.429 0.434 0.440 0.446 0.458 0.483 0.507 0.556 0.605 0.655
180 0.272 0.272 0.279 0.286 0.293 0.300 0.308 0.317 0.334 0.369 0.403 0.472 0.541 0.610
Table XIII. QA away-along data [cGyh–1U–1] for the Buchler model G0814 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.0206 0.0206 0.0206 0.0205 0.0204 0.0200 0.01944 0.01791 0.01606 0.01410 0.01225 0.01056
6 0.0283 0.0283 0.0283 0.0281 0.0279 0.0271 0.0261 0.0234 0.0204 0.01739 0.01469 0.01237
5 0.0406 0.0407 0.0406 0.0403 0.0399 0.0384 0.0364 0.0315 0.0262 0.0215 0.01762 0.01440
4 0.0631 0.0633 0.0631 0.0625 0.0613 0.0579 0.0534 0.0433 0.0341 0.0267 0.0209 0.01661
3 0.1119 0.1122 0.1113 0.1087 0.1050 0.0948 0.0832 0.0611 0.0443 0.0326 0.0244 0.01877
2 0.250 0.249 0.242 0.229 0.212 0.1732 0.1373 0.0858 0.0559 0.0385 0.0277 0.0207
1.5 0.443 0.439 0.414 0.375 0.330 0.243 0.1774 0.0997 0.0616 0.0411 0.0291 0.0214
1 0.989 0.960 0.840 0.688 0.547 0.342 0.224 0.1127 0.0663 0.0431 0.0301 0.0220
0.5 4.00 3.37 2.18 1.362 0.892 0.449 0.264 0.1221 0.0694 0.0444 0.0307 0.0223
0 1.37×109 17.83 4.46 1.982 1.117 0.498 0.281 0.1253 0.0704 0.0448 0.0309 0.0224
–0.5 1.287 3.32 2.18 1.364 0.892 0.449 0.264 0.1220 0.0694 0.0444 0.0307 0.0223
–1 0.336 0.899 0.830 0.687 0.547 0.342 0.224 0.1126 0.0662 0.0431 0.0301 0.0220
–1.5 0.1582 0.398 0.399 0.370 0.329 0.244 0.1776 0.0997 0.0615 0.0411 0.0290 0.0214
–2 0.0939 0.219 0.227 0.222 0.209 0.1729 0.1374 0.0858 0.0559 0.0385 0.0277 0.0207
–3 0.0462 0.0931 0.1003 0.1017 0.1007 0.0933 0.0828 0.0611 0.0443 0.0326 0.0244 0.01876
–4 0.0284 0.0510 0.0560 0.0574 0.0577 0.0561 0.0525 0.0432 0.0341 0.0267 0.0209 0.01659
–5 0.01962 0.0314 0.0353 0.0366 0.0370 0.0369 0.0355 0.0311 0.0261 0.0215 0.01762 0.01438
–6 0.01459 0.0212 0.0241 0.0252 0.0257 0.0258 0.0253 0.0230 0.0202 0.01732 0.01465 0.01233
–7 0.01137 0.01552 0.01744 0.01824 0.01868 0.01888 0.01869 0.01751 0.01585 0.01399 0.01218 0.01050
A.1.5. GammaMed HDR 12i (Varian Medical Systems)

Source Description
The model GammaMed HDR 12i source consists of an iridium core of 3.5 mm in length and
0.7 mm in diameter, encapsulated in a stainless steel wire as shown in Figure 6, which is nearly
identical to the mHDR-v1 source. The distance from the physical tip of the source to the distal face
of the active source core is 0.86 mm.
64 HEBD report
Figure 6. Materials and dimensions (mm) of the Varian Medical

Systems GammaMed HDR 12i source.[65]
Publications
Ballester et al.[65] published the absolute dose distributions in water as 2D Cartesian look-up
tables for the source using the GEANT3 MC code.[171] The methodology is the same described in
Appendix A.1.4 for the Buchler source from the same group. Ballester et al. [private communication]
have reported a misprint in ref. [65] where the phantom dimensions given (40 cm height and 40 cm
diameter) are incorrect. They also used this absolute dose distribution data to derive TG-43
parameters for this source. They derived, using L = 3.5 mm, = (1.118 ± 0.003) cGyh–1U–1.
A second study was done by Taylor and Rogers[139] that obtained = (1.117 ± 0.003)
cGyh–1U–1.
Consensus Data
The gL(r) data from both studies are in good agreement, but the Taylor and Rogers results
present a step at 1 cm. F(r,) data from both studies are indistinguishable. An averaged CON = (1.118
± 0.004) cGyh–1U–1 is taken as the consensus value (Table IV). Due to the gL(r) data step at 1 cm in
the Taylor and Rogers data and taking into account the electron transport inclusion and angular
mesh, datasets from Ballester et al.[65] have been taken as CONgL(r) and CONF(r,) (Table V and Table
XIV).
(cGyh–1U–1) for TPS quality assurance purposes (Table XV).
Table XIV. F(r,) for the GammaMed HDR 12i source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 1.75 2 2.5 3 3.5 4 5 6 8 10
0 0.676 0.676 0.665 0.654 0.639 0.633 0.639 0.635 0.646 0.637 0.647 0.644 0.676 0.677 0.712 0.711 0.754 0.785
1 0.665 0.665 0.655 0.646 0.635 0.631 0.638 0.635 0.646 0.640 0.650 0.648 0.677 0.677 0.706 0.707 0.747 0.779
2 0.724 0.724 0.694 0.663 0.644 0.640 0.646 0.641 0.652 0.650 0.660 0.661 0.690 0.693 0.719 0.728 0.766 0.790
3 0.742 0.742 0.706 0.669 0.653 0.651 0.656 0.651 0.661 0.661 0.671 0.673 0.700 0.704 0.724 0.734 0.771 0.795
4 0.741 0.741 0.710 0.679 0.664 0.660 0.664 0.659 0.670 0.673 0.682 0.686 0.710 0.715 0.731 0.744 0.778 0.802
5 0.746 0.746 0.718 0.690 0.677 0.672 0.674 0.668 0.678 0.683 0.692 0.699 0.721 0.727 0.742 0.756 0.787 0.807
6 0.769 0.769 0.735 0.700 0.691 0.688 0.688 0.681 0.691 0.696 0.704 0.712 0.731 0.737 0.750 0.765 0.795 0.814
7 0.775 0.775 0.744 0.713 0.701 0.698 0.699 0.694 0.704 0.710 0.717 0.724 0.741 0.749 0.760 0.776 0.803 0.820
8 0.789 0.789 0.755 0.721 0.714 0.713 0.713 0.708 0.717 0.723 0.729 0.738 0.753 0.760 0.770 0.786 0.811 0.826
9 0.796 0.796 0.765 0.734 0.727 0.725 0.725 0.720 0.729 0.734 0.740 0.750 0.763 0.771 0.781 0.796 0.819 0.833
10 0.808 0.808 0.776 0.745 0.739 0.737 0.736 0.733 0.740 0.746 0.751 0.762 0.773 0.781 0.791 0.806 0.826 0.840
15 0.852 0.852 0.829 0.806 0.801 0.797 0.795 0.796 0.800 0.803 0.807 0.815 0.822 0.829 0.839 0.849 0.862 0.871
20 0.974 0.974 0.876 0.855 0.849 0.845 0.843 0.847 0.849 0.848 0.853 0.856 0.862 0.868 0.875 0.881 0.890 0.897
30 0.981 0.981 0.931 0.920 0.917 0.914 0.914 0.911 0.914 0.913 0.915 0.915 0.918 0.920 0.922 0.927 0.931 0.936
40 0.992 0.992 0.965 0.955 0.954 0.952 0.951 0.949 0.950 0.950 0.949 0.950 0.954 0.954 0.955 0.958 0.959 0.962
50 0.995 0.995 0.980 0.974 0.975 0.974 0.972 0.972 0.973 0.974 0.972 0.973 0.973 0.973 0.975 0.976 0.977 0.978
60 0.998 0.998 0.990 0.988 0.988 0.987 0.985 0.984 0.988 0.987 0.986 0.986 0.987 0.987 0.988 0.988 0.989 0.989
70 0.999 0.999 0.995 0.995 0.995 0.995 0.994 0.992 0.995 0.994 0.994 0.994 0.996 0.995 0.995 0.996 0.995 0.995
80 1.002 1.002 1.000 1.000 0.999 0.999 0.999 0.998 0.998 0.998 0.998 0.998 1.000 1.000 0.999 1.000 0.999 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 1.000 1.000 0.999 0.998 0.998 0.999 0.998 0.997 0.999 0.998 0.998 0.998 0.997 0.998 0.998 0.998 0.999 0.998
110 0.998 0.998 0.995 0.994 0.993 0.995 0.993 0.991 0.993 0.993 0.992 0.993 0.992 0.992 0.992 0.993 0.994 0.994
120 0.997 0.997 0.989 0.987 0.986 0.986 0.985 0.982 0.984 0.984 0.983 0.984 0.985 0.984 0.984 0.986 0.985 0.986
130 0.997 0.997 0.978 0.971 0.971 0.969 0.969 0.967 0.970 0.968 0.967 0.968 0.970 0.968 0.970 0.974 0.972 0.974
140 0.993 0.993 0.960 0.949 0.949 0.947 0.946 0.945 0.947 0.946 0.945 0.947 0.948 0.946 0.949 0.954 0.954 0.956
150 0.978 0.978 0.924 0.912 0.909 0.909 0.906 0.905 0.908 0.909 0.910 0.912 0.913 0.912 0.915 0.921 0.924 0.929
160 0.945 0.945 0.891 0.841 0.838 0.839 0.836 0.837 0.839 0.842 0.845 0.847 0.854 0.855 0.861 0.868 0.876 0.888
165 0.853 0.853 0.817 0.781 0.782 0.783 0.782 0.783 0.786 0.788 0.795 0.798 0.807 0.811 0.821 0.831 0.845 0.859
170 0.828 0.828 0.765 0.702 0.713 0.703 0.707 0.704 0.713 0.715 0.724 0.730 0.740 0.748 0.762 0.779 0.801 0.817
171 0.775 0.775 0.738 0.701 0.689 0.690 0.687 0.684 0.694 0.696 0.705 0.712 0.723 0.731 0.748 0.766 0.790 0.807
172 0.772 0.772 0.724 0.676 0.676 0.678 0.669 0.664 0.674 0.677 0.684 0.691 0.705 0.713 0.732 0.751 0.777 0.795
173 0.657 0.657 0.654 0.651 0.648 0.657 0.627 0.642 0.652 0.655 0.661 0.669 0.685 0.694 0.715 0.734 0.762 0.783
174 0.635 0.635 0.630 0.625 0.620 0.618 0.601 0.620 0.628 0.633 0.636 0.645 0.663 0.673 0.695 0.715 0.745 0.769
175 0.671 0.671 0.647 0.623 0.599 0.575 0.581 0.601 0.600 0.607 0.609 0.618 0.638 0.647 0.672 0.690 0.723 0.752
176 0.616 0.616 0.602 0.588 0.574 0.560 0.544 0.569 0.588 0.556 0.576 0.588 0.610 0.619 0.648 0.665 0.700 0.733
177 0.242 0.242 0.281 0.319 0.358 0.396 0.444 0.492 0.553 0.500 0.527 0.540 0.566 0.577 0.614 0.634 0.671 0.711
178 0.959 0.959 0.900 0.842 0.783 0.725 0.652 0.579 0.506 0.433 0.448 0.479 0.550 0.540 0.583 0.588 0.635 0.682
179 0.495 0.495 0.496 0.496 0.497 0.498 0.499 0.500 0.501 0.502 0.504 0.506 0.508 0.510 0.522 0.572 0.584 0.642
180 0.315 0.315 0.321 0.327 0.333 0.339 0.347 0.355 0.362 0.370 0.385 0.400 0.415 0.430 0.460 0.491 0.551 0.612
66 HEBD report
Table XV. QA away-along data [cGyh–1U–1] for the GammaMed HDR 12i source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01654 0.01686 0.01712 0.01744 0.01769 0.01797 0.01795 0.01707 0.01563 0.01386 0.01212 0.01048
6 0.0221 0.0227 0.0233 0.0238 0.0242 0.0246 0.0243 0.0225 0.0200 0.01721 0.01458 0.01231
5 0.0322 0.0326 0.0334 0.0343 0.0349 0.0353 0.0344 0.0306 0.0259 0.0214 0.01754 0.01436
4 0.0481 0.0503 0.0525 0.0540 0.0548 0.0542 0.0512 0.0426 0.0339 0.0266 0.0209 0.01660
3 0.0817 0.0877 0.0933 0.0961 0.0964 0.0909 0.0815 0.0607 0.0442 0.0325 0.0244 0.01880
2 0.1822 0.200 0.213 0.214 0.204 0.1712 0.1368 0.0858 0.0560 0.0385 0.0278 0.0207
1.5 0.324 0.361 0.381 0.362 0.325 0.243 0.1778 0.0999 0.0617 0.0412 0.0291 0.0215
1 0.737 0.857 0.819 0.687 0.547 0.343 0.225 0.1131 0.0665 0.0433 0.0302 0.0221
0.5 3.37 3.48 2.21 1.367 0.892 0.450 0.266 0.1226 0.0697 0.0446 0.0309 0.0224
0 3.89×108 15.63 4.32 1.965 1.118 0.502 0.283 0.1262 0.0709 0.0451 0.0311 0.0226
–0.5 1.659 3.45 2.20 1.364 0.892 0.449 0.266 0.1226 0.0696 0.0446 0.0308 0.0224
–1 0.395 0.837 0.813 0.682 0.544 0.342 0.224 0.1129 0.0664 0.0432 0.0301 0.0221
–1.5 0.1811 0.345 0.376 0.359 0.324 0.242 0.1770 0.0997 0.0615 0.0411 0.0291 0.0215
–2 0.1057 0.1852 0.208 0.212 0.202 0.1704 0.1363 0.0856 0.0558 0.0384 0.0277 0.0207
–3 0.0507 0.0770 0.0890 0.0938 0.0951 0.0903 0.0810 0.0603 0.0440 0.0324 0.0244 0.01875
–4 0.0306 0.0426 0.0488 0.0519 0.0534 0.0535 0.0507 0.0424 0.0338 0.0265 0.0208 0.01654
–5 0.0208 0.0275 0.0308 0.0327 0.0338 0.0346 0.0339 0.0304 0.0258 0.0213 0.01746 0.01430
–6 0.01526 0.01881 0.0211 0.0225 0.0234 0.0240 0.0239 0.0223 0.01982 0.01712 0.01450 0.01225
–7 0.01176 0.01383 0.01539 0.01634 0.01695 0.01749 0.01761 0.01685 0.01550 0.01377 0.01205 0.01042
A.1.6. GammaMed HDR Plus (Varian Medical Systems)
Source Description
The model GammaMed HDR Plus source, shown in Figure 7, is almost identical to the HDR
model 12i. With an active core of 3.5 mm in length and 0.7 mm in diameter, the physical source is
4.52 mm in length and 0.9 mm in diameter. The distance from the physical tip of the source to the
distal face of the active source core is 0.62 mm, which is smaller than the model HDR 12i.
Publications
In the same publication with the Model 12i data (Appendix A.1.5), Ballester et al.[65] published
the absolute dose distributions in water as 2D Cartesian look-up tables for the Model Plus. They also
used this absolute dose distribution data to derive TG-43 parameters for this source. Using L = 3.5
mm, they reported = (1.118 ± 0.003) cGyh–1U–1.
A second study by Taylor and Rogers[139] (Appendex A.1.1) derived = (1.115 ± 0.003)
cGyh–1U–1.
Figure 7. Materials and dimensions (mm) of the Varian Medical

Systems GammaMed HDR Plus source.[65]
Consensus Data
Both studies provide similar TG-43 parameters, but the gL(r) data from Taylor and Rogers are
noisy. F(r,) data from both studies are indistinguishable. Averaged CON = (1.117 ± 0.004)
cGyh–1U–1 is taken as consensus value (Table IV). Due to the gL(r) data fluctuations in Taylor and
Rogers, the data from Ballester et al., have been taken as CONgL(r) and CONF(r,) for Table V and
Table XVI. In Ballester et al., dose was scored instead kerma giving more accuracy in values close to
the source and it presented higher angular resolution close to the source longitudinal axis.
(cGyh–1U–1) for TPS quality assurance purposes (Table XVII).
Table XVI. F(r,) for the GammaMed HDR Plus source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 1.75 2 2.5 3 3.5 4 5 6 8 10
0 0.695 0.695 0.666 0.636 0.630 0.608 0.615 0.634 0.625 0.629 0.648 0.654 0.660 0.683 0.702 0.716 0.758 0.789
1 0.711 0.711 0.677 0.643 0.632 0.609 0.614 0.632 0.626 0.633 0.656 0.667 0.676 0.698 0.716 0.727 0.762 0.786
2 0.715 0.715 0.684 0.653 0.640 0.620 0.624 0.638 0.634 0.641 0.661 0.671 0.679 0.697 0.717 0.730 0.764 0.794
3 0.708 0.708 0.684 0.660 0.650 0.634 0.637 0.647 0.646 0.653 0.671 0.682 0.691 0.705 0.726 0.739 0.771 0.798
4 0.736 0.736 0.701 0.666 0.654 0.645 0.652 0.662 0.663 0.668 0.680 0.690 0.697 0.711 0.736 0.750 0.779 0.805
5 0.728 0.728 0.706 0.684 0.673 0.664 0.668 0.674 0.676 0.682 0.693 0.704 0.712 0.724 0.748 0.762 0.788 0.811
6 0.722 0.722 0.709 0.696 0.688 0.681 0.683 0.686 0.691 0.697 0.707 0.718 0.725 0.734 0.757 0.770 0.795 0.817
7 0.736 0.736 0.720 0.705 0.697 0.692 0.697 0.700 0.707 0.712 0.719 0.729 0.736 0.745 0.769 0.780 0.802 0.823
8 0.732 0.732 0.726 0.720 0.715 0.712 0.713 0.713 0.719 0.724 0.731 0.743 0.751 0.758 0.779 0.789 0.810 0.830
9 0.744 0.744 0.738 0.733 0.729 0.726 0.728 0.727 0.734 0.738 0.743 0.754 0.762 0.769 0.790 0.799 0.818 0.837
10 0.762 0.762 0.753 0.743 0.738 0.738 0.741 0.740 0.748 0.752 0.755 0.765 0.772 0.778 0.799 0.808 0.826 0.844
68 HEBD report
Table XVI (continued).
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 1.75 2 2.5 3 3.5 4 5 6 8 10
15 0.837 0.837 0.820 0.803 0.801 0.802 0.804 0.802 0.809 0.811 0.813 0.821 0.828 0.829 0.844 0.848 0.863 0.873
20 0.962 0.962 0.866 0.855 0.854 0.852 0.853 0.852 0.858 0.858 0.862 0.865 0.870 0.869 0.878 0.880 0.893 0.900
30 0.968 0.968 0.923 0.917 0.916 0.912 0.913 0.912 0.918 0.918 0.918 0.921 0.923 0.923 0.927 0.930 0.933 0.939
40 0.979 0.979 0.956 0.951 0.952 0.948 0.949 0.946 0.950 0.951 0.950 0.953 0.955 0.954 0.958 0.958 0.959 0.963
50 0.987 0.987 0.977 0.973 0.973 0.971 0.972 0.971 0.972 0.973 0.973 0.974 0.975 0.974 0.977 0.976 0.978 0.978
60 0.993 0.993 0.987 0.984 0.985 0.985 0.987 0.985 0.987 0.988 0.989 0.989 0.988 0.988 0.989 0.988 0.988 0.988
70 0.994 0.994 0.995 0.994 0.994 0.995 0.996 0.993 0.996 0.996 0.996 0.996 0.996 0.996 0.996 0.995 0.995 0.996
80 0.998 0.998 0.999 0.999 0.998 0.999 1.000 0.998 1.000 1.000 1.000 1.000 1.000 1.000 0.999 0.999 0.999 0.999
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 1.000 1.000 0.999 0.999 0.999 0.999 0.998 0.998 0.998 0.998 0.999 0.999 0.999 0.999 1.000 0.999 1.000 0.999
110 0.998 0.998 0.996 0.994 0.995 0.995 0.995 0.993 0.995 0.994 0.995 0.995 0.995 0.995 0.995 0.994 0.995 0.995
120 0.998 0.998 0.990 0.985 0.984 0.985 0.986 0.984 0.987 0.987 0.987 0.987 0.988 0.989 0.988 0.987 0.989 0.989
130 0.994 0.994 0.976 0.973 0.971 0.972 0.972 0.970 0.972 0.973 0.974 0.974 0.974 0.975 0.976 0.977 0.977 0.979
140 0.991 0.991 0.958 0.950 0.947 0.948 0.947 0.947 0.949 0.950 0.952 0.953 0.954 0.953 0.956 0.958 0.959 0.962
150 0.973 0.973 0.923 0.914 0.914 0.914 0.914 0.912 0.915 0.916 0.917 0.919 0.921 0.920 0.925 0.927 0.931 0.935
160 0.966 0.966 0.873 0.851 0.850 0.847 0.850 0.848 0.853 0.856 0.857 0.863 0.867 0.870 0.876 0.878 0.889 0.895
165 0.828 0.828 0.814 0.801 0.798 0.796 0.798 0.801 0.802 0.806 0.809 0.818 0.822 0.829 0.838 0.843 0.860 0.870
170 0.789 0.789 0.756 0.723 0.720 0.725 0.725 0.729 0.730 0.734 0.743 0.754 0.761 0.771 0.784 0.795 0.819 0.831
171 0.730 0.730 0.715 0.700 0.699 0.706 0.706 0.710 0.712 0.716 0.725 0.735 0.744 0.755 0.768 0.782 0.809 0.822
172 0.722 0.722 0.699 0.676 0.679 0.686 0.686 0.689 0.692 0.696 0.705 0.716 0.725 0.738 0.752 0.768 0.798 0.811
173 0.627 0.627 0.635 0.642 0.649 0.664 0.663 0.666 0.671 0.675 0.684 0.695 0.705 0.719 0.735 0.752 0.785 0.799
174 0.574 0.574 0.596 0.618 0.640 0.643 0.641 0.643 0.650 0.653 0.662 0.672 0.684 0.698 0.715 0.733 0.769 0.784
175 0.627 0.627 0.623 0.619 0.615 0.611 0.615 0.616 0.625 0.627 0.636 0.646 0.659 0.674 0.692 0.713 0.752 0.769
176 0.710 0.710 0.674 0.638 0.602 0.566 0.568 0.585 0.597 0.598 0.608 0.618 0.632 0.645 0.666 0.688 0.731 0.750
177 0.687 0.687 0.658 0.630 0.601 0.572 0.536 0.500 0.565 0.564 0.575 0.584 0.600 0.610 0.634 0.659 0.706 0.729
178 0.450 0.450 0.459 0.467 0.476 0.485 0.496 0.507 0.518 0.529 0.521 0.533 0.553 0.560 0.591 0.620 0.672 0.702
179 0.329 0.329 0.340 0.350 0.361 0.371 0.384 0.397 0.410 0.423 0.449 0.475 0.501 0.527 0.548 0.572 0.621 0.659
180 0.417 0.417 0.421 0.426 0.430 0.434 0.440 0.445 0.451 0.456 0.467 0.478 0.489 0.501 0.523 0.545 0.589 0.633
Table XVII. QA away-along data [cGyh–1U–1] for the GammaMed HDR Plus source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01664 0.01685 0.01719 0.01749 0.01771 0.01798 0.01795 0.01711 0.0156 0.01386 0.01211 0.01047
6 0.0223 0.0228 0.0235 0.0239 0.0243 0.0246 0.0243 0.0226 0.0200 0.01720 0.01458 0.01229
5 0.0317 0.0326 0.0337 0.0347 0.0352 0.0354 0.0344 0.0307 0.0259 0.0214 0.01755 0.01435
4 0.0484 0.0501 0.0521 0.0538 0.0548 0.0543 0.0513 0.0428 0.0339 0.0266 0.0209 0.01659
3 0.0827 0.0880 0.0935 0.0965 0.0970 0.0913 0.0816 0.0607 0.0442 0.0325 0.0244 0.01878
2 0.1798 0.201 0.215 0.216 0.205 0.1711 0.1367 0.0857 0.0560 0.0385 0.0277 0.0207
1.5 0.323 0.364 0.384 0.364 0.326 0.243 0.1776 0.0998 0.0617 0.0412 0.0291 0.0215
1 0.707 0.861 0.820 0.685 0.545 0.343 0.225 0.1130 0.0664 0.0432 0.0302 0.0221
0.5 3.34 3.47 2.21 1.363 0.892 0.449 0.266 0.1225 0.0696 0.0446 0.0309 0.0224
0 4.02×108 15.70 4.32 1.966 1.117 0.501 0.283 0.1259 0.0707 0.0451 0.0311 0.0226
–0.5 2.17 3.46 2.20 1.362 0.891 0.449 0.265 0.1224 0.0696 0.0446 0.0308 0.0224
–1 0.505 0.853 0.820 0.684 0.545 0.343 0.224 0.1128 0.0664 0.0433 0.0302 0.0221
–1.5 0.227 0.356 0.382 0.363 0.326 0.243 0.1776 0.0997 0.0616 0.0411 0.0291 0.0215
–2 0.1304 0.1907 0.213 0.215 0.204 0.1713 0.1368 0.0857 0.0560 0.0385 0.0277 0.0207
–3 0.0605 0.0804 0.0916 0.0959 0.0967 0.0910 0.0814 0.0607 0.0442 0.0325 0.0244 0.01877
–4 0.0355 0.0445 0.0504 0.0533 0.0546 0.0542 0.0512 0.0427 0.0339 0.0266 0.0209 0.01659
–5 0.0236 0.0283 0.0317 0.0336 0.0346 0.0352 0.0343 0.0307 0.0259 0.0214 0.01754 0.01435
–6 0.01695 0.01974 0.0219 0.0231 0.0239 0.0244 0.0242 0.0225 0.0199 0.01720 0.01457 0.01229
–7 0.01279 0.01461 0.01599 0.01681 0.01737 0.01782 0.01788 0.01705 0.0156 0.01384 0.01210 0.01046
A.1.7. GI192M11 (E&Z BEBIG)
Source Description
This source is composed of a cylindrical 192Ir active core with 3.5 mm active length and an
active diameter of 0.6 mm covered by a 316L stainless steel capsule. A schematic view of this source
is shown in Figure 8.

HDR model GI192M11 source.[71]
70 HEBD report
Publications
The MC code GEANT4 (version 6.1) was used by Granero et al.[71] to estimate dose rate in
water and air-kerma strength around the source. The code was benchmarked for HDR 192Ir sources by
comparison of the dose rate distributions obtained with published data of Williamson et al.[47] and
Daskalov et al.[93,169] for the mHDR-v1 and mHDR-v2, respectively. In the calculations, Compton
scattering, photoelectric effect and Rayleigh scattering processes were used from the low-energy
package of GEANT4. This low energy package uses the EPDL97 cross sections tabulation.[173] The
192
Ir photon spectrum was taken from the NuDat database neglecting the -spectrum.[20] A cutoff energy
of 10 keV for photons was used. Only collision kerma was scored using the linear track-length kerma
estimator to estimate dose. The source was located in the center of a spherical 40 cm radius water
phantom. The density of the water used in the simulation was 0.998 g/cm3 at 22 °C, as is
recommended in the TG-43U1 report. Two different grid systems were used in order to obtain the
dose rate in the form of away-along tables and in the form given by the TG-43 formalism. The first
one was composed of 400800 0.05 cm thick and 0.05 cm high cylindrical rings concentric to the
longitudinal source axis, and has been used to obtain the dose rate in Cartesian coordinates. To
obtain the dose rate in polar coordinates following the TG-43 formalism, a grid system composed of
0.05 cm thick, concentric spherical sections and an angular width of 1° in the polar angle was used.
The source was along the z-axis with positive z towards the source tip. The origin of the coordinates
was located at the geometric center of the active core. The origin of the polar angle is at the tip side
of the source. Standard deviations of the mean (k = 1) dose rate values of less than 0.5% were
obtained, except along the longitudinal axis where 1% is reached. To estimate the air-kerma strength,
the source was located in a (4 4 4) m3 air volume. The composition and density used for the air in
the simulation are the ones recommended in Table XIV of the TG-43U1 report[2] for air with relative
humidity of 40%. Cylindrical cells 1 cm thick and 1 cm high located in the plane z = 0 were used to
score air-kerma along the transverse axis of the source from y = 5 cm to y = 150 cm. Air-kerma
strength values were found to be well described by a linear equation kair ( y ) y 2 = SK + by where the
slope b describes the deviation in k ( y ) y 2 due to a buildup of scattered photons in air. The air-kerma
air
strength was derived with a statistical uncertainty (k = 1) in air-kerma values of less than 0.5%. They
derived = (1.108 ± 0.003) cGyh–1U–1.
Taylor and Rogers[139] (Appendix A.1.1) studied this source with the same geometry and source
cable as in Granero et al.[71] obtaining = (1.112 ± 0.003) cGyh–1U–1.
Consensus Data
Both studies provide similar TG-43 parameters. The values are only 0.36% different from
each other and the F(r,) data are indistinguishable. The gL(r) data are also similar but the Taylor and
Rogers results are noisy. The average of values from both studies is taken as the consensus value
CON = (1.110 ± 0.004) cGyh–1U–1 (Table IV). Due to the gL(r) data fluctuations in Taylor and
Rogers, the data from Granero et al. have been taken as CONgL(r), while the data from Taylor and
Rogers is selected for CONF(r,) for Table V and Table XVIII.
(cGyh–1U–1) for TPS quality assurance purposes (Table XIX).
Table XVIII. F(r,) for the E&Z BEBIG model GI192M11 source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
0 0.668 0.668 0.651 0.615 0.621 0.644 0.667 0.689 0.734 0.769
1 0.671 0.671 0.650 0.609 0.625 0.648 0.673 0.695 0.740 0.773
2 0.668 0.668 0.649 0.611 0.634 0.659 0.682 0.705 0.749 0.780
3 0.660 0.660 0.649 0.625 0.647 0.673 0.694 0.715 0.758 0.788
5 0.668 0.668 0.662 0.648 0.671 0.693 0.713 0.731 0.770 0.796
7 0.691 0.691 0.686 0.677 0.696 0.718 0.736 0.754 0.788 0.813
10 0.727 0.727 0.724 0.717 0.736 0.756 0.771 0.787 0.816 0.836
12 0.755 0.755 0.752 0.747 0.763 0.779 0.792 0.804 0.830 0.850
15 0.796 0.796 0.792 0.785 0.797 0.810 0.821 0.832 0.853 0.868
20 0.849 0.849 0.846 0.839 0.845 0.857 0.865 0.873 0.887 0.897
25 0.891 0.891 0.885 0.873 0.882 0.889 0.895 0.898 0.909 0.916
30 0.914 0.914 0.909 0.899 0.908 0.913 0.917 0.918 0.930 0.932
35 0.937 0.937 0.933 0.924 0.930 0.934 0.938 0.940 0.947 0.951
40 0.956 0.956 0.951 0.940 0.946 0.949 0.951 0.953 0.958 0.957
45 0.965 0.965 0.962 0.955 0.959 0.963 0.965 0.966 0.968 0.970
50 0.974 0.974 0.972 0.967 0.970 0.973 0.974 0.977 0.978 0.978
55 0.986 0.986 0.980 0.972 0.977 0.980 0.979 0.980 0.984 0.985
60 0.990 0.990 0.985 0.978 0.985 0.988 0.989 0.988 0.989 0.988
65 0.993 0.993 0.990 0.986 0.990 0.992 0.993 0.992 0.996 0.994
70 0.996 0.996 0.995 0.992 0.993 0.997 0.996 0.995 0.997 0.996
75 0.998 0.998 0.997 0.996 0.996 0.997 0.998 0.998 1.000 0.998
80 1.000 1.000 1.001 0.995 0.999 1.000 0.998 0.999 1.001 1.001
85 1.000 1.000 1.002 0.996 0.999 0.999 1.002 1.001 1.002 1.002
90 1 1 1 1 1 1 1 1 1 1
95 1.000 1.000 1.001 0.995 0.999 1.002 1.002 1.001 1.002 1.002
100 0.999 0.999 0.999 0.997 0.998 1.000 1.002 1.001 1.000 1.002
105 0.999 0.999 0.998 0.996 0.996 0.998 0.999 0.999 1.001 1.000
110 0.996 0.996 0.995 0.991 0.994 0.994 0.993 0.994 0.995 0.993
115 0.994 0.994 0.992 0.988 0.988 0.991 0.994 0.993 0.993 0.992
120 0.990 0.990 0.989 0.983 0.985 0.985 0.987 0.987 0.989 0.988
125 0.986 0.986 0.982 0.977 0.979 0.981 0.981 0.982 0.985 0.986
130 0.972 0.972 0.971 0.968 0.971 0.974 0.974 0.976 0.978 0.978
135 0.966 0.966 0.963 0.957 0.960 0.965 0.965 0.966 0.967 0.970
140 0.955 0.955 0.950 0.942 0.948 0.951 0.954 0.956 0.959 0.961
145 0.938 0.938 0.934 0.928 0.931 0.936 0.938 0.940 0.946 0.949
150 0.919 0.919 0.914 0.905 0.910 0.916 0.919 0.922 0.931 0.936
155 0.891 0.891 0.886 0.877 0.882 0.889 0.894 0.898 0.908 0.914
160 0.833 0.833 0.835 0.838 0.846 0.854 0.862 0.870 0.883 0.893
165 0.774 0.774 0.777 0.783 0.794 0.807 0.818 0.827 0.848 0.863
72 HEBD report
Table XVIII (continued).
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10

168 0.725 0.725 0.729 0.737 0.752 0.769 0.783 0.797 0.821 0.842
170 0.685 0.685 0.690 0.699 0.719 0.738 0.754 0.769 0.800 0.822
173 0.614 0.614 0.620 0.632 0.655 0.679 0.700 0.719 0.760 0.788
175 0.554 0.554 0.560 0.573 0.600 0.626 0.652 0.674 0.723 0.759
177 0.458 0.458 0.466 0.482 0.513 0.544 0.575 0.606 0.668 0.713
178 0.461 0.461 0.467 0.478 0.500 0.521 0.543 0.565 0.620 0.675
179 0.330 0.330 0.338 0.352 0.381 0.410 0.439 0.468 0.540 0.612
180 0.243 0.243 0.252 0.268 0.300 0.332 0.365 0.397 0.478 0.559
Table XIX. QA away-along data [cGyh–1U–1] for the E&Z BEBIG model GI192M11 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01628 0.01661 0.01692 0.01718 0.01745 0.01773 0.01774 0.01697 0.01551 0.01379 0.01199 0.01040
6 0.0219 0.0224 0.0229 0.0234 0.0239 0.0242 0.0241 0.0224 0.01988 0.01708 0.01449 0.01222
5 0.0309 0.0319 0.0328 0.0338 0.0345 0.0348 0.0341 0.0303 0.0257 0.0213 0.01746 0.01428
4 0.0470 0.0491 0.0512 0.0530 0.0539 0.0537 0.0507 0.0424 0.0337 0.0264 0.0208 0.01651
3 0.0809 0.0863 0.0916 0.0947 0.0953 0.0901 0.0807 0.0603 0.0438 0.0323 0.0243 0.01874
2 0.1761 0.1947 0.210 0.211 0.202 0.1694 0.1357 0.0851 0.0556 0.0383 0.0276 0.0207
1.5 0.313 0.354 0.376 0.357 0.321 0.241 0.1760 0.0992 0.0613 0.0409 0.0290 0.0214
1 0.711 0.838 0.806 0.676 0.540 0.339 0.223 0.1122 0.0660 0.0430 0.0300 0.0220
0.5 3.31 3.43 2.19 1.348 0.882 0.446 0.263 0.1217 0.0692 0.0444 0.0307 0.0224
8
0 3.82×10 15.50 4.30 1.955 1.110 0.497 0.281 0.1251 0.0703 0.0448 0.0309 0.0225
–0.5 1.281 3.44 2.19 1.354 0.884 0.446 0.263 0.1218 0.0693 0.0444 0.0307 0.0224
–1 0.310 0.833 0.810 0.678 0.541 0.339 0.222 0.1121 0.0661 0.0431 0.0300 0.0220
–1.5 0.1438 0.343 0.375 0.358 0.322 0.241 0.1762 0.0991 0.0611 0.0409 0.0290 0.0214
–2 0.0851 0.1837 0.208 0.211 0.202 0.1697 0.1359 0.0851 0.0557 0.0383 0.0276 0.0207
–3 0.0418 0.0769 0.0890 0.0941 0.0950 0.0902 0.0808 0.0603 0.0439 0.0323 0.0243 0.01869
–4 0.0257 0.0419 0.0488 0.0520 0.0535 0.0535 0.0508 0.0424 0.0337 0.0264 0.0208 0.01650
–5 0.01782 0.0269 0.0307 0.0327 0.0340 0.0346 0.0340 0.0304 0.0258 0.0213 0.01746 0.01429
–6 0.01328 0.01864 0.0211 0.0224 0.0233 0.0240 0.0240 0.0224 0.01986 0.01711 0.01448 0.01222
–7 0.01038 0.01372 0.01537 0.01633 0.01690 0.01755 0.01765 0.01694 0.01553 0.01377 0.01203 0.01039
A.1.8. Ir2.A85-2 (E&Z BEBIG)
Source Description
This HDR source is shown in Figure 9 together with the coordinate axes used to give the dose
rate tables and the TG-43 parameters for the sources. The HDR source is composed of a cylindrical
pure iridium core (density 22.42 g/cm3) with 3.5 mm active length and with a diameter of 0.6 mm.
The source is covered by a capsule made of 316L stainless steel. This design is very similar to the
old E&Z BEBIG HDR source model GI192M11 with the main difference being that the external
diameter of the outer capsule is 0.9 mm in this new source and 1 mm in the old one.

HDR model Ir2.A85-2 source.[174]
Publications
There is only one study of this source by Granero et al.[174] that accomplishes the prerequisites
of Li et al.[17] This study used the GEANT4 code following the methodology outlined in Appendix
A.1.7 for the GI192M11 source model and is validated for this very similar source.
Consensus Data
Consensus data have been taken from the only publication available (Tables IV, V, and XX).
Derived from the consensus TG-43 dataset, an away-along dose rate table is presented (cGyh–1U–1)
for TPS quality assurance purposes (Table XXI).
74 HEBD report
Table XX. F(r,) for the E&Z BEBIG model Ir2.A85-2 source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.666 0.666 0.634 0.602 0.592 0.590 0.596 0.617 0.642 0.664 0.683 0.701 0.720 0.753
1 0.667 0.667 0.637 0.607 0.597 0.599 0.608 0.632 0.656 0.678 0.697 0.714 0.732 0.761
2 0.667 0.667 0.641 0.615 0.609 0.616 0.629 0.654 0.678 0.699 0.716 0.733 0.749 0.775
3 0.665 0.665 0.644 0.623 0.623 0.631 0.643 0.666 0.689 0.710 0.726 0.743 0.758 0.784
4 0.665 0.665 0.650 0.635 0.635 0.644 0.655 0.679 0.699 0.720 0.736 0.753 0.766 0.791
5 0.668 0.668 0.658 0.648 0.648 0.658 0.669 0.691 0.712 0.731 0.747 0.763 0.776 0.798
6 0.679 0.679 0.670 0.661 0.663 0.673 0.683 0.705 0.724 0.742 0.757 0.772 0.785 0.805
8 0.705 0.705 0.698 0.691 0.692 0.702 0.712 0.731 0.748 0.764 0.778 0.790 0.801 0.820
10 0.732 0.732 0.728 0.724 0.725 0.733 0.742 0.759 0.774 0.787 0.800 0.810 0.819 0.836
15 0.806 0.806 0.800 0.794 0.795 0.800 0.805 0.816 0.826 0.836 0.845 0.851 0.859 0.870
20 0.860 0.860 0.853 0.846 0.845 0.848 0.852 0.860 0.867 0.874 0.879 0.885 0.890 0.898
25 0.895 0.895 0.890 0.885 0.884 0.886 0.888 0.893 0.898 0.903 0.907 0.910 0.914 0.920
30 0.921 0.921 0.917 0.913 0.912 0.912 0.915 0.918 0.922 0.925 0.928 0.930 0.933 0.936
40 0.956 0.956 0.953 0.950 0.949 0.950 0.950 0.953 0.954 0.956 0.957 0.958 0.960 0.961
50 0.976 0.976 0.974 0.972 0.972 0.972 0.973 0.974 0.974 0.975 0.976 0.976 0.977 0.978
60 0.990 0.990 0.986 0.986 0.985 0.985 0.986 0.986 0.987 0.987 0.988 0.987 0.988 0.988
70 0.996 0.996 0.994 0.994 0.993 0.994 0.994 0.994 0.995 0.995 0.995 0.995 0.996 0.995
80 0.999 0.999 0.999 0.998 0.998 0.998 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 1.000 1.000 0.999 0.999 0.998 0.998 0.998 0.998 0.999 0.999 0.999 0.998 0.999 0.999
110 0.996 0.996 0.994 0.994 0.994 0.994 0.994 0.995 0.995 0.995 0.995 0.995 0.995 0.995
120 0.991 0.991 0.986 0.986 0.986 0.986 0.986 0.986 0.987 0.987 0.988 0.988 0.988 0.989
130 0.974 0.974 0.973 0.972 0.971 0.972 0.972 0.973 0.974 0.975 0.975 0.976 0.976 0.977
140 0.955 0.955 0.952 0.949 0.948 0.949 0.950 0.952 0.954 0.955 0.957 0.958 0.959 0.961
150 0.922 0.922 0.917 0.912 0.911 0.912 0.914 0.917 0.921 0.925 0.928 0.930 0.933 0.936
155 0.887 0.887 0.886 0.885 0.884 0.885 0.888 0.893 0.898 0.903 0.907 0.911 0.914 0.920
160 0.849 0.849 0.848 0.847 0.846 0.849 0.853 0.861 0.868 0.874 0.881 0.885 0.891 0.898
165 0.791 0.791 0.793 0.795 0.797 0.801 0.807 0.818 0.828 0.837 0.846 0.853 0.860 0.871
170 0.718 0.718 0.721 0.725 0.728 0.735 0.744 0.760 0.775 0.788 0.800 0.810 0.820 0.836
172 0.686 0.686 0.690 0.694 0.698 0.706 0.716 0.735 0.751 0.766 0.780 0.791 0.803 0.821
174 0.651 0.651 0.655 0.660 0.664 0.673 0.684 0.706 0.726 0.744 0.759 0.772 0.785 0.806
175 0.634 0.634 0.638 0.643 0.647 0.656 0.668 0.691 0.711 0.730 0.747 0.762 0.775 0.798
176 0.618 0.618 0.622 0.627 0.631 0.640 0.652 0.676 0.697 0.717 0.735 0.751 0.765 0.790
177 0.599 0.599 0.604 0.610 0.615 0.626 0.638 0.662 0.685 0.706 0.725 0.742 0.756 0.782
178 0.591 0.591 0.595 0.599 0.602 0.609 0.622 0.647 0.670 0.693 0.713 0.730 0.746 0.771
179 0.589 0.589 0.589 0.590 0.590 0.591 0.602 0.626 0.649 0.676 0.696 0.713 0.728 0.759
180 0.590 0.590 0.588 0.587 0.585 0.582 0.592 0.613 0.636 0.666 0.686 0.704 0.718 0.755
Table XXI. QA away-along data [cGyh–1U–1] for the E&Z BEBIG model Ir2.A85-2 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01573 0.01644 0.01683 0.01715 0.01740 0.01774 0.01776 0.01699 0.01554 0.01376 0.01201 0.01038
6 0.0211 0.0222 0.0228 0.0234 0.0239 0.0243 0.0241 0.0224 0.01984 0.01710 0.01447 0.01220
5 0.0298 0.0317 0.0328 0.0338 0.0345 0.0349 0.0341 0.0304 0.0257 0.0212 0.01741 0.01424
4 0.0452 0.0487 0.0511 0.0531 0.0541 0.0537 0.0509 0.0424 0.0336 0.0264 0.0207 0.01647
3 0.0774 0.0858 0.0918 0.0952 0.0956 0.0904 0.0808 0.0602 0.0438 0.0323 0.0242 0.01866
2 0.1689 0.1951 0.211 0.212 0.203 0.1698 0.1357 0.0850 0.0555 0.0382 0.0275 0.0206
1.5 0.298 0.357 0.378 0.360 0.322 0.241 0.1761 0.0989 0.0611 0.0408 0.0289 0.0214
1 0.684 0.847 0.815 0.680 0.542 0.339 0.222 0.1119 0.0659 0.0429 0.0299 0.0219
0.5 3.22 3.45 2.19 1.354 0.884 0.446 0.263 0.1215 0.0690 0.0443 0.0306 0.0223
8
0 3.80×10 15.48 4.29 1.953 1.109 0.497 0.280 0.1250 0.0702 0.0447 0.0308 0.0224
–0.5 2.99 3.44 2.19 1.354 0.885 0.446 0.263 0.1214 0.0690 0.0443 0.0306 0.0223
–1 0.676 0.849 0.815 0.679 0.542 0.339 0.222 0.1120 0.0659 0.0429 0.0299 0.0219
–1.5 0.294 0.358 0.379 0.360 0.322 0.241 0.1760 0.0989 0.0611 0.0408 0.0289 0.0213
–2 0.1677 0.1959 0.212 0.213 0.203 0.1697 0.1356 0.0849 0.0555 0.0382 0.0275 0.0206
–3 0.0769 0.0857 0.0920 0.0954 0.0958 0.0904 0.0807 0.0602 0.0438 0.0323 0.0243 0.01866
–4 0.0447 0.0485 0.0513 0.0532 0.0542 0.0538 0.0509 0.0424 0.0336 0.0264 0.0207 0.01647
–5 0.0298 0.0315 0.0328 0.0338 0.0345 0.0349 0.0341 0.0304 0.0257 0.0212 0.01740 0.01424
–6 0.0212 0.0221 0.0228 0.0234 0.0239 0.0243 0.0241 0.0224 0.01983 0.01708 0.01446 0.01219
–7 0.01580 0.01637 0.01679 0.01715 0.01742 0.01776 0.01779 0.01700 0.01554 0.01375 0.01201 0.01038
A.1.9. M-19 (Source Production and Equipment)
Source Description
The M-19 source was produced by the Source Production and Equipment Co., Inc. (Rose, LA)
for use with the AccuSource HDR remote afterloader. The active core of this source is 3.5 mm in
length with 0.65 mm diameter, while the physical source is 5.1 mm in length with an outer diameter
of 1.17 mm, as shown in Figure 10. The distance from the physical tip of the source to the distal face
is 0.65 mm.
Figure 10. Materials and dimensions (mm) of the Source

Production and Equipment M-19 source.[5]
76 HEBD report
Publications
Version 5.1.4 of the MCNP5 Monte Carlo computer code was used by Medich et al.[5] to study
this source.192Ir photons were generated uniformly inside the iridium core with photon and secondary
electron transport replicated, using default MCPLIB04 photo atomic cross-section tables.
Simulations were performed for both water and air/vacuum computer models with a sufficient
number of photon histories generated to obtain a Monte Carlo tally precision of approximately 1% or
lower within each tally cell. All simulations were operated in the photon and electron transport mode
(Mode: p,e in the MCNP code) so that both primary photons and resulting secondary electrons were
properly transported. The 192Ir photon spectrum was simplified by disregarding photons with
intensities below 0.1% and by omitting 192Ir source x-rays lower than 15 keV since transmission of
these photons through the encapsulating steel shell is dosimetrically negligible. The resulting 192Ir
spectrum uncertainty (0.5%) was calculated as the intensity weighted average of the uncertainty in
each spectral line. The M-19 source was placed at the center of a spherical water phantom of 40 cm
radius. Dosimetric data were determined at radial distances ranging from 0.5 cm to 10 cm (0.5 cm
increments) and over angles ranging from 0° to 180° (10° increments) using the MCNP5 F6 energy
deposition tally. Dosimetric data in a water phantom, suitable for use as an away-along table, were
also generated for 1 mm3 tally volumes between ±10 cm along the source axis and out +10 cm away
from the source axis using the MCNP5 *F4 Mesh track-length tally. Here, the phantom radius was
adjusted to 50 cm to accommodate the outlying edges of the tally, roughly 14 cm from source center,
to allow for full scattering conditions within the phantom. The air-kerma strength in free space, sK,
was calculated centering the M-19 source at the origin of an evacuated phantom in which a critical
volume containing air at STP (standard temperature pressure) was added 100 cm from source center;
dimensions of the critical volume were chosen to limit volumetric averaging errors to below 1%. The
x-ray cutoff energy was chosen to be 10 keV; photons within the critical target with energies less
than or equal to 10 keV were removed from the final air-kerma rate calculation. Medich et al., report
= (1.13 ± 0.03) cGyh–1U–1.
Taylor and Rogers[139] (Appendix A.1.1) report = (1.114 ± 0.001) cGyh–1U–1.
Consensus Data
The calculated by Medich et al.[5] is significantly higher than the rest of the HDR 192Ir source
models studied in this report. The average value of /GL(r0,0) calculated for all sources in this report
is 1.124 cGycm2h–1U–1 (maximum and minimum values 1.129 and 1.119, respectively) with a
standard deviation of 0.004 cGycm2h–1U–1, i.e., all values lie in the interval of 1.5 standard
deviations. Nevertheless, the corresponding value of Medich et al., at 4.3 standard deviations is
extremely unlikely. Because the M-19 does not present any characteristic (source core dimensions or
encapsulation thickness) different from those of the rest of the HDR 192Ir sources, we adopt as
consensus data the value given by Taylor and Rogers that fulfills the mentioned condition: CON =
(1.114 ± 0.001) cGyh–1U–1 (Table IV). gL(r) data in both studies are noisy and contain steps at
various r-values. F(r,) data present differences at small and large angles. Because the gL(r) and
F(r,) reported by Taylor and Rogers have better radial and angular mesh, a lower statistical
uncertainty, and use a more modern cross-section library, these are taken as consenus datasets
(Table V and Table XXII).
(cGyh–1U–1) for TPS quality assurance purposes (Table XXIII).
Table XXII. F(r,) for the SPEC In. Co. model M-19 source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
0 0.679 0.679 0.661 0.624 0.633 0.655 0.676 0.701 0.741 0.774
1 0.681 0.681 0.662 0.623 0.636 0.657 0.681 0.704 0.746 0.777
2 0.679 0.679 0.661 0.624 0.643 0.667 0.692 0.712 0.754 0.783
3 0.674 0.674 0.660 0.633 0.654 0.678 0.703 0.725 0.762 0.790
5 0.677 0.677 0.671 0.659 0.681 0.703 0.724 0.744 0.777 0.801
7 0.700 0.700 0.695 0.685 0.704 0.723 0.743 0.759 0.793 0.816
10 0.735 0.735 0.732 0.725 0.740 0.757 0.775 0.789 0.818 0.836
12 0.759 0.759 0.756 0.750 0.765 0.778 0.795 0.807 0.831 0.848
15 0.792 0.792 0.790 0.787 0.797 0.809 0.821 0.831 0.853 0.867
20 0.882 0.882 0.841 0.835 0.844 0.852 0.863 0.870 0.884 0.894
25 0.913 0.913 0.878 0.873 0.878 0.883 0.892 0.897 0.907 0.915
30 0.935 0.935 0.905 0.899 0.907 0.911 0.917 0.920 0.928 0.929
35 0.950 0.950 0.927 0.924 0.926 0.929 0.935 0.941 0.944 0.948
40 0.961 0.961 0.946 0.942 0.943 0.944 0.951 0.953 0.955 0.955
45 0.970 0.970 0.959 0.956 0.958 0.960 0.963 0.964 0.966 0.968
50 0.977 0.977 0.967 0.966 0.968 0.968 0.972 0.975 0.977 0.976
55 0.984 0.984 0.977 0.975 0.975 0.977 0.981 0.984 0.983 0.982
60 0.988 0.988 0.983 0.981 0.983 0.984 0.987 0.987 0.989 0.987
65 0.992 0.992 0.987 0.986 0.988 0.988 0.992 0.992 0.994 0.993
70 0.995 0.995 0.992 0.992 0.993 0.993 0.997 0.997 0.997 0.995
75 0.997 0.997 0.994 0.996 0.996 0.996 0.999 0.998 0.999 0.998
80 0.998 0.998 0.997 0.999 0.998 0.997 1.002 1.003 1.002 0.999
85 0.999 0.999 1.001 0.997 0.998 0.998 1.004 1.003 1.000 1.001
90 1 1 1 1 1 1 1 1 1 1
95 1.000 1.000 0.999 0.998 0.998 0.997 1.002 1.001 1.001 1.000
100 0.998 0.998 0.998 0.996 0.997 0.997 1.000 1.002 0.999 0.999
105 0.997 0.997 0.996 0.995 0.995 0.996 1.000 1.000 1.000 0.996
110 0.995 0.995 0.992 0.992 0.994 0.994 0.996 0.997 0.994 0.991
115 0.992 0.992 0.990 0.987 0.988 0.988 0.994 0.993 0.992 0.992
120 0.988 0.988 0.983 0.983 0.984 0.983 0.986 0.987 0.987 0.985
125 0.984 0.984 0.977 0.975 0.976 0.976 0.982 0.983 0.983 0.982
130 0.978 0.978 0.969 0.964 0.968 0.970 0.974 0.976 0.976 0.976
135 0.971 0.971 0.958 0.955 0.957 0.958 0.963 0.964 0.965 0.965
78 HEBD report
Table XXII (continued).
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
140 0.962 0.962 0.945 0.940 0.943 0.944 0.950 0.953 0.956 0.959
145 0.951 0.951 0.928 0.924 0.927 0.929 0.936 0.937 0.942 0.944
150 0.936 0.936 0.906 0.899 0.903 0.907 0.915 0.918 0.925 0.929
155 0.914 0.914 0.876 0.868 0.875 0.881 0.890 0.896 0.903 0.909
160 0.882 0.882 0.836 0.826 0.836 0.844 0.855 0.865 0.878 0.887
165 0.781 0.781 0.778 0.773 0.783 0.795 0.809 0.820 0.842 0.857
168 0.734 0.734 0.732 0.728 0.746 0.761 0.778 0.791 0.818 0.837
170 0.700 0.700 0.700 0.699 0.718 0.735 0.755 0.771 0.801 0.822
173 0.634 0.634 0.640 0.652 0.676 0.698 0.720 0.737 0.773 0.798
175 0.610 0.610 0.616 0.628 0.651 0.674 0.698 0.718 0.757 0.785
177 0.586 0.586 0.592 0.604 0.628 0.652 0.679 0.700 0.744 0.774
178 0.573 0.573 0.579 0.592 0.617 0.642 0.670 0.692 0.735 0.766
179 0.569 0.569 0.575 0.586 0.609 0.632 0.658 0.682 0.728 0.761
180 0.569 0.569 0.574 0.585 0.606 0.628 0.656 0.679 0.724 0.757
Table XXIII. QA away-along data [cGyh–1U–1] for the SPEC In. Co. model M-19 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01656 0.01683 0.01716 0.01741 0.01763 0.01786 0.01783 0.01701 0.01554 0.01383 0.01204 0.01046
6 0.0223 0.0227 0.0233 0.0237 0.0241 0.0243 0.0242 0.0225 0.01994 0.01711 0.01454 0.01228
5 0.0315 0.0325 0.0334 0.0341 0.0347 0.0349 0.0341 0.0305 0.0258 0.0214 0.01751 0.01433
4 0.0478 0.0499 0.0518 0.0534 0.0541 0.0537 0.0508 0.0425 0.0338 0.0266 0.0209 0.01657
3 0.0828 0.0879 0.0924 0.0951 0.0955 0.0902 0.0808 0.0604 0.0441 0.0325 0.0245 0.01881
2 0.1803 0.1979 0.211 0.211 0.202 0.1696 0.1361 0.0854 0.0558 0.0385 0.0278 0.0208
1.5 0.319 0.359 0.376 0.358 0.321 0.241 0.1764 0.0994 0.0616 0.0411 0.0291 0.0216
1 0.724 0.844 0.808 0.678 0.541 0.340 0.223 0.1126 0.0663 0.0433 0.0303 0.0221
0.5 3.37 3.42 2.19 1.355 0.885 0.447 0.264 0.1222 0.0696 0.0446 0.0309 0.0225
0 3.90×108 15.59 4.31 1.961 1.114 0.499 0.282 0.1259 0.0705 0.0449 0.0310 0.0226
–0.5 2.93 3.41 2.19 1.356 0.886 0.447 0.264 0.1221 0.0695 0.0445 0.0308 0.0225
–1 0.679 0.826 0.805 0.677 0.541 0.340 0.223 0.1127 0.0664 0.0432 0.0302 0.0221
–1.5 0.302 0.346 0.372 0.357 0.321 0.241 0.1765 0.0994 0.0615 0.0411 0.0292 0.0215
–2 0.1727 0.1902 0.207 0.210 0.201 0.1696 0.1358 0.0854 0.0558 0.0385 0.0278 0.0208
–3 0.0794 0.0843 0.0897 0.0934 0.0943 0.0900 0.0808 0.0604 0.0441 0.0325 0.0244 0.01876
–4 0.0464 0.0482 0.0503 0.0521 0.0532 0.0533 0.0508 0.0424 0.0338 0.0266 0.0209 0.01654
–5 0.0306 0.0314 0.0323 0.0332 0.0340 0.0345 0.0340 0.0304 0.0258 0.0213 0.01749 0.01433
–6 0.0217 0.0221 0.0226 0.0231 0.0235 0.0240 0.0240 0.0224 0.01988 0.01713 0.01451 0.01227
–7 0.01616 0.01641 0.01671 0.01696 0.01721 0.01758 0.01762 0.01691 0.01550 0.01379 0.01207 0.01043
A.1.10. Flexisource (Isodose Control)
Source Description
The active core of the Isodose Control (Veenendaal, The Netherlands) source is a pure iridium
cylinder (density 22.42 g/cm3) with an active length of 3.5 mm and a diameter of 0.6 mm. The
stainless-steel-304 capsule (composition by weight: Fe 67.92%, Cr 19%, Ni 10%, Mn 2%, Si 1%,
and C 0.08%, density 8 g/cm3) leads to outer dimensions of the source of 0.85 mm in diameter and
4.6 mm of total length. The 304 stainless steel cable is a cylinder of 5 mm length and 0.5 mm in
diameter (Figure 11).
Figure 11. Materials and dimensions (mm) of the Isodose Control Flexisource.[175]
Publications
There are two studies about this source: the first one uses the GEANT4 code[175] as described
by Granero et al.[71] in the study of the HDR source GI192M11 model (Appendix A.1.7); the second
one by Taylor and Rogers[139] (Appendix A.1.1).
Consensus Data
Both studies provide similar TG-43 parameters. values from both studies are only 0.6%
different from each other and the F(r,) data are indistinguishable. The gL(r) data are also similar but
the Taylor and Rogers results are noisy. The average of values is taken as the consensus value
CON = (1.113 ± 0.011) cGyh–1U–1 (Table IV). Due to the gL(r) data fluctuations in Taylor and
Rogers, the data from Granero et al., have been taken as CONgL(r), while the data from Taylor and
Rogers is selected for CONF(r,) in Table V and Table XXIV.
(cGyh–1U–1) for TPS quality assurance purposes (Table XXV).
80 HEBD report
Table XXIV. F(r,) for the Isodose Control model Flexisource. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
0 0.672 0.672 0.654 0.617 0.626 0.647 0.672 0.695 0.738 0.774
1 0.671 0.671 0.652 0.615 0.629 0.652 0.678 0.699 0.744 0.777
2 0.669 0.669 0.651 0.615 0.638 0.664 0.688 0.711 0.751 0.783
3 0.663 0.663 0.652 0.629 0.650 0.677 0.699 0.719 0.759 0.789
5 0.671 0.671 0.665 0.653 0.676 0.698 0.719 0.737 0.775 0.802
7 0.694 0.694 0.690 0.682 0.703 0.725 0.743 0.760 0.792 0.816
10 0.735 0.735 0.731 0.725 0.744 0.763 0.780 0.794 0.821 0.841
12 0.762 0.762 0.760 0.756 0.770 0.785 0.799 0.812 0.835 0.854
15 0.803 0.803 0.799 0.791 0.804 0.817 0.829 0.839 0.857 0.873
20 0.852 0.852 0.850 0.845 0.851 0.861 0.870 0.878 0.889 0.898
25 0.892 0.892 0.887 0.878 0.886 0.893 0.899 0.904 0.912 0.920
30 0.917 0.917 0.913 0.904 0.911 0.917 0.921 0.922 0.932 0.936
35 0.936 0.936 0.933 0.928 0.932 0.936 0.941 0.943 0.949 0.953
40 0.955 0.955 0.951 0.944 0.948 0.951 0.953 0.955 0.958 0.961
45 0.964 0.964 0.962 0.957 0.960 0.964 0.967 0.968 0.967 0.970
50 0.973 0.973 0.972 0.969 0.971 0.973 0.975 0.978 0.978 0.980
55 0.986 0.986 0.979 0.975 0.979 0.981 0.983 0.983 0.983 0.986
60 0.990 0.990 0.984 0.982 0.985 0.987 0.990 0.990 0.989 0.989
65 0.993 0.993 0.989 0.988 0.990 0.993 0.994 0.994 0.995 0.993
70 0.996 0.996 0.993 0.993 0.994 0.996 0.997 0.998 0.995 0.996
75 0.997 0.997 0.995 0.997 0.996 0.998 0.999 0.999 0.999 0.999
80 0.999 0.999 1.000 0.995 1.000 1.000 1.000 1.001 1.002 1.001
85 1.000 1.000 1.000 0.998 0.999 0.999 1.001 1.001 1.001 1.001
90 1 1 1 1 1 1 1 1 1 1
95 1.000 1.000 0.999 0.995 0.999 1.001 1.003 1.003 1.000 1.002
100 0.999 0.999 0.998 0.995 0.998 1.000 1.004 1.002 0.999 0.999
105 0.998 0.998 0.996 0.993 0.996 0.997 0.999 1.001 1.000 1.002
110 0.996 0.996 0.993 0.992 0.993 0.993 0.994 0.996 0.995 0.994
115 0.994 0.994 0.991 0.986 0.989 0.991 0.995 0.995 0.992 0.994
120 0.990 0.990 0.986 0.985 0.984 0.985 0.988 0.990 0.987 0.988
125 0.985 0.985 0.979 0.977 0.979 0.982 0.984 0.983 0.983 0.985
130 0.972 0.972 0.971 0.968 0.971 0.974 0.976 0.977 0.978 0.979
135 0.963 0.963 0.962 0.959 0.961 0.965 0.967 0.967 0.966 0.970
140 0.952 0.952 0.950 0.945 0.949 0.952 0.955 0.959 0.961 0.963
145 0.937 0.937 0.935 0.932 0.933 0.938 0.942 0.943 0.946 0.951
150 0.918 0.918 0.915 0.908 0.914 0.919 0.922 0.925 0.932 0.937
155 0.891 0.891 0.888 0.881 0.887 0.895 0.900 0.905 0.913 0.919
160 0.839 0.839 0.841 0.845 0.853 0.861 0.871 0.878 0.890 0.898
165 0.783 0.783 0.787 0.793 0.806 0.819 0.831 0.840 0.857 0.874
168 0.748 0.748 0.751 0.758 0.770 0.786 0.802 0.812 0.834 0.855
170 0.711 0.711 0.715 0.724 0.741 0.760 0.776 0.791 0.818 0.838
Table XXIV (continued).
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
173 0.659 0.659 0.663 0.673 0.693 0.715 0.733 0.750 0.785 0.809
175 0.614 0.614 0.620 0.631 0.652 0.678 0.701 0.720 0.760 0.791
177 0.542 0.542 0.550 0.566 0.599 0.631 0.660 0.684 0.729 0.766
178 0.474 0.474 0.487 0.512 0.564 0.599 0.632 0.659 0.712 0.751
179 0.440 0.440 0.453 0.480 0.534 0.571 0.606 0.635 0.693 0.734
180 0.442 0.442 0.452 0.473 0.514 0.555 0.591 0.625 0.680 0.722
Table XXV. QA away-along data [cGyh–1U–1] for the Isodose Control model Flexisource.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01642 0.01672 0.01701 0.01730 0.01758 0.01788 0.01786 0.01705 0.01559 0.0138 0.01204 0.01042
6 0.0221 0.0226 0.0231 0.0236 0.0241 0.0244 0.0242 0.0225 0.0200 0.01713 0.01451 0.01226
5 0.0312 0.0322 0.0332 0.0342 0.0348 0.0351 0.0343 0.0305 0.0258 0.0213 0.01750 0.01432
4 0.0474 0.0496 0.0518 0.0537 0.0545 0.0541 0.0511 0.0426 0.0338 0.0265 0.0208 0.01654
3 0.0815 0.0870 0.0927 0.0957 0.0961 0.0907 0.0812 0.0605 0.0441 0.0324 0.0244 0.01875
2 0.1778 0.197 0.212 0.213 0.203 0.1702 0.1361 0.0854 0.0558 0.0384 0.0277 0.0207
1.5 0.315 0.359 0.379 0.360 0.323 0.241 0.1765 0.0995 0.0615 0.0410 0.0290 0.0215
1 0.715 0.848 0.812 0.680 0.542 0.340 0.223 0.1125 0.0662 0.0431 0.0301 0.0221
0.5 3.34 3.45 2.20 1.354 0.886 0.447 0.264 0.1219 0.0694 0.0445 0.0307 0.0224
0 3.85×108 15.55 4.31 1.959 1.113 0.498 0.281 0.1254 0.0704 0.0449 0.0309 0.0225
–0.5 2.31 3.45 2.20 1.357 0.885 0.446 0.264 0.1220 0.0696 0.0445 0.0308 0.0224
–1 0.548 0.850 0.815 0.682 0.543 0.340 0.223 0.1123 0.0663 0.0432 0.0301 0.0220
–1.5 0.250 0.357 0.380 0.361 0.323 0.242 0.1766 0.0994 0.0613 0.0411 0.0291 0.0214
–2 0.1460 0.194 0.212 0.213 0.203 0.1704 0.1363 0.0854 0.0559 0.0384 0.0277 0.0207
–3 0.0699 0.0842 0.0921 0.0959 0.0962 0.0909 0.0813 0.0605 0.0440 0.0324 0.0244 0.01872
–4 0.0418 0.0473 0.0511 0.0535 0.0546 0.0541 0.0512 0.0426 0.0337 0.0265 0.0208 0.01651
–5 0.0281 0.0305 0.0325 0.0339 0.0348 0.0352 0.0343 0.0305 0.0259 0.0213 0.01748 0.01431
–6 0.0200 0.0213 0.0225 0.0233 0.0240 0.0244 0.0242 0.0225 0.0199 0.01717 0.01450 0.01225
–7 0.01506 0.01578 0.01651 0.01706 0.01745 0.01786 0.01787 0.01707 0.01559 0.01382 0.01207 0.01042
A.2. Pulsed Dose Rate 192Ir sources
A.2.1. GammaMed PDR 12i (Varian Medical Systems)
Source Description
A 1.1 mm external diameter, 3.36 mm long 192Ir source is used in the GammaMed 12i PDR
system. The source design (Figure 12) incorporates an active core of length 0.5 mm and diameter
0.6 mm, whose center is located 2.61 mm from the source tip. A 1.4 mm long, 0.6 mm diameter
aluminum plug is also located within the source capsule, distal to the active core. The encapsulating
82 HEBD report
material is stainless steel having a sidewall thickness of 0.2 mm. The active core and plug are the
same as those in the GammaMed Plus source.
Figure 12. Materials and dimensions (mm) of the Varian

Medical Systems GammaMed PDR 12i source.[69]
Publications
Pérez-Calatayud et al.[69] used the GEANT3 MC code[171] as previously described in Appendix
A.1.4 with the same methodology in the study of the Buchler source.[64] Taylor and Rogers[139] also
studied this source using previously described methods (Appendix A.1.1).
Consensus Data
Both studies adhere to recommendations for MC dosimetry given in Li et al.[17] and the TG-
43U1 report.[2] Reported values differ by 0.6%. gL(r) agree to within 1% (and mostly to within
0.5%) over the range r = 0.2 cm to 10 cm after correction of the Pérez-Calatayud et al.[69] data to
reflect unbounded scattering conditions. F(r,) agree everywhere to within 2% (and mostly to within
1%). L = 0.5 mm was used to calculate GL(r,) in both studies. The average of the published values,
CON = (1.126 ± 0.003) cGyh–1U–1 (Table XXVI) is recommended. For CONgL(r), data from Pérez-
Calatayud et al.[69] corrected to unbounded scattering conditions and presented in Table XXVII are
recommended, as it was obtained scoring dose and exhibits fewer fluctuations than the Taylor and
Rogers[139] data, especially near the reference distance r = 1 cm. For the CONF(r,), data from Pérez-
Calatayud et al.[69] reproduced in Table XXVIII are recommended, as they were obtained with more
complete angular sampling near the longitudinal axis of the source.
(cGyh–1U–1) for TPS quality assurance purposes (Table XXIX).
Table XXVI. Dose rate constant for PDR sources.
CON Statistical uncertainty CON/GL(r,)
Source Name (Manufacturer) [cGy·h–1·U–1] (k = 1) [cGycm2h–1U–1]
GammaMed PDR 12i (Varian) 1.126 0.3% 1.126

GammaMed PDR Plus (Varian) 1.123 0.3% 1.123
mPDR-v1 (Nucletron) 1.120 0.6% 1.121
Ir2.A85-1 (E&Z BEBIG) 1.124 1.0% 1.124
Table XXVII. Radial dose function values for PDR sources. Extrapolated data are underlined. Values inside
the source are in italics. In [brackets] are the corrected values from bounded to unbounded geometry.
gL(r)
Varian Varian
GammaMed GammaMed Nucletron E&Z BEBIG
PDR 12i PDR Plus mPDR-v1 Ir2.A85-1
r [cm] L = 0.05 cm L = 0.05 cm L = 0.12 cm L = 0.05 cm
0 1.009 1.005 1.011 0.997

0.2 [1.009] 1.005 1.011
0.25 [1.007] 1.000 1.007 0.997
0.5 [0.999] 0.994 1.002 0.997
0.75 [1.000] 0.998 1.001 0.999
1 1 1 1 1
1.5 [1.002] 1.003 1.002 1.003
2 [1.006] 1.008 1.005 1.006
3 [1.008] 1.012 1.009 1.008
4 [1.008] 1.014 1.006 1.007
5 [1.007] 1.012 1.007 1.004
6 [1.002] 1.007 1.001 0.997
8 [0.985] 0.988 0.983 0.975
10 [0.960] 0.954 0.947 0.943
84 HEBD report
Table XXVIII. F(r,) for the GammaMed PDR 12i source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 1.75 2 2.5 3 3.5 4 5 6 8 10
0 0.943 0.943 0.944 0.945 0.945 0.945 0.946 0.947 0.948 0.952 0.952 0.953 0.956 0.960 0.960 0.960 0.963 0.969
1 0.943 0.943 0.944 0.945 0.945 0.945 0.946 0.947 0.948 0.952 0.952 0.953 0.960 0.960 0.960 0.961 0.963 0.969
2 0.943 0.943 0.944 0.945 0.945 0.945 0.946 0.947 0.948 0.952 0.952 0.953 0.956 0.960 0.960 0.961 0.965 0.970
3 0.943 0.943 0.944 0.945 0.945 0.945 0.946 0.947 0.948 0.952 0.952 0.953 0.956 0.960 0.960 0.962 0.966 0.970
4 0.944 0.944 0.944 0.945 0.945 0.945 0.946 0.947 0.948 0.953 0.953 0.953 0.956 0.960 0.960 0.962 0.966 0.971
5 0.944 0.944 0.945 0.945 0.945 0.945 0.947 0.948 0.949 0.953 0.953 0.953 0.956 0.960 0.960 0.963 0.967 0.972
6 0.946 0.946 0.946 0.947 0.947 0.947 0.950 0.949 0.950 0.954 0.953 0.954 0.956 0.961 0.960 0.963 0.966 0.971
7 0.948 0.948 0.948 0.949 0.949 0.949 0.951 0.951 0.950 0.955 0.955 0.955 0.956 0.961 0.961 0.964 0.967 0.972
8 0.948 0.948 0.948 0.948 0.949 0.949 0.951 0.951 0.950 0.954 0.955 0.955 0.956 0.962 0.962 0.965 0.968 0.973
9 0.946 0.946 0.947 0.948 0.949 0.950 0.951 0.952 0.951 0.956 0.956 0.956 0.958 0.963 0.963 0.966 0.968 0.973
10 0.948 0.948 0.949 0.950 0.951 0.952 0.953 0.953 0.953 0.957 0.957 0.957 0.959 0.963 0.965 0.967 0.969 0.974
15 0.961 0.961 0.963 0.964 0.965 0.967 0.966 0.966 0.966 0.968 0.968 0.968 0.970 0.971 0.974 0.975 0.976 0.980
20 0.970 0.970 0.976 0.978 0.979 0.979 0.978 0.979 0.979 0.979 0.979 0.979 0.981 0.980 0.983 0.984 0.984 0.987
30 0.975 0.975 0.992 0.994 0.995 0.995 0.993 0.994 0.994 0.994 0.993 0.994 0.994 0.994 0.995 0.994 0.995 0.995
40 0.987 0.987 0.998 0.999 1.001 1.001 1.000 1.000 1.000 1.000 1.000 1.000 0.999 0.999 1.001 0.999 1.000 0.999
50 0.993 0.993 1.001 1.003 1.004 1.004 1.003 1.004 1.003 1.003 1.002 1.002 1.002 1.002 1.003 1.001 1.002 1.001
60 0.996 0.996 1.003 1.005 1.006 1.005 1.004 1.005 1.004 1.004 1.003 1.003 1.003 1.003 1.004 1.002 1.002 1.003
70 0.996 0.996 1.003 1.005 1.005 1.005 1.004 1.005 1.004 1.004 1.003 1.003 1.003 1.003 1.003 1.003 1.002 1.002
80 0.995 0.995 1.001 1.003 1.002 1.003 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 0.995 0.995 1.001 1.002 1.003 1.003 1.002 1.002 1.002 1.002 1.002 1.001 1.001 1.001 1.001 1.001 1.001 1.001
110 0.996 0.996 1.002 1.004 1.005 1.004 1.003 1.004 1.003 1.002 1.002 1.002 1.001 1.001 1.002 1.001 1.001 1.000
120 0.994 0.994 1.001 1.003 1.004 1.003 1.001 1.003 1.001 1.002 1.002 1.001 1.001 1.001 1.001 1.000 1.000 1.000
130 0.988 0.988 0.997 0.999 1.000 1.000 0.998 1.000 0.998 0.999 0.999 0.998 0.998 0.997 0.998 0.997 0.997 0.997
140 0.978 0.978 0.990 0.993 0.994 0.994 0.994 0.994 0.994 0.994 0.994 0.994 0.994 0.993 0.994 0.993 0.993 0.993
150 0.973 0.973 0.981 0.984 0.986 0.986 0.986 0.986 0.985 0.985 0.985 0.984 0.985 0.984 0.986 0.985 0.986 0.986
160 0.968 0.968 0.968 0.968 0.968 0.968 0.968 0.970 0.970 0.970 0.970 0.970 0.971 0.971 0.971 0.971 0.973 0.973
165 0.942 0.942 0.946 0.950 0.950 0.950 0.950 0.953 0.951 0.953 0.952 0.954 0.956 0.957 0.959 0.959 0.961 0.964
170 0.915 0.915 0.915 0.915 0.915 0.915 0.915 0.917 0.917 0.917 0.920 0.921 0.923 0.926 0.932 0.935 0.942 0.946
171 0.906 0.906 0.906 0.906 0.905 0.905 0.906 0.908 0.908 0.908 0.909 0.910 0.913 0.917 0.923 0.927 0.936 0.941
172 0.892 0.892 0.892 0.892 0.893 0.893 0.893 0.895 0.895 0.896 0.897 0.898 0.901 0.906 0.912 0.916 0.928 0.934
173 0.881 0.881 0.881 0.881 0.880 0.880 0.880 0.881 0.881 0.876 0.882 0.883 0.886 0.892 0.898 0.902 0.918 0.925
174 0.819 0.819 0.826 0.833 0.840 0.847 0.856 0.865 0.866 0.857 0.865 0.864 0.867 0.875 0.880 0.884 0.904 0.913
175 1.434 1.434 1.357 1.279 1.202 1.124 1.027 0.930 0.833 0.833 0.836 0.841 0.844 0.854 0.858 0.862 0.885 0.898
176 0.649 0.649 0.666 0.682 0.699 0.716 0.738 0.759 0.780 0.801 0.806 0.812 0.816 0.828 0.830 0.835 0.861 0.878
177 0.683 0.683 0.688 0.692 0.697 0.702 0.708 0.714 0.720 0.726 0.738 0.750 0.774 0.789 0.790 0.798 0.827 0.850
178 0.583 0.583 0.589 0.595 0.601 0.608 0.615 0.623 0.631 0.638 0.654 0.669 0.685 0.700 0.731 0.746 0.778 0.809
179 0.537 0.537 0.542 0.546 0.550 0.555 0.560 0.565 0.571 0.576 0.587 0.597 0.608 0.619 0.640 0.662 0.704 0.747
180 0.468 0.468 0.473 0.478 0.483 0.488 0.494 0.500 0.506 0.513 0.525 0.537 0.550 0.562 0.586 0.611 0.660 0.709
Table XXIX. QA away-along data [cGyh–1U–1] for the GammaMed PDR 12i source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.0219 0.0219 0.0219 0.0218 0.0216 0.0212 0.0206 0.01893 0.01694 0.01483 0.01283 0.01105
6 0.0301 0.0301 0.0300 0.0297 0.0294 0.0287 0.0276 0.0247 0.0214 0.01819 0.01531 0.01286
5 0.0435 0.0434 0.0431 0.0427 0.0421 0.0406 0.0384 0.0330 0.0274 0.0224 0.01823 0.01490
4 0.0681 0.0679 0.0672 0.0661 0.0648 0.0610 0.0561 0.0453 0.0353 0.0275 0.0215 0.01708
3 0.1202 0.1194 0.1174 0.1147 0.1108 0.0998 0.0870 0.0631 0.0455 0.0333 0.0250 0.01922
2 0.269 0.266 0.257 0.243 0.224 0.1810 0.1420 0.0875 0.0569 0.0391 0.0282 0.0211
1.5 0.475 0.465 0.440 0.397 0.347 0.252 0.1819 0.1012 0.0624 0.0417 0.0295 0.0218
1 1.0645 1.022 0.891 0.720 0.565 0.349 0.227 0.1139 0.0669 0.0437 0.0305 0.0224
0.5 4.26 3.56 2.26 1.392 0.905 0.453 0.267 0.1229 0.0699 0.0449 0.0311 0.0227
0 3.86×109 18.07 4.50 2.00 1.126 0.502 0.283 0.1261 0.0710 0.0453 0.0313 0.0228
–0.5 2.15 3.53 2.24 1.388 0.903 0.453 0.267 0.1229 0.0699 0.0449 0.0311 0.0227
–1 0.550 1.000 0.883 0.715 0.562 0.348 0.227 0.1137 0.0669 0.0436 0.0305 0.0224
–1.5 0.251 0.445 0.436 0.394 0.344 0.251 0.1814 0.1010 0.0623 0.0416 0.0295 0.0218
–2 0.1451 0.245 0.252 0.241 0.222 0.1798 0.1413 0.0873 0.0568 0.0391 0.0281 0.0211
–3 0.0678 0.1045 0.1123 0.1125 0.1096 0.0989 0.0863 0.0628 0.0453 0.0332 0.0249 0.01918
–4 0.0399 0.0573 0.0624 0.0638 0.0635 0.0604 0.0556 0.0449 0.0351 0.0273 0.0214 0.01703
–5 0.0266 0.0354 0.0392 0.0407 0.0409 0.0400 0.0380 0.0327 0.0272 0.0222 0.01815 0.01484
–6 0.01914 0.0240 0.0266 0.0279 0.0284 0.0281 0.0272 0.0244 0.0212 0.01807 0.01523 0.01280
–7 0.01450 0.01742 0.01930 0.0202 0.0206 0.0207 0.0203 0.01872 0.01679 0.01472 0.01276 0.01099
A.2.2. GammaMed PDR Plus (Varian Medical Systems)
Source Description
A 0.9 mm external diameter, 2.92 mm long 192Ir source is used in the GammaMed Plus PDR
system. The source design (Figure 13) incorporates an active core of length 0.5 mm and diameter
0.6 mm, whose center is located 2.37 mm from the source tip. A 1.4 mm long, 0.6 mm diameter
aluminum plug is also located within the source capsule, distal to the active core. The encapsulating
material is stainless steel having a sidewall thickness of 0.1 mm.
Figure 13. Materials and dimensions (mm) of the Varian

Medical Systems GammaMed PDR Plus source.[69]
86 HEBD report
Publications
Pérez-Calatayud et al.[69] used the MC code GEANT3[171] to score dose in a water cylinder
40 cm in length and 40 cm in diameter surrounding the source and 6 cm of stainless steel cable.
Additional details are in Appendix A.1.4 about the methodology followed by the same research
group in the study of the Buchler source.[64]
Taylor and Rogers[139] used BrachyDose[132] to score kerma using a track-length estimator in a
water cube of side 80 cm surrounding the source and 6 cm of cable. See Appendix A.1.1 for
additional details about this study.
Consensus Data
Both studies adhere to recommendations for MC dosimetry given in Li et al.[17] and TG-
43U1.[2] Reported values agree to within 0.4%. gL(r) agree to within 1% over the range r = 0.2 cm
to 10 cm after correction of the Pérez-Calatayud et al. data to reflect unbounded scattering
conditions.[69] F(r,) agree everywhere to within 1% except near = 0°, where agreement is within
2%. An active length L = 0.5 mm was used to calculate the geometry function in both studies. The
reported dosimetric data is of high quality. The average of the published values was used for CON =
(1.123 ± 0.003) cGyh–1U–1 and is recommended (see Table XXVI). For CONgL(r), data from Taylor
and Rogers[139] reproduced in Table XXVII are recommended, as they were calculated in a large
phantom that closely approximates unbounded scattering conditions. For CONF(r,), data from Pérez-
Calatayud et al.[69] reproduced in Table XXX are recommended, as they were obtained with more
complete angular sampling near the longitudinal axis of the source.
(cGyh–1U–1) for TPS quality assurance purposes (Table XXXI).
Table XXX. F(r,) for the GammaMed PDR Plus source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.2 0.4 0.6 0.8 1 1.25 1.5 1.75 2 2.5 3 3.5 4 5 6 8 10
0 0.940 0.940 0.940 0.940 0.948 0.951 0.952 0.952 0.952 0.952 0.952 0.952 0.952 0.954 0.954 0.960 0.960 0.965
1 0.941 0.941 0.941 0.941 0.949 0.953 0.953 0.953 0.953 0.953 0.953 0.953 0.953 0.954 0.956 0.961 0.961 0.969
2 0.946 0.946 0.944 0.941 0.949 0.953 0.953 0.953 0.953 0.954 0.955 0.957 0.958 0.958 0.959 0.968 0.970 0.976
3 0.945 0.945 0.945 0.945 0.951 0.953 0.953 0.953 0.954 0.955 0.960 0.960 0.960 0.960 0.962 0.969 0.970 0.976
4 0.948 0.948 0.949 0.949 0.955 0.957 0.957 0.957 0.957 0.958 0.962 0.962 0.961 0.961 0.964 0.969 0.971 0.976
5 0.948 0.948 0.949 0.951 0.956 0.957 0.957 0.957 0.957 0.959 0.962 0.963 0.961 0.961 0.965 0.969 0.971 0.977
6 0.947 0.947 0.949 0.951 0.956 0.957 0.958 0.959 0.958 0.960 0.962 0.963 0.963 0.963 0.968 0.971 0.973 0.977
7 0.948 0.948 0.951 0.955 0.959 0.960 0.962 0.962 0.962 0.962 0.963 0.963 0.963 0.966 0.970 0.972 0.974 0.978
8 0.951 0.951 0.955 0.959 0.962 0.962 0.964 0.964 0.964 0.964 0.964 0.965 0.965 0.968 0.972 0.974 0.976 0.979
9 0.951 0.951 0.955 0.960 0.963 0.962 0.965 0.966 0.965 0.965 0.967 0.967 0.967 0.969 0.974 0.975 0.977 0.980
10 0.956 0.956 0.961 0.965 0.967 0.966 0.969 0.969 0.969 0.969 0.970 0.971 0.970 0.971 0.976 0.977 0.978 0.981
15 0.969 0.969 0.973 0.977 0.978 0.977 0.980 0.979 0.980 0.980 0.980 0.980 0.981 0.981 0.985 0.984 0.986 0.987
20 0.973 0.973 0.985 0.988 0.990 0.989 0.991 0.989 0.992 0.990 0.989 0.990 0.991 0.990 0.991 0.990 0.992 0.992
30 0.979 0.979 0.995 0.998 0.999 0.999 0.999 1.000 1.000 1.000 0.999 1.000 1.000 1.000 0.999 0.999 0.999 0.999
40 0.985 0.985 1.000 1.003 1.004 1.003 1.003 1.004 1.003 1.004 1.003 1.004 1.002 1.002 1.002 1.002 1.002 1.002
50 0.990 0.990 1.003 1.005 1.006 1.005 1.004 1.004 1.005 1.004 1.004 1.004 1.003 1.004 1.004 1.004 1.003 1.003
60 0.992 0.992 1.005 1.006 1.007 1.006 1.005 1.006 1.006 1.005 1.005 1.004 1.004 1.005 1.004 1.003 1.003 1.003
70 0.993 0.993 1.004 1.005 1.006 1.005 1.004 1.006 1.005 1.004 1.004 1.004 1.003 1.004 1.003 1.003 1.002 1.003
80 0.999 0.999 1.002 1.002 1.003 1.003 1.003 1.004 1.003 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 0.998 0.998 1.002 1.003 1.002 1.002 1.002 1.002 1.002 1.002 1.001 1.001 1.001 1.002 1.001 1.001 1.001 1.001
110 0.992 0.992 1.003 1.005 1.004 1.004 1.003 1.004 1.003 1.003 1.003 1.002 1.001 1.003 1.002 1.001 1.001 1.001
120 0.989 0.989 1.001 1.003 1.003 1.004 1.003 1.004 1.003 1.002 1.002 1.002 1.001 1.003 1.002 1.001 1.000 1.001
130 0.985 0.985 0.998 1.001 1.001 1.001 1.001 1.002 1.001 0.999 1.001 1.000 1.000 1.000 0.999 1.000 0.999 0.999
140 0.977 0.977 0.994 0.997 0.996 0.996 0.996 0.997 0.997 0.997 0.997 0.998 0.996 0.998 0.996 0.997 0.996 0.995
150 0.970 0.970 0.987 0.990 0.990 0.990 0.989 0.990 0.990 0.991 0.990 0.991 0.990 0.991 0.992 0.991 0.991 0.990
160 0.956 0.956 0.972 0.975 0.975 0.975 0.977 0.977 0.977 0.977 0.977 0.978 0.978 0.978 0.978 0.978 0.979 0.981
165 0.956 0.956 0.958 0.960 0.960 0.960 0.961 0.962 0.962 0.963 0.965 0.966 0.967 0.969 0.967 0.970 0.970 0.972
170 0.938 0.938 0.937 0.937 0.933 0.933 0.934 0.935 0.936 0.937 0.939 0.939 0.939 0.944 0.944 0.949 0.954 0.956
171 0.925 0.925 0.925 0.925 0.925 0.923 0.921 0.925 0.924 0.925 0.928 0.929 0.928 0.935 0.936 0.941 0.949 0.951
172 0.908 0.908 0.910 0.912 0.912 0.912 0.912 0.912 0.912 0.912 0.916 0.918 0.917 0.925 0.928 0.933 0.942 0.945
173 0.896 0.896 0.897 0.898 0.899 0.899 0.899 0.899 0.899 0.899 0.903 0.903 0.903 0.913 0.916 0.921 0.933 0.937
174 0.880 0.880 0.880 0.880 0.880 0.881 0.883 0.883 0.883 0.884 0.885 0.887 0.887 0.897 0.903 0.908 0.922 0.929
175 0.823 0.823 0.832 0.841 0.850 0.859 0.859 0.859 0.859 0.859 0.863 0.865 0.866 0.878 0.887 0.892 0.906 0.917
176 0.814 0.814 0.815 0.817 0.818 0.820 0.822 0.823 0.824 0.831 0.836 0.836 0.840 0.851 0.866 0.872 0.887 0.904
177 0.744 0.744 0.749 0.755 0.760 0.766 0.773 0.780 0.780 0.790 0.797 0.798 0.804 0.814 0.836 0.844 0.860 0.884
178 0.568 0.568 0.581 0.595 0.608 0.622 0.639 0.656 0.673 0.690 0.724 0.729 0.739 0.756 0.786 0.799 0.816 0.852
179 0.855 0.855 0.852 0.850 0.847 0.845 0.841 0.838 0.835 0.831 0.825 0.818 0.812 0.805 0.792 0.779 0.753 0.802
180 0.962 0.962 0.955 0.948 0.941 0.934 0.925 0.916 0.907 0.899 0.881 0.864 0.846 0.829 0.794 0.759 0.689 0.694
88 HEBD report
Table XXXI. QA away-along data [cGyh–1U–1] for the GammaMed PDR Plus source.
y (cm)
z (cm) 0.00 0.25 0.50 0.75 1.00 1.50 2.00 3.00 4.00 5.00 6.00 7.00
7 0.0220 0.0222 0.0221 0.0220 0.0219 0.0214 0.0208 0.01910 0.01704 0.01486 0.01281 0.01098
6 0.0302 0.0304 0.0303 0.0301 0.0298 0.0290 0.0279 0.0249 0.0215 0.01826 0.01532 0.01282
5 0.0434 0.0436 0.0435 0.0433 0.0428 0.0411 0.0388 0.0333 0.0275 0.0225 0.01828 0.01489
4 0.0679 0.0681 0.0677 0.0669 0.0656 0.0618 0.0568 0.0455 0.0355 0.0276 0.0216 0.01710
3 0.1203 0.1208 0.1191 0.1164 0.1123 0.1008 0.0876 0.0635 0.0457 0.0334 0.0251 0.01926
2 0.2694 0.268 0.260 0.246 0.226 0.182 0.1426 0.0879 0.0572 0.0393 0.0283 0.0212
1.5 0.4769 0.471 0.445 0.400 0.348 0.253 0.1824 0.1015 0.0627 0.0418 0.0296 0.0219
1 1.069 1.032 0.896 0.721 0.565 0.349 0.228 0.1141 0.0672 0.0438 0.0306 0.0225
0.5 4.21 3.56 2.25 1.389 0.904 0.453 0.267 0.1232 0.0702 0.0451 0.0312 0.0228
0 3.82×109 17.91 4.46 1.991 1.123 0.501 0.283 0.1263 0.0712 0.0455 0.0314 0.0229
–0.5 4.26 3.53 2.24 1.384 0.902 0.452 0.267 0.1231 0.0702 0.0450 0.0312 0.0228
–1 1.049 1.010 0.886 0.716 0.563 0.348 0.227 0.1140 0.0671 0.0438 0.0306 0.0224
–1.5 0.4589 0.453 0.439 0.395 0.345 0.251 0.1818 0.1013 0.0626 0.0417 0.0296 0.0219
–2 0.2543 0.251 0.255 0.243 0.223 0.1806 0.1419 0.0877 0.0571 0.0392 0.0282 0.0211
–3 0.1091 0.1077 0.1148 0.1143 0.1108 0.0998 0.0869 0.0632 0.0455 0.0333 0.0250 0.01923
–4 0.0590 0.0592 0.0641 0.0651 0.0646 0.0611 0.0562 0.0452 0.0353 0.0275 0.0215 0.01705
–5 0.0361 0.0376 0.0405 0.0415 0.0415 0.0405 0.0384 0.0330 0.0274 0.0224 0.01821 0.01484
–6 0.0239 0.0256 0.0277 0.0285 0.0289 0.0285 0.0275 0.0247 0.0214 0.01815 0.01524 0.01277
–7 0.01659 0.01852 0.0201 0.0207 0.0211 0.0210 0.0205 0.01889 0.01689 0.01475 0.01273 0.01092
A.2.3. mPDR-v1 (Nucletron)
Source Description
The microSelectron PDR is a single 1 Ci (4.1×103 U) source of 192Ir with active core 1.2 mm
long and 0.6 mm in diameter (Figure 14). Like the HDR 192Ir sources of this vendor, the source is
encapsulated in a 316L stainless steel capsule with an outer diameter of 1.1 mm. The distance from
the physical tip of the source to the distal face is 0.5 mm.
Figure 14. Materials and dimensions (mm) of the Nucletron mPDR-v1 source.[55]
Publications
This source model has been evaluated by Karaiskos et al.[55] using a custom, yet well-
benchmarked MC simulation code (see Karaiskos et al.[49] in Appendix A.1.1). The MC code used
the detailed active core, encapsulation geometry, and materials of the source design. Water kerma
approximation was utilized and results were calculated using the mass energy absorption coefficients
from Hubbell and Seltzer (version 1.03).[176] 192Ir source photon spectrum from Glasgow and
Dillman[162] was considered. The photon cutoff was 2 keV. The source was centrally positioned in a
30 cm diameter spherical water phantom as well as in an unbounded water phantom. The phantom
spheres were divided into discrete concentric spherical shells of 0.05 cm intervals up to 0.5 cm, 0.1
cm intervals between 0.5 cm and 3 cm, and 0.5 cm intervals at larger r values. All shells were split in
1° intervals with respect to . Air-kerma strength was derived using both simulations in free space
and dry air. A point source geometry factor was used to derive radial dose and anisotropy functions.
They reported = (1.121 ± 0.006) cGyh–1U–1. The anisotropy function was tabulated up to 5 cm.
Taylor and Rogers,[139] see Appendix A.1.1, obtained = (1.119 ± 0.003) cGyh–1U–1.
Consensus Data
The average of two MC study values is recommended as CON .[55,139] CON = (1.120 ± 0.006)
cGyh–1U–1 (see Table XXVI). The data of Karaiskos et al., corrected to unbounded phantom and also
corrected by the linear geometry function, with L = 0.12 cm, were selected for CONgL(r) (Table XXVII)
because of fluctuations in the Taylor and Rogers[139] data at 1 cm, which clearly affects their
normalization. For CONF(r,), the data by Taylor and Rogers are taken because of the higher
resolution. For r = 0.25 cm, the values of Karaiskos et al.[55] are proposed as consensus data because
it presents a wider angular range. See Table XXXII.
(cGyh–1U–1) for TPS quality assurance purposes (Table XXXIII).
90 HEBD report
Table XXXII. F(r,) for the Nucletron mPDR-v1 source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
0 0.854 0.854 0.875 0.886 0.883 0.890 0.894 0.899 0.916 0.927
1 0.855 0.855 0.876 0.879 0.883 0.891 0.900 0.902 0.916 0.928
2 0.856 0.856 0.875 0.880 0.885 0.893 0.899 0.903 0.916 0.928
3 0.857 0.857 0.874 0.881 0.888 0.897 0.903 0.906 0.920 0.931
5 0.859 0.859 0.879 0.886 0.893 0.899 0.907 0.909 0.924 0.933
7 0.861 0.861 0.885 0.895 0.898 0.906 0.911 0.912 0.927 0.938
10 0.867 0.867 0.891 0.898 0.904 0.909 0.919 0.919 0.932 0.941
12 0.872 0.872 0.897 0.904 0.908 0.915 0.921 0.922 0.934 0.944
15 0.875 0.875 0.904 0.914 0.914 0.919 0.924 0.924 0.936 0.944
20 0.887 0.887 0.916 0.924 0.926 0.931 0.937 0.937 0.945 0.955
25 0.899 0.899 0.927 0.937 0.936 0.940 0.945 0.943 0.953 0.959
30 0.911 0.911 0.940 0.948 0.948 0.951 0.952 0.950 0.960 0.964
35 0.928 0.928 0.950 0.957 0.959 0.961 0.963 0.961 0.969 0.974
40 0.941 0.941 0.962 0.970 0.967 0.970 0.972 0.969 0.975 0.975
45 0.952 0.952 0.971 0.977 0.976 0.976 0.978 0.976 0.983 0.985
50 0.964 0.964 0.979 0.986 0.984 0.985 0.986 0.983 0.986 0.990
55 0.982 0.982 0.986 0.988 0.988 0.988 0.990 0.985 0.991 0.991
60 0.988 0.988 0.989 0.995 0.992 0.992 0.994 0.992 0.993 0.995
65 0.992 0.992 0.993 0.996 0.996 0.997 0.999 0.995 0.996 0.999
70 0.994 0.994 0.996 1.000 0.998 0.998 1.000 0.997 0.999 1.001
75 0.996 0.996 0.997 1.002 0.999 0.998 0.999 0.995 0.998 1.000
80 0.998 0.998 0.999 1.008 1.001 1.001 1.003 0.999 1.002 1.000
85 0.999 0.999 0.998 1.006 1.000 0.999 1.000 0.998 1.001 1.004
90 1 1 1 1 1 1 1 1 1 1
95 1.000 1.000 1.000 1.005 1.001 1.002 1.002 0.996 1.003 1.004
100 0.999 0.999 0.998 1.001 1.000 1.000 1.001 0.998 0.999 1.002
105 0.997 0.997 0.999 1.004 1.001 1.001 1.001 0.999 1.002 1.005
110 0.995 0.995 0.999 0.999 0.998 0.997 0.997 0.990 0.997 0.997
115 0.993 0.993 0.995 0.998 0.996 0.996 0.998 0.992 0.994 0.997
120 0.989 0.989 0.991 0.999 0.992 0.991 0.994 0.990 0.993 0.996
125 0.984 0.984 0.987 0.993 0.988 0.991 0.993 0.989 0.991 0.992
130 1.000 1.000 0.980 0.986 0.984 0.984 0.987 0.985 0.985 0.988
135 0.969 0.969 0.973 0.981 0.976 0.978 0.980 0.975 0.982 0.982
140 0.957 0.957 0.963 0.973 0.968 0.969 0.971 0.967 0.972 0.978
145 0.946 0.946 0.951 0.960 0.956 0.957 0.962 0.958 0.965 0.970
150 0.934 0.934 0.939 0.948 0.943 0.947 0.951 0.949 0.955 0.960
155 0.918 0.918 0.920 0.923 0.924 0.928 0.933 0.930 0.939 0.945
160 0.898 0.898 0.898 0.899 0.902 0.907 0.911 0.911 0.924 0.935
165 0.858 0.858 0.859 0.862 0.869 0.878 0.885 0.887 0.903 0.915
168 0.830 0.830 0.832 0.835 0.841 0.852 0.861 0.863 0.884 0.897
170 0.803 0.803 0.805 0.808 0.815 0.828 0.839 0.847 0.869 0.885
Table XXXII (continued).

r (cm)
(deg) 0 0.25 0.5 1 2 3 4 5 7.5 10
173 0.733 0.733 0.737 0.745 0.762 0.780 0.795 0.807 0.835 0.859
175 0.685 0.685 0.692 0.705 0.730 0.749 0.770 0.783 0.818 0.843
177 0.688 0.688 0.693 0.702 0.721 0.742 0.762 0.776 0.810 0.838
178 0.686 0.686 0.690 0.700 0.718 0.739 0.758 0.772 0.809 0.835
179 0.678 0.678 0.684 0.695 0.717 0.736 0.757 0.769 0.807 0.834
180 0.693 0.693 0.696 0.703 0.716 0.738 0.759 0.767 0.809 0.832
Table XXXIII. QA away-along data [cGyh–1U–1] for the Nucletron mPDR-v1 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.0207 0.0207 0.0207 0.0206 0.0205 0.0201 0.01956 0.01810 0.01626 0.01430 0.01236 0.01069
6 0.0282 0.0283 0.0283 0.0282 0.0280 0.0272 0.0262 0.0235 0.0206 0.01763 0.01491 0.01252
5 0.0406 0.0408 0.0407 0.0405 0.0400 0.0385 0.0365 0.0316 0.0264 0.0218 0.01785 0.01458
4 0.0631 0.0635 0.0633 0.0626 0.0612 0.0580 0.0534 0.0435 0.0344 0.0269 0.0211 0.01683
3 0.1119 0.1123 0.1112 0.1086 0.1050 0.0949 0.0834 0.0613 0.0445 0.0328 0.0246 0.01900
2 0.249 0.250 0.242 0.229 0.212 0.1739 0.1379 0.0860 0.0562 0.0387 0.0279 0.0208
1.5 0.443 0.438 0.415 0.376 0.331 0.245 0.1781 0.1001 0.0618 0.0412 0.0292 0.0216
1 0.997 0.964 0.846 0.692 0.549 0.343 0.224 0.1129 0.0663 0.0433 0.0303 0.0222
0.5 3.98 3.37 2.19 1.365 0.893 0.449 0.265 0.1224 0.0695 0.0446 0.0309 0.0225
0 1.45×109 17.73 4.46 1.988 1.120 0.499 0.282 0.1257 0.0705 0.0452 0.0312 0.0226
–0.5 3.16 3.35 2.19 1.371 0.896 0.449 0.265 0.1224 0.0695 0.0446 0.0309 0.0225
–1 0.791 0.904 0.837 0.693 0.550 0.343 0.224 0.1129 0.0664 0.0433 0.0303 0.0222
–1.5 0.355 0.390 0.401 0.372 0.330 0.245 0.1783 0.1000 0.0615 0.0412 0.0293 0.0216
–2 0.202 0.212 0.228 0.224 0.210 0.1735 0.1382 0.0862 0.0561 0.0385 0.0278 0.0209
–3 0.0928 0.0935 0.1003 0.1030 0.1017 0.0940 0.0832 0.0613 0.0446 0.0327 0.0246 0.01896
–4 0.0535 0.0537 0.0554 0.0576 0.0583 0.0565 0.0529 0.0434 0.0343 0.0269 0.0211 0.01682
–5 0.0347 0.0349 0.0354 0.0365 0.0373 0.0371 0.0357 0.0315 0.0264 0.0217 0.01783 0.01458
–6 0.0244 0.0245 0.0247 0.0252 0.0257 0.0260 0.0255 0.0233 0.0205 0.01759 0.01489 0.01249
–7 0.01811 0.01812 0.01818 0.01838 0.01870 0.01906 0.01892 0.01779 0.01618 0.01424 0.01237 0.01066
A.2.4. Ir2.A85-1 (E&Z BEBIG)
Source Description
The model Ir2.A85-1 source (E&Z BEBIG) is composed of two iridium (density 22.42 g/cm3)
cylindrical pellets 0.5 mm in length and 0.5 mm in diameter. The distal pellet represents the active
192
Ir source. The external capsule has the same inner and outer diameter (0.9 mm) as the HDR source
type Ir2.A85-2 and is also made of 316L stainless steel. See Figure 15.
92 HEBD report
Figure 15. Materials and dimensions (mm) of the E&Z BEBIG Ir2.A85-1 source.[174]
Publications
The only study of this source model was done by Granero et al.[174] using the GEANT4 code
and following the prerequisites in Li et al.[17] This source is very close in materials/geometry to the
already discussed model GammaMed PDR Plus source. The most significant difference is the
distance from active edge to tip (1.8 mm vs. 1.2 mm). values for both source models are in very
good agreement. In the simulations, 5 mm of guiding cable was considered. They provided
dosimetric data in the TG-43 U1 formalism and as an away-along table. This study follows the
methodology outlined in Appendix A.1.7 for the GI192M11 source model.
Consensus Data
The data from Granero et al.[174] are taken as the consensus dataset. They reported = CON
(1.124 ± 0.011) cGyh–1U–1 (see Table XXVI), with CONgL(r) and CONF(r,) reproduced in Tables
XXVII and XXXIV.
(cGyh–1U–1) for TPS quality assurance purposes (Table XXXV).
Table XXXIV. F(r,) for the E&Z BEBIG PDR-Ir2.A85-1 model. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.929 0.929 0.925 0.921 0.923 0.925 0.927 0.926 0.931 0.937 0.939 0.942 0.941 0.947
1 0.926 0.926 0.926 0.926 0.928 0.930 0.933 0.935 0.939 0.944 0.948 0.950 0.950 0.956
2 0.931 0.931 0.932 0.933 0.934 0.937 0.940 0.945 0.948 0.952 0.956 0.959 0.960 0.965
3 0.935 0.935 0.936 0.937 0.938 0.940 0.943 0.947 0.951 0.954 0.958 0.961 0.962 0.967
4 0.935 0.935 0.937 0.939 0.941 0.943 0.946 0.950 0.954 0.957 0.960 0.963 0.965 0.969
5 0.937 0.937 0.939 0.941 0.942 0.944 0.947 0.951 0.955 0.959 0.962 0.965 0.966 0.970
6 0.939 0.939 0.940 0.941 0.942 0.944 0.947 0.952 0.955 0.960 0.962 0.965 0.966 0.970
8 0.938 0.938 0.940 0.942 0.943 0.946 0.948 0.952 0.956 0.959 0.962 0.964 0.966 0.969
10 0.941 0.941 0.943 0.945 0.947 0.949 0.952 0.956 0.958 0.961 0.964 0.966 0.968 0.972
15 0.946 0.946 0.948 0.950 0.952 0.955 0.957 0.960 0.963 0.965 0.967 0.969 0.971 0.974
20 0.954 0.954 0.956 0.958 0.959 0.961 0.963 0.966 0.969 0.970 0.972 0.975 0.976 0.978
25 0.965 0.965 0.966 0.967 0.968 0.970 0.971 0.973 0.975 0.977 0.979 0.980 0.980 0.983
30 0.974 0.974 0.975 0.976 0.976 0.977 0.978 0.980 0.982 0.983 0.984 0.985 0.985 0.987
40 0.987 0.987 0.988 0.989 0.990 0.990 0.990 0.991 0.992 0.992 0.993 0.994 0.994 0.994
50 0.995 0.995 0.996 0.997 0.997 0.997 0.997 0.998 0.998 0.998 0.998 0.999 0.999 0.999
60 0.998 0.998 1.001 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.002 1.003 1.002 1.002
70 1.001 1.001 1.003 1.003 1.004 1.004 1.004 1.004 1.004 1.005 1.004 1.004 1.004 1.003
80 1.001 1.001 1.002 1.002 1.003 1.003 1.003 1.003 1.003 1.003 1.003 1.002 1.002 1.002
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 0.999 0.999 0.999 0.999 0.999 0.998 0.998 0.998 0.998 0.998 0.998 0.998 0.997 0.997
110 0.993 0.993 0.994 0.994 0.994 0.993 0.993 0.993 0.993 0.993 0.993 0.993 0.992 0.992
120 0.983 0.983 0.985 0.985 0.985 0.985 0.986 0.986 0.986 0.986 0.986 0.986 0.986 0.986
130 0.971 0.971 0.971 0.971 0.972 0.972 0.972 0.973 0.973 0.974 0.974 0.975 0.975 0.976
140 0.944 0.944 0.946 0.948 0.948 0.949 0.950 0.952 0.953 0.955 0.956 0.957 0.958 0.960
150 0.905 0.905 0.907 0.909 0.911 0.913 0.915 0.919 0.922 0.926 0.928 0.931 0.933 0.937
155 0.878 0.878 0.880 0.882 0.884 0.888 0.891 0.897 0.903 0.907 0.911 0.914 0.917 0.922
160 0.842 0.842 0.846 0.850 0.854 0.859 0.864 0.872 0.879 0.885 0.890 0.895 0.900 0.907
165 0.811 0.811 0.815 0.819 0.822 0.829 0.835 0.846 0.855 0.863 0.870 0.876 0.881 0.890
170 0.780 0.780 0.784 0.789 0.793 0.802 0.810 0.823 0.833 0.842 0.851 0.858 0.865 0.876
172 0.770 0.770 0.774 0.778 0.782 0.790 0.798 0.811 0.823 0.833 0.842 0.850 0.857 0.869
174 0.748 0.748 0.753 0.758 0.763 0.773 0.783 0.799 0.812 0.822 0.833 0.842 0.849 0.862
175 0.738 0.738 0.743 0.749 0.754 0.765 0.775 0.791 0.805 0.816 0.826 0.836 0.845 0.858
176 0.730 0.730 0.735 0.741 0.746 0.757 0.767 0.784 0.799 0.811 0.821 0.832 0.840 0.856
177 0.722 0.722 0.728 0.734 0.740 0.752 0.762 0.780 0.795 0.806 0.817 0.826 0.836 0.849
178 0.721 0.721 0.726 0.732 0.737 0.748 0.758 0.775 0.789 0.801 0.813 0.822 0.831 0.844
179 0.714 0.714 0.718 0.723 0.727 0.736 0.743 0.758 0.774 0.788 0.800 0.810 0.820 0.837
180 0.707 0.707 0.711 0.715 0.719 0.727 0.732 0.747 0.763 0.777 0.789 0.799 0.812 0.829
94 HEBD report
Table XXXV. QA away-along data [cGyh–1U–1] for the E&Z BEBIG PDR Ir2.A85-1 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.0213 0.0217 0.0217 0.0216 0.0214 0.0209 0.0203 0.01858 0.01659 0.01452 0.01257 0.01080
6 0.0292 0.0297 0.0297 0.0295 0.0292 0.0283 0.0271 0.0243 0.0210 0.01790 0.01505 0.01262
5 0.0423 0.0430 0.0429 0.0424 0.0417 0.0400 0.0378 0.0325 0.0270 0.0221 0.01799 0.01467
4 0.0659 0.0672 0.0666 0.0655 0.0641 0.0601 0.0553 0.0447 0.0349 0.0272 0.0213 0.01688
3 0.1166 0.1189 0.1170 0.1137 0.1093 0.0983 0.0858 0.0625 0.0451 0.0331 0.0248 0.01905
2 0.262 0.264 0.255 0.239 0.220 0.1788 0.1408 0.0872 0.0567 0.0390 0.0280 0.0209
1.5 0.464 0.463 0.433 0.390 0.341 0.250 0.1809 0.1010 0.0622 0.0415 0.0293 0.0217
1 1.038 1.007 0.874 0.710 0.560 0.348 0.227 0.1137 0.0668 0.0435 0.0304 0.0222
0.5 4.16 3.48 2.23 1.383 0.902 0.453 0.267 0.1229 0.0698 0.0448 0.0310 0.0225
9
0 3.75×10 17.87 4.48 1.996 1.124 0.501 0.283 0.1259 0.0708 0.0451 0.0311 0.0226
–0.5 3.20 3.19 2.16 1.356 0.889 0.448 0.265 0.1223 0.0696 0.0446 0.0309 0.0225
–1 0.809 0.865 0.804 0.675 0.541 0.341 0.224 0.1126 0.0663 0.0433 0.0302 0.0221
–1.5 0.364 0.390 0.384 0.360 0.322 0.242 0.1769 0.0995 0.0615 0.0411 0.0291 0.0215
–2 0.207 0.220 0.221 0.215 0.204 0.1703 0.1363 0.0855 0.0559 0.0385 0.0278 0.0208
–3 0.0941 0.0987 0.1005 0.0998 0.0980 0.0912 0.0812 0.0605 0.0441 0.0325 0.0244 0.01880
–4 0.0540 0.0562 0.0570 0.0572 0.0567 0.0547 0.0515 0.0427 0.0339 0.0266 0.0209 0.01661
–5 0.0351 0.0363 0.0367 0.0369 0.0368 0.0361 0.0347 0.0307 0.0259 0.0214 0.01756 0.01437
–6 0.0246 0.0253 0.0255 0.0257 0.0257 0.0254 0.0247 0.0227 0.0200 0.01724 0.01460 0.01232
–7 0.01809 0.01859 0.01875 0.01886 0.01887 0.01873 0.01838 0.01727 0.01571 0.01390 0.01213 0.01049
A.3. Low Dose Rate 192Ir sources
A.3.1. Steel clad 192Ir seed (Best Industries)
Source Description
The source, designated model 81-01 (Best Industries, Springfield, VA), is cylindrical in shape
with an overall length of 3.0 mm and an external diameter of 0.5 mm (Figure 16). The active core
element is 70% mass Pt and 30% mass Ir with a 3.0 mm length and 0.1 mm diameter. This core is
encapsulated in a 0.2 mm thick 304 stainless steel shell for a total diameter of 0.5 mm. According to
product literature, sources are available in activities of up to 15 mCi.
Publications
The dosimetry of the Best Medical 192Ir seed has been studied extensively using MC
simulation[27,46,72,86,177–182] and experimental measurement.[1,163,180–182]
Figure 16. Materials and dimensions (mm) of the Best Medical

model 81-01 192Ir seed.[46] Drawing is not to scale.
Anctil et al.[163] made TLD measurements in a polystyrene phantom of size (30 30 16.5)
cm3 using 1.0 mm 6 mm LiF rods calibrated in a 6 MV linac beam and having a measurement
precision of 3%. Approximately 7 cGy was delivered to each TLD position in the phantom.
Measurements were repeated 5 except at the reference position, where they were repeated 24
using bilateral TLD placement to minimize source positioning uncertainties in the transverse
direction. A distance-dependent photon energy response correction was made using factors taken
from Meigooni et al.[164] TG-43 parameters were obtained using a line source approximation for the
geometry function, with L = 3 mm. was (1.110 ± 0.032) cGyh–1U–1. The radial dose function was
obtained over the distance range 1.0 cm to 10.0 cm in 1.0 cm steps, and the anisotropy function was
obtained on a polar grid sampling of the same radial points and an angular range from 0° to 170° in
10° steps.
Ballester et al.[72] used the GEANT4 code[183] to calculate dosimetry parameters for the Best
Medical 192Ir seed. The air-kerma strength was calculated with a statistical uncertainty of <0.5% in a
(4 4 4) m3 dry air volume using the 192Ir emission spectrum from the NuDat database (NNDC),
excluding emissions <10 keV. Kerma rate was scored in 1 cm3 detectors located on the transverse
axis at distances r = 5 cm to 150 cm from the source, the values fitted to the expression
K air ( r ) r 2 = SK + br. Collisional kerma, approximating absorbed dose, was scored within an 80 cm
diameter water sphere in a set of concentric spherical shell segments 0.5 mm thick and 1° wide in
polar angle. Statistical uncertainty was <0.5% except along the source longitudinal axis, where it was
<2%. TG-43 parameters were derived using a line source approximation for the geometry function
with L = 3 mm. was (1.112 ± 0.003) cGyh–1U–1. gL(r) was calculated for variable-length steps
within the range 0.25 cm to 20.0 cm. F(r,) was obtained on a polar grid spanning the same radial
interval and an angular interval from 0° to 90° in variable-angle steps.
96 HEBD report
Wang et al.[134] used a modified version of the EGS4 MC code[134,184] to calculate dosimetry
parameters for the Best Medical 192Ir seed over a limited radial range 0.05 cm < r < 1.0 cm, of
interest in intravascular brachytherapy. The 192Ir emission spectrum used was that of Glasgow and
Dillman.[162] Both photons and electrons were transported, and dose was scored in a water phantom
with dimensions large compared to the most energetic secondary particles, using an analog estimator
and a cylindrical coordinate system. The statistical accuracy of dose estimates was <0.5% for all
radial positions r > 0.4 mm and all axial positions z < 10 mm. Doses were normalized to the source
strength, and TG-43 parameters were derived using a line source approximation for the geometry
function with L = 3 mm. was (1.109 ± 0.004) cGyh–1U–1. The radial dose function calculated
within an extended range 5 mm < r < 30 mm was found to be in excellent agreement with the
published data of Williamson[46] and Wang and Sloboda.[184]
Consensus Data
Previously recommended dosimetry parameters for this source provided in the original TG-43
[1]
report were derived from a combination of measured and MC data. Since the publication of TG-43,
additional high-quality data have become available in the form of TLD measurements[163] and MC
calculations.[72,86,177–179,185] The quality of the MC data as evaluated by guidelines described in Li et
al.[17] and TG-43U1 report[2] is generally superior to that of the experimental data, with few
exceptions. Hence for , the average of five MC values,[46,72,86,179,185] CON = (1.110 ± 0.015)
cGyh–1U–1 (see Table XXXVI) is recommended.
Table XXXVI. Dose rate constant for different LDR 192Ir sources.
CON CON/GL(r,)
Statistical uncertainty
Seed Name (Manufacturer) [cGyh U–1]
–1
(k = 1) [cGycm2h–1U–1]
Model 81-01 (Best Industries) 1.110 1.3% 1.118
Wire 0.5 cm (E&Z BEBIG) 1.096 0.2% 1.118
Wire 1.0 cm (E&Z BEBIG) 1.036 0.2% 1.118
To calculate GL(r,), L = 0.3 cm was used. For CON Lg (r), a combination of data from two
studies is recommended: for 0.05 cm r 0.5 cm, the data of Wang and Li[185] are recommended
because electron transport was explicitly taken into account and dose was scored directly; for
0.75 cm r 10 cm, the data of Ballester et al.[72] are recommended because they were obtained with
recommended unbounded scatter conditions. These data are reproduced in Table XXXVII. For
CONF(r,), the Ballester et al.
[72]
data reproduced in Table XXXVIII are recommended, as they were
obtained with denser angular sampling near the source long axis.
(cGyh–1U–1) for TPS quality assurance purposes (Table XXXIX).
Table XXXVII. Radial dose function values for LDR 192Ir sources.
Extrapolated data are underlined. Values inside the source are in italics.
gL(r)
81-01 seed Wire 0.5 cm Wire 1.0 cm
Best Industries E&Z BEBIG E&Z BEBIG
r [cm] L = 0.3 cm L = 0.5 cm L = 1 cm
0 0.979 0.983 0.973
0.05 0.979
0.1 0.986
0.15 0.989
0.2 0.991
0.25 0.992 0.983 0.973
0.5 0.996 0.994 0.990
0.75 0.997 0.998 0.997
1 1 1 1
1.5 1.004 1.004 1.004
2 1.008 1.006 1.007
3 1.010 1.008 1.009
4 1.009 1.007 1.009
5 1.005 1.003 1.004
6 0.999 0.996 0.997
8 0.977 0.973 0.975
10 0.945 0.941 0.942
Table XXXVIII. F(r,) for the Best Industries model 81-01192Ir seed. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.745 0.745 0.649 0.643 0.644 0.651 0.663 0.692 0.713 0.744 0.766 0.783 0.793 0.822
1 0.755 0.755 0.671 0.665 0.666 0.674 0.686 0.711 0.735 0.759 0.782 0.793 0.808 0.832
2 0.787 0.787 0.716 0.712 0.713 0.723 0.733 0.755 0.775 0.794 0.812 0.823 0.837 0.855
3 0.828 0.828 0.764 0.760 0.760 0.768 0.777 0.795 0.810 0.827 0.839 0.850 0.861 0.877
4 0.859 0.859 0.800 0.795 0.794 0.800 0.806 0.821 0.836 0.848 0.859 0.866 0.876 0.893
5 0.880 0.880 0.825 0.820 0.820 0.825 0.829 0.843 0.856 0.865 0.875 0.882 0.890 0.905
6 0.896 0.896 0.845 0.839 0.838 0.841 0.847 0.859 0.870 0.879 0.888 0.893 0.902 0.912
8 0.913 0.913 0.870 0.867 0.868 0.871 0.875 0.884 0.893 0.900 0.904 0.910 0.917 0.924
10 0.930 0.930 0.893 0.891 0.891 0.893 0.897 0.904 0.910 0.918 0.921 0.925 0.930 0.936
15 0.956 0.956 0.932 0.930 0.928 0.927 0.929 0.934 0.939 0.945 0.946 0.949 0.952 0.957
20 0.970 0.970 0.953 0.953 0.951 0.951 0.951 0.954 0.957 0.960 0.963 0.963 0.966 0.969
25 0.979 0.979 0.967 0.965 0.964 0.964 0.965 0.966 0.970 0.972 0.972 0.973 0.974 0.977
30 0.984 0.984 0.977 0.976 0.975 0.974 0.974 0.976 0.977 0.979 0.978 0.979 0.981 0.983
40 0.990 0.990 0.986 0.987 0.985 0.985 0.984 0.986 0.987 0.988 0.987 0.989 0.988 0.990
50 0.994 0.994 0.992 0.993 0.993 0.991 0.990 0.991 0.992 0.994 0.994 0.994 0.994 0.995
60 0.998 0.998 0.996 0.997 0.997 0.996 0.995 0.996 0.997 0.998 0.998 0.998 0.998 0.998
70 0.999 0.999 0.997 0.998 0.997 0.998 0.996 0.998 0.998 1.000 0.999 0.999 0.998 0.999
80 1.000 1.000 1.000 1.000 0.999 0.999 0.998 0.998 0.999 1.001 1.000 1.000 0.999 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
98 HEBD report
Table XXXIX. QA away-along data [cGyh–1U–1] for the Best Industries model 81-01192Ir seed.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01770 0.01861 0.01951 0.0200 0.0202 0.0202 0.01983 0.01838 0.01647 0.01441 0.01247 0.01072
6 0.0238 0.0255 0.0269 0.0274 0.0277 0.0275 0.0267 0.0241 0.0209 0.01775 0.01493 0.01253
5 0.0335 0.0369 0.0390 0.0398 0.0400 0.0392 0.0373 0.0322 0.0268 0.0219 0.01785 0.01456
4 0.0504 0.0580 0.0614 0.0624 0.0621 0.0593 0.0549 0.0443 0.0347 0.0270 0.0212 0.01676
3 0.0871 0.1047 0.1100 0.1099 0.1073 0.0975 0.0852 0.0620 0.0448 0.0328 0.0246 0.01890
2 0.1879 0.241 0.246 0.237 0.219 0.1776 0.1396 0.0864 0.0562 0.0386 0.0278 0.0208
1.5 0.328 0.435 0.427 0.389 0.340 0.248 0.1792 0.1001 0.0617 0.0412 0.0291 0.0216
1 0.737 0.989 0.878 0.709 0.557 0.344 0.225 0.1127 0.0663 0.0432 0.0302 0.0221
0.5 3.18 3.65 2.24 1.371 0.892 0.448 0.264 0.1218 0.0694 0.0445 0.0308 0.0225
8
0 4.89×10 15.99 4.33 1.957 1.110 0.497 0.281 0.1254 0.0705 0.0449 0.0310 0.0226
A.3.2. LDR 192Ir wires (E&Z BEBIG)
Source Description
Platinum encapsulated 192Ir wires are used as interstitial sources in LDR brachytherapy in manual
and remote afterloading systems in Europe. There are several different models of 192Ir wires that are
commercially available.[186] 192Ir wires of 0.3 mm and 0.5 mm in total diameter, encapsulated with
0.1 mm Pt are the most clinically used source models (Figure 17). Currently there is only one
manufacturer: E&Z BEBIG. The total length of the source wires as supplied by the manufacturer is
14 cm. The wire is flexible and is designed to be cut to the desired length in clinical practice, so one
can obtain wires of any length and curvature. TPSs calculate dose distributions around the wires with
different algorithms using stored data for elemental wires: punctual source, 0.5 cm long wire, 1 cm
long, etc.

LDR 192Ir wire.[82] Plot is not to scale.
Publications
Elongated source dosimetry, most appropriate for 192Ir wires, will be covered by TG-143. The
current report focused only on data for the fundamental lengths used by TPS. So, consensus datasets
only for 0.5 cm and 1 cm wire lengths will be produced. For the 0.5 cm and 1 cm wires there is only
one publication[82] using GEANT4, scoring kerma in an unbounded phantom. However, several MC
and EXP studies have been done for the 5 cm Ir wire: Karaiskos et al.,[88] van der Laarse et al.,[82]
Ballester et al.,[130] and Pérez-Calatayud et al.[187] The studies of Ballester et al., and Perez-Calatayud
et al., were not considered because a bug was discovered in GEANT3 that affected the dose
calculated along the source. There are two EXP studies: Bahar-Gogani et al.[188] that used a liquid
ionization chamber and Gillin et al.[189] that used TLD. In the comparison, the MC study of Karaiskos
et al.[88] data has been corrected from the particle streaming function to the geometry function GL(r,)
and unbounded scattering conditions.[31] A comparison has been done between the previously
commented MC and EXP studies using away-along dose rate tables corrected by r2, showing very
good agreement within uncertainties except at points where the different phantoms used introduced
dose differences.
Consensus Data
The previous comparison done for the same source but with L = 5 cm supports the GEANT4
code on the van der Laarse et al.[82] study as the only study for the 0.5 cm and 1 cm wire lengths. So,
CON (see Table XXXVI), CONgL(r) (see Table XXXVII), and CONF(r,) (Tables XL and XLIII)
consensus for the 0.5 cm and 1 cm length wires are taken from van der Laarse et al.[82] study.
(cGyh–1U–1) for TPS quality assurance purposes (Tables XLI and XLII).
Table XL. F(r,) for the E&Z BEBIG L = 0.5 cm wire length. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.660 0.660 0.599 0.538 0.519 0.514 0.522 0.547 0.578 0.605 0.632 0.657 0.682 0.715
1 0.662 0.662 0.604 0.546 0.528 0.523 0.532 0.558 0.588 0.616 0.644 0.666 0.689 0.723
2 0.662 0.662 0.609 0.556 0.541 0.539 0.550 0.578 0.606 0.634 0.661 0.681 0.701 0.735
3 0.663 0.663 0.617 0.571 0.560 0.561 0.573 0.602 0.629 0.656 0.680 0.700 0.718 0.751
4 0.680 0.680 0.640 0.600 0.592 0.596 0.608 0.635 0.661 0.686 0.707 0.725 0.742 0.773
5 0.708 0.708 0.672 0.636 0.630 0.634 0.645 0.669 0.693 0.714 0.734 0.750 0.766 0.793
6 0.734 0.734 0.703 0.672 0.666 0.669 0.679 0.701 0.722 0.741 0.758 0.773 0.787 0.809
8 0.788 0.788 0.759 0.730 0.725 0.728 0.736 0.753 0.769 0.784 0.797 0.809 0.819 0.838
10 0.825 0.825 0.801 0.777 0.772 0.773 0.779 0.793 0.806 0.817 0.828 0.838 0.846 0.861
15 0.889 0.889 0.871 0.853 0.848 0.847 0.851 0.859 0.867 0.873 0.879 0.885 0.891 0.899
20 0.926 0.926 0.911 0.896 0.893 0.892 0.894 0.899 0.904 0.908 0.912 0.916 0.920 0.925
25 0.947 0.947 0.936 0.925 0.923 0.921 0.922 0.925 0.928 0.931 0.934 0.936 0.938 0.942
100 HEBD report
Table XL (continued).
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
30 0.961 0.961 0.953 0.945 0.942 0.940 0.941 0.943 0.945 0.947 0.949 0.950 0.952 0.955
40 0.977 0.977 0.973 0.969 0.967 0.966 0.967 0.968 0.969 0.970 0.971 0.971 0.973 0.973
50 0.989 0.989 0.986 0.983 0.983 0.981 0.982 0.982 0.982 0.983 0.983 0.983 0.984 0.984
60 0.996 0.996 0.993 0.991 0.990 0.990 0.991 0.991 0.991 0.991 0.992 0.991 0.992 0.992
70 0.998 0.998 0.997 0.996 0.996 0.996 0.996 0.996 0.996 0.996 0.997 0.996 0.996 0.997
80 0.999 0.999 1.000 0.999 0.999 0.998 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Table XLI. QA away-along data [cGyh–1U–1] for the E&Z BEBIG L = 0.5 cm wire length.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01481 0.01535 0.01631 0.01727 0.01791 0.01847 0.01852 0.01757 0.01592 0.01404 0.01222 0.01052
6 0.01959 0.0207 0.0224 0.0238 0.0247 0.0253 0.0251 0.0231 0.0203 0.01740 0.01468 0.01234
5 0.0272 0.0293 0.0327 0.0349 0.0360 0.0365 0.0355 0.0312 0.0262 0.0215 0.01760 0.01438
4 0.0409 0.0456 0.0521 0.0556 0.0569 0.0561 0.0527 0.0433 0.0341 0.0266 0.0209 0.01659
3 0.0690 0.0828 0.0961 0.1005 0.1006 0.0937 0.0829 0.0611 0.0442 0.0325 0.0244 0.01876
2.5 0.0973 0.1227 0.1407 0.1450 0.1420 0.1260 0.1064 0.0726 0.0499 0.0355 0.0261 0.01977
2 0.1492 0.200 0.225 0.224 0.211 0.1738 0.1377 0.0857 0.0558 0.0384 0.0277 0.0207
1.5 0.264 0.380 0.403 0.377 0.332 0.245 0.1777 0.0994 0.0614 0.0410 0.0290 0.0214
1 0.619 0.927 0.863 0.702 0.552 0.342 0.223 0.1122 0.0660 0.0430 0.0300 0.0220
0.75 1.201 1.722 1.370 0.987 0.710 0.396 0.245 0.1175 0.0678 0.0438 0.0304 0.0222
0.5 3.55 3.88 2.26 1.365 0.885 0.445 0.263 0.1215 0.0692 0.0444 0.0307 0.0224
0.25 5.22×105 9.60 3.47 1.744 1.035 0.481 0.275 0.1241 0.0700 0.0447 0.0309 0.0225
0 2.61×108 13.81 4.12 1.915 1.096 0.495 0.280 0.1250 0.0703 0.0448 0.0309 0.0225
Table XLII. F(r,) for the E&Z BEBIG L = 1 cm wire length. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.681 0.681 0.603 0.525 0.447 0.411 0.411 0.435 0.474 0.512 0.544 0.571 0.605 0.647
1 0.684 0.684 0.607 0.530 0.453 0.421 0.423 0.451 0.489 0.525 0.558 0.585 0.616 0.658
2 0.691 0.691 0.621 0.551 0.481 0.454 0.458 0.489 0.524 0.558 0.589 0.617 0.642 0.683
3 0.725 0.725 0.660 0.595 0.530 0.506 0.512 0.540 0.571 0.602 0.629 0.656 0.678 0.714
4 0.772 0.772 0.710 0.648 0.586 0.562 0.568 0.593 0.621 0.647 0.671 0.693 0.713 0.745
5 0.811 0.811 0.753 0.695 0.637 0.614 0.616 0.638 0.663 0.685 0.706 0.724 0.741 0.771
6 0.842 0.842 0.788 0.734 0.680 0.657 0.659 0.678 0.699 0.718 0.737 0.753 0.766 0.793
8 0.887 0.887 0.840 0.793 0.746 0.725 0.725 0.740 0.754 0.770 0.783 0.796 0.806 0.826
10 0.911 0.911 0.872 0.833 0.794 0.775 0.775 0.785 0.797 0.809 0.820 0.829 0.838 0.852
15 0.946 0.946 0.920 0.894 0.868 0.853 0.851 0.856 0.862 0.869 0.875 0.881 0.886 0.895
20 0.963 0.963 0.945 0.927 0.909 0.897 0.895 0.897 0.900 0.905 0.909 0.913 0.915 0.921
25 0.973 0.973 0.960 0.947 0.934 0.925 0.924 0.925 0.927 0.930 0.933 0.934 0.937 0.940
30 0.992 0.992 0.976 0.960 0.951 0.945 0.943 0.943 0.944 0.947 0.947 0.949 0.951 0.954
40 0.993 0.993 0.985 0.977 0.972 0.969 0.968 0.968 0.968 0.970 0.970 0.971 0.971 0.972
50 0.995 0.995 0.991 0.987 0.984 0.984 0.983 0.982 0.982 0.983 0.983 0.983 0.984 0.985
60 0.996 0.996 0.995 0.993 0.992 0.992 0.991 0.992 0.991 0.992 0.991 0.991 0.991 0.992
70 0.998 0.998 0.998 0.997 0.997 0.997 0.996 0.997 0.996 0.996 0.996 0.996 0.996 0.996
80 0.999 0.999 1.000 0.999 0.999 0.999 1.000 1.000 0.999 0.999 0.999 0.999 0.999 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
Table XLIII. QA away-along data [cGyh–1U–1] for the E&Z BEBIG L = 1 cm wire length.
Values inside the source are in italics. Extrapolated data are underlined.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01292 0.01398 0.01566 0.01690 0.01769 0.01838 0.01849 0.01757 0.01594 0.01405 0.01221 0.01053
6 0.01695 0.01880 0.0216 0.0234 0.0246 0.0253 0.0251 0.0232 0.0203 0.01740 0.01468 0.01235
5 0.0232 0.0269 0.0318 0.0346 0.0359 0.0366 0.0356 0.0313 0.0263 0.0216 0.01762 0.01439
4 0.0339 0.0428 0.0514 0.0556 0.0571 0.0564 0.0530 0.0434 0.0342 0.0267 0.0209 0.01658
3 0.0560 0.0802 0.0967 0.1018 0.1019 0.0948 0.0835 0.0613 0.0443 0.0325 0.0244 0.01875
2.5 0.0794 0.1219 0.1437 0.1484 0.1449 0.1277 0.1073 0.0728 0.0500 0.0355 0.0261 0.01976
2 0.1232 0.205 0.234 0.232 0.217 0.1765 0.1387 0.0858 0.0558 0.0383 0.0276 0.0207
1.5 0.230 0.412 0.433 0.397 0.344 0.248 0.1784 0.0993 0.0613 0.0409 0.0290 0.0214
1 0.666 1.138 0.972 0.746 0.568 0.343 0.223 0.1118 0.0658 0.0429 0.0300 0.0220
0.75 1.871 2.39 1.560 1.033 0.719 0.394 0.243 0.1169 0.0676 0.0437 0.0304 0.0222
0.5 1.20×105 5.65 2.42 1.365 0.873 0.439 0.260 0.1209 0.0689 0.0443 0.0306 0.0223
0.25 5.33×105 8.83 3.19 1.640 0.991 0.470 0.272 0.1233 0.0698 0.0446 0.0308 0.0224
0 1.33×108 9.63 3.47 1.746 1.036 0.481 0.275 0.1241 0.0701 0.0447 0.0309 0.0225
102 HEBD report
137
A.4. Cs sources
A.4.1. CSM3 (E&Z BEBIG)
Source Description
This 137Cs source manufactured by E&Z BEBIG is used in manual and remote-controlled LDR
afterloading systems. The source (Figure 18) is composed of three cylindrical pollucite pellets,
0.08 cm in diameter and 0.36 cm long contained in a 2.03 cm long outer stainless-steel cylinder with
an outer diameter of 0.265 cm. The 137Cs radionuclide is uniformly distributed in the active pellets.
The source is asymmetric due to the presence of the eyelet and the upper wedge-shaped end.
Figure 18. Materials and dimensions (mm) of the E&Z BEBIG model CSM3 source.[141]
Publications
The CSM3 source has been studied by Williamson[141] and Liu et al.[190] using analytical
methods, and by Pérez-Calatayud et al.[191] using MC. Only calculated data have been published for
this source, although in Pérez-Calatayud et al.[191] the MC results were validated using TLD
dosimetry for a very similar source model, CSM2 (the CSM2 has the same design as the CSM3 but
with the central pollucite pellet made inactive). The CSM3 source belongs in the category of
conventionally encapsulated 137Cs and 192Ir, similar in design to existing ones where a single
dosimetric study is sufficient as recommended.[17] Because this is a segmented active volume source,
to obtain the parameters and functions of the TG-43 formalism, an effective active length Leff of
1.8 cm was used (Leff = NS, where N is the number of active pellets and S the separation between the
centers of two consecutive active pellets) as proposed by Williamson[141] and recommended in the
TG-43U1 report.[2] The origin for dose calculations in Williamson[141] and Liu et al.[190] is the
geometrical center of the three active source pellets, while in Perez-Calatayud et al.[191] it is the center
of the capsule. So, the origins are 0.15 mm apart. For the purposes of this report, the data in Pérez-
Calatayud et al.[191] were interpolated to effectively shift the origin to the geometrical center of the
three active pellets.
Williamson[141] studied the dosimetric proprieties of this source. The source was considered
symmetrical, neglecting the asymmetry between the two source ends. MC was used to fit the
parameters for a Sievert-based algorithm that was later used to give the away-along dose rate tables
for this source. No TG-43 formatted data were presented. Williamson[141] used a tissue attenuation
and scatter factor calculated by himself.[192]
Liu et al.[190] produced a dosimetric report with the TG-43 formalism for these sources using
the same Sievert-derived algorithm as Williamson with identical fitted parameters (attenuation
coefficients) but considering the sources as linear sources with the radioactivity uniformly distributed
on the central source axis. In contrast with Williamson’s study, the authors used the Meisberger
polynomial[92] for tissue attenuation.
Pérez–Calatayud et al.[191] used the GEANT4 MC code.[183] The application of this calculation
method was experimentally validated with TLD. Absorbed dose was approximated by kerma with a
cutoff of 10 keV. Kerma was scored in an R = 20 cm water sphere surrounding the source. Source sK
was determined in dry air, using a linear fitting function to correct for air attenuation and scattering.
For both simulations, in water and dry air, the linear track-length kerma estimator[129] was used. gL(r)
was obtained using the line-source approximation with L = 1.8 cm over a radial range r = 0.25 cm to
15 cm. It was fit with 5th order polynomials in two domains, 0.25 cm < r < 0.8 cm and 0.8 cm r <
15 cm, respectively. The anisotropy function was obtained over the same radial range and an angular
range = 0° to 180°, with 1° angular sampling close to the source long axis.
Consensus Data
The Pérez-Calatayud et al.[191] study adhered to recommendations for MC dosimetry given in
Li et al.[17] and TG-43U1 report[2] with the exception that it did not provide experimental verification
of source geometry or address source geometry uncertainty. Reported values differ by 0.2%.
Radial dose functions from the studies of Liu et al.[190] and Pérez-Calatayud et al.[191] agree to within
0.5%. Anisotropy functions show significant disagreement due to the simplifications of the Liu et
al.[190] study: symmetrical source and radioactivity uniformly distributed along the source axis. The
average published values were used for CON = (0.902 ± 0.003) cGyh–1U–1 (see Table XLIV). Due to
the data range and resolution, both CONgL(r) and CONF(r,) were taken from Pérez-Calatayud et al.[191]
as presented in Tables XLV and XLVI. These data are provided for full scatter conditions. An away-
along table (Table XLVII) derived from the recommended consensus datasets is presented for TPS
quality assurance purposes.
104 HEBD report
Table XLIV. Dose rate constant of 137Cs sources.

CON CON/GL(r,)
Statistical uncertainty
Seed Name (Manufacturer) [cGyh U–1]
–1
(k = 1) [cGycm2h–1U–1]
CSM-3 (E&Z BEBIG) 0.902 0.33% 1.107
IPL (RPD) 0.948 0.30% 1.101
CSM11 (E&Z BEBIG) 1.094 0.18% 1.103
The value gL(r = 0.25 cm) = 1.080 presents a step with respect to its neighbor gL(y= 0.5 cm) =
1.006. A possible reason could be an artifact of GL(r,) due to choice of Leff = 1.8 cm and the
three source segments. A study was done by HEBD comparing: (a) gL(r) obtained using GL(r,) and
Leff = 1.8 cm, and (b) gL(r) obtained using the particle streaming function as used by Rivard[87] and
Karaiskos et al.[89] This study demonstrated that the gL(r) step was attributed to GL(r,) due to choice
of Leff = 1.8 cm.
Table XLV. Radial dose function values for 137Cs LDR sources.
Interpolated/extrapolated data are boldface/underlined.
gL(r)
E&Z BEBIG RPD E&Z BEBIG
CSM3 IPL CSM11
r [cm] L = 1.8 cm L = 1.48 cm L = 0.32 cm
0 1.080 1.012 1.010
0.25 1.080 1.012 1.010
0.5 1.006 1.003 1.005
0.75 1.002 1.001 1.003
1 1 1 1
1.5 0.995 0.996 0.995
2 0.989 0.992 0.990
3 0.978 0.982 0.980
4 0.965 0.971 0.969
5 0.952 0.958 0.956
6 0.937 0.944 0.942
8 0.905 0.913 0.911
10 0.869 0.877 0.875
Table XLVI. F(r,) for the E&Z BEBIG CSM3 source. Values inside the source are in italics.
Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 2.5 3 4 5 6 7 8 10
0 0.812 0.812 0.819 0.825 0.832 0.846 0.860 0.863 0.862 0.861 0.859 0.871 0.875 0.862 0.875
1 0.818 0.818 0.824 0.829 0.835 0.846 0.857 0.856 0.856 0.855 0.852 0.859 0.862 0.862 0.870
2 0.821 0.821 0.825 0.830 0.834 0.844 0.853 0.850 0.847 0.846 0.844 0.848 0.853 0.857 0.864
3 0.815 0.815 0.819 0.823 0.827 0.835 0.843 0.840 0.836 0.837 0.837 0.841 0.846 0.850 0.860
4 0.808 0.808 0.812 0.816 0.819 0.827 0.834 0.831 0.830 0.830 0.831 0.835 0.841 0.846 0.858
5 0.806 0.806 0.809 0.812 0.816 0.822 0.828 0.826 0.826 0.828 0.830 0.835 0.842 0.847 0.859
6 0.801 0.801 0.805 0.808 0.812 0.819 0.826 0.825 0.826 0.830 0.835 0.841 0.847 0.852 0.862
8 0.801 0.801 0.806 0.811 0.817 0.827 0.838 0.840 0.841 0.847 0.851 0.856 0.861 0.868 0.877
10 0.623 0.623 0.668 0.712 0.757 0.846 0.857 0.860 0.862 0.867 0.871 0.876 0.880 0.885 0.892
15 0.833 0.833 0.844 0.855 0.865 0.887 0.897 0.900 0.903 0.907 0.910 0.913 0.916 0.919 0.924
20 0.946 0.946 0.941 0.936 0.931 0.920 0.928 0.930 0.932 0.935 0.936 0.939 0.940 0.941 0.944
25 1.243 1.243 1.150 1.058 0.965 0.944 0.947 0.949 0.951 0.953 0.954 0.956 0.957 0.958 0.960
30 0.903 0.903 0.972 1.041 0.985 0.960 0.962 0.963 0.964 0.966 0.966 0.967 0.968 0.968 0.970
40 0.861 0.861 0.960 1.016 0.998 0.981 0.979 0.980 0.981 0.981 0.981 0.983 0.983 0.983 0.984
50 0.923 0.923 0.967 1.003 1.000 0.991 0.990 0.990 0.989 0.990 0.990 0.990 0.991 0.991 0.992
60 0.963 0.963 0.979 0.999 1.000 0.996 0.995 0.995 0.995 0.995 0.995 0.995 0.995 0.996 0.996
70 0.987 0.987 0.991 1.000 1.000 0.999 0.998 0.997 0.998 0.998 0.998 0.998 0.999 0.998 0.999
80 0.999 0.999 0.998 1.000 1.000 1.000 1.000 0.999 0.999 0.999 0.999 1.000 0.999 1.000 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 0.998 0.998 0.998 0.999 1.000 1.000 1.000 1.000 1.000 1.000 0.999 1.000 1.000 1.000 1.001
110 0.986 0.986 0.991 0.998 1.000 0.999 0.999 0.998 0.998 0.999 0.998 0.998 0.999 0.998 0.999
120 0.960 0.960 0.979 0.999 1.001 0.996 0.995 0.995 0.994 0.996 0.995 0.995 0.995 0.995 0.997
130 0.918 0.918 0.967 1.004 1.001 0.991 0.990 0.990 0.989 0.990 0.990 0.991 0.991 0.991 0.992
140 0.856 0.856 0.960 1.015 0.998 0.981 0.980 0.980 0.980 0.982 0.982 0.982 0.983 0.982 0.983
150 0.902 0.902 0.972 1.041 0.984 0.960 0.961 0.962 0.963 0.965 0.965 0.966 0.968 0.968 0.970
155 1.242 1.242 1.150 1.058 0.966 0.943 0.947 0.947 0.949 0.951 0.951 0.953 0.954 0.955 0.957
160 0.946 0.946 0.941 0.936 0.930 0.920 0.925 0.926 0.927 0.930 0.932 0.935 0.937 0.939 0.942
165 0.840 0.840 0.849 0.857 0.866 0.884 0.891 0.894 0.897 0.902 0.906 0.910 0.912 0.914 0.920
170 0.637 0.637 0.676 0.715 0.754 0.832 0.846 0.851 0.853 0.859 0.864 0.870 0.874 0.879 0.888
172 0.784 0.784 0.790 0.796 0.802 0.815 0.827 0.829 0.832 0.838 0.842 0.848 0.854 0.859 0.869
174 0.790 0.790 0.793 0.796 0.800 0.807 0.813 0.812 0.813 0.817 0.823 0.830 0.837 0.842 0.854
175 0.798 0.798 0.800 0.802 0.805 0.810 0.814 0.812 0.812 0.814 0.819 0.826 0.832 0.837 0.850
176 0.800 0.800 0.803 0.806 0.810 0.816 0.823 0.820 0.819 0.820 0.823 0.828 0.833 0.838 0.849
177 0.808 0.808 0.811 0.815 0.818 0.825 0.832 0.829 0.827 0.825 0.827 0.831 0.837 0.840 0.851
178 0.820 0.820 0.823 0.826 0.829 0.835 0.841 0.838 0.837 0.835 0.836 0.841 0.844 0.849 0.859
179 0.814 0.814 0.818 0.823 0.827 0.835 0.843 0.843 0.843 0.840 0.841 0.846 0.847 0.851 0.860
180 0.792 0.792 0.798 0.805 0.812 0.825 0.838 0.842 0.839 0.835 0.836 0.841 0.843 0.842 0.851
106 HEBD report
Table XLVII. QA away-along data [cGyh–1U–1] for the E&Z BEBIG CSM3 source.
Values inside the source are in italics. Extrapolated values are underlined.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01852 0.01802 0.01771 0.01772 0.01787 0.01805 0.01789 0.01674 0.01502 0.01315 0.01136 0.00974
6 0.0257 0.0249 0.0244 0.0246 0.0249 0.0250 0.0245 0.0222 0.01920 0.01630 0.01366 0.01142
5 0.0374 0.0364 0.0359 0.0364 0.0368 0.0364 0.0349 0.0301 0.0249 0.0202 0.01638 0.01331
4 0.0605 0.0583 0.0580 0.0590 0.0590 0.0568 0.0524 0.0419 0.0324 0.0250 0.01945 0.01534
3 0.1140 0.1084 0.1094 0.1098 0.1072 0.0965 0.0832 0.0592 0.0420 0.0305 0.0227 0.01733
2 0.295 0.279 0.277 0.260 0.235 0.1812 0.1378 0.0824 0.0527 0.0359 0.0257 0.01906
1.5 0.647 0.599 0.545 0.459 0.375 0.252 0.1753 0.0949 0.0578 0.0382 0.0269 0.01974
1 4.85 2.21 1.326 0.856 0.598 0.338 0.215 0.1061 0.0619 0.0401 0.0278 0.02026
0.5 1.82×105 6.46 2.35 1.288 0.818 0.412 0.246 0.1140 0.0647 0.0413 0.0284 0.02059
0 9.71×107 6.91 2.63 1.440 0.902 0.441 0.257 0.1169 0.0657 0.0417 0.0286 0.02071
–0.5 1.78×105 6.46 2.35 1.289 0.818 0.412 0.246 0.1140 0.0647 0.0413 0.0284 0.02060
–1 4.73 2.21 1.326 0.856 0.598 0.338 0.215 0.1061 0.0620 0.0401 0.0278 0.02028
–1.5 0.631 0.590 0.544 0.459 0.375 0.252 0.1753 0.0949 0.0578 0.0383 0.0269 0.01976
–2 0.288 0.275 0.275 0.260 0.234 0.1811 0.1378 0.0824 0.0527 0.0359 0.0257 0.01907
–3 0.1109 0.1066 0.1083 0.1090 0.1066 0.0963 0.0831 0.0592 0.0420 0.0305 0.0227 0.01732
–4 0.0587 0.0576 0.0573 0.0584 0.0587 0.0565 0.0523 0.0419 0.0324 0.0250 0.01945 0.01533
–5 0.0365 0.0360 0.0354 0.0361 0.0365 0.0363 0.0348 0.0301 0.0249 0.0202 0.01639 0.01331
–6 0.0248 0.0246 0.0242 0.0244 0.0247 0.0249 0.0244 0.0221 0.01920 0.01629 0.01366 0.01142
–7 0.01784 0.01784 0.01754 0.01753 0.0177 0.0179 0.01782 0.01669 0.01502 0.01314 0.01136 0.00974
A.4.2. IPL (Radiation Products Design)
Source Description
The IPL 137Cs, Model 67-6520, sources are 3.05 mm in diameter and 20 mm in length. These
sources are manufactured by Isotope Product Laboratories (IPL, Valencia, CA) and distributed by
Radiation Products Design, Inc. (Albertville, MN). See Figure 19.
Figure 19. Materials and dimensions (mm) of the Radiation Products Design model
67-6520 137Cs source.[193] The source tip is on the side of the aluminum ring.
Figure 19 shows a schematic diagram of this source model. The capsules of these sources are
composed of two layers of 304 stainless steel with a total wall thickness of 0.584 mm. There are two
end caps (one for each capsule layer) on each end of the source. The total thickness of the end cap on
one side is 2 mm and on the opposite side it is 3 mm. The active portion of the source is 1.52 mm in
diameter and 14.8 mm in length. The 137Cs radionuclide is uniformly distributed in a core of cesium
oxide ceramic, assuming approximately 5.29 mg Cs2O in a 50 mCi source. The mass density of the
active ceramic material is 1.47 g/cm3, while the density of the ceramic itself is 1.27 g/cm3. A color-
coded aluminum ring easily identifies the source activity and defines the source tip. The SK
calibration is traceable to NIST through the University of Wisconsin ADCL in Madison.
Publications
The GEANT4 (version 8.0) MC code was used by Meigooni et al.[193] to calculate the air-
kerma and the dose rate distributions around an IPL 137Cs source in liquid water and in Solid WaterTM
phantom materials. TLD measurements were done to validate MC calculations. The track-length
estimator was used to derive kerma. In order to validate the accuracy of the source design,
dimensions, and composition materials used in the MC studies, simulations were performed in a
(30 30 25) cm3 Solid WaterTM phantom, which is identical to that used in the experimental setup
for TLD measurements. They followed AAPM TG-43U1 recommendations[2] in both MC
calculations and TLD measurements. In their data analysis, an active length L = 1.48 cm was used to
calculate GL(r,) in both dosimetric investigations. In this study, the MC-calculated values were
validated by comparison of the simulated data with the TLD measured values in the same phantom
material.
Consensus Data
The data from Meigooni et al.[193] are the only published data about this source. Their MC results
were validated against TLD measurement. In general, the agreement was good. Moreover, the MC
value they obtained, once corrected by the geometry factor, is close to that for the CSM3 source, as
expected. Subsequently, MC = 0.948 cGyh–1U–1 ± 2.6% (see Table XLIV), MCgL(r), and MCF(r,)
were introduced for their clinical applications (Table XLV and Table XLVIII, respectively). Because
there is only the one study for this source, the derived MC TG-43 data from Meigooni et al.[193] are
recommended as consensus data. In addition, Meigooni et al.[193] provided the tabulated data that was
required in source characterization with the primary and scatter dose separation (PSS)
formalism.[73,148] Derived from the consensus TG-43 dataset, an away-along dose rate table is
presented (cGyh–1U–1) for TPS quality assurance purposes (Table XLIX).
108 HEBD report
Table XLVIII. F(r,θ) for the Radiation Products Design IPL source. Values inside the source are in italics.
r (cm)
θ (deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.935 0.935 0.930 0.926 0.921 0.912 0.903 0.899 0.899 0.898 0.905 0.910 0.904 0.910
1 0.939 0.939 0.934 0.930 0.925 0.916 0.907 0.906 0.906 0.908 0.911 0.915 0.915 0.919
2 0.930 0.930 0.927 0.925 0.922 0.917 0.912 0.910 0.911 0.913 0.914 0.917 0.921 0.922
3 0.925 0.925 0.923 0.922 0.920 0.917 0.914 0.910 0.909 0.911 0.913 0.915 0.918 0.921
4 0.933 0.933 0.930 0.927 0.924 0.918 0.912 0.905 0.904 0.906 0.909 0.911 0.913 0.919
5 0.937 0.937 0.933 0.929 0.925 0.917 0.909 0.901 0.900 0.902 0.904 0.907 0.910 0.916
6 0.938 0.938 0.933 0.928 0.923 0.913 0.903 0.897 0.898 0.900 0.903 0.907 0.910 0.915
8 0.919 0.919 0.916 0.913 0.910 0.904 0.898 0.898 0.900 0.905 0.908 0.910 0.914 0.920
10 0.921 0.921 0.919 0.917 0.915 0.911 0.907 0.907 0.910 0.914 0.918 0.920 0.923 0.928
15 1.004 1.004 0.992 0.980 0.968 0.944 0.940 0.937 0.937 0.940 0.941 0.943 0.944 0.948
20 1.050 1.050 1.027 1.004 0.981 0.966 0.960 0.957 0.958 0.959 0.960 0.961 0.961 0.964
25 1.026 1.026 1.014 1.002 0.988 0.978 0.974 0.971 0.971 0.971 0.971 0.971 0.971 0.972
30 1.018 1.018 1.009 1.000 0.993 0.985 0.983 0.980 0.978 0.979 0.979 0.979 0.979 0.980
40 1.007 1.007 1.003 0.999 0.997 0.993 0.992 0.990 0.990 0.990 0.989 0.989 0.989 0.989
50 1.005 1.005 1.002 0.999 0.998 0.996 0.996 0.995 0.994 0.995 0.994 0.994 0.994 0.994
60 1.005 1.005 1.001 0.999 0.999 0.999 0.999 0.998 0.998 0.998 0.998 0.998 0.997 0.997
70 1.002 1.002 1.001 1.000 1.000 0.999 1.000 1.000 0.999 0.999 1.000 0.999 0.999 0.999
80 1.000 1.000 1.000 0.999 1.000 1.000 1.000 1.000 1.000 1.001 1.000 1.000 1.000 0.999
90 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
100 1.001 1.001 1.000 1.000 1.000 0.999 1.000 1.000 1.000 1.000 1.000 1.000 0.999 0.999
110 1.002 1.002 1.001 1.000 1.000 0.999 1.000 0.999 0.999 1.000 0.999 0.999 0.999 0.999
120 1.004 1.004 1.001 1.000 0.999 0.998 0.999 0.997 0.997 0.998 0.997 0.997 0.997 0.997
130 1.003 1.003 1.001 0.999 0.998 0.997 0.996 0.996 0.994 0.995 0.994 0.994 0.994 0.994
140 1.009 1.009 1.004 0.999 0.997 0.992 0.992 0.990 0.989 0.990 0.989 0.990 0.989 0.989
150 1.017 1.017 1.009 1.001 0.993 0.985 0.983 0.980 0.979 0.980 0.980 0.980 0.980 0.980
155 1.027 1.027 1.014 1.001 0.988 0.977 0.974 0.971 0.971 0.971 0.972 0.972 0.972 0.973
160 1.050 1.050 1.027 1.004 0.981 0.964 0.960 0.958 0.958 0.960 0.961 0.961 0.962 0.964
165 1.000 1.000 0.989 0.978 0.967 0.945 0.941 0.939 0.940 0.942 0.944 0.946 0.947 0.950
170 0.922 0.922 0.921 0.920 0.919 0.917 0.915 0.915 0.916 0.920 0.922 0.926 0.927 0.932
172 0.927 0.927 0.924 0.922 0.919 0.914 0.909 0.908 0.910 0.913 0.916 0.919 0.922 0.927
174 0.953 0.953 0.948 0.943 0.938 0.928 0.918 0.911 0.910 0.912 0.915 0.918 0.920 0.925
175 0.959 0.959 0.954 0.950 0.945 0.936 0.927 0.918 0.917 0.917 0.918 0.920 0.922 0.927
176 0.962 0.962 0.958 0.954 0.950 0.942 0.934 0.925 0.923 0.924 0.925 0.926 0.927 0.933
177 0.953 0.953 0.951 0.949 0.947 0.943 0.939 0.934 0.931 0.931 0.930 0.931 0.933 0.936
178 0.953 0.953 0.951 0.949 0.947 0.943 0.939 0.937 0.935 0.935 0.935 0.935 0.938 0.939
179 0.953 0.953 0.950 0.948 0.945 0.940 0.935 0.931 0.932 0.934 0.934 0.933 0.936 0.939
180 0.940 0.940 0.938 0.937 0.935 0.932 0.929 0.922 0.925 0.929 0.927 0.928 0.930 0.937
Table XLIX. QA away-along data [cGy⋅h–1⋅U–1] for the Radiation Products Design IPL source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01919 0.01931 0.01910 0.01889 0.01880 0.01868 0.01833 0.01699 0.01519 0.01326 0.01144 0.00980
6 0.0265 0.0267 0.0263 0.0261 0.0260 0.0257 0.0249 0.0224 0.01937 0.01640 0.01373 0.01148
5 0.0387 0.0392 0.0384 0.0382 0.0380 0.0372 0.0354 0.0303 0.0250 0.02031 0.01645 0.01336
4 0.0621 0.0624 0.0611 0.0608 0.0603 0.0574 0.0527 0.0420 0.0325 0.0251 0.01952 0.01539
3 0.1149 0.1143 0.1120 0.1109 0.1076 0.0965 0.0832 0.0593 0.0421 0.0306 0.0228 0.01738
2 0.285 0.278 0.271 0.255 0.230 0.1794 0.1373 0.0825 0.0529 0.0360 0.0257 0.01913
1.5 0.587 0.557 0.514 0.440 0.365 0.250 0.1750 0.0951 0.0580 0.0384 0.0270 0.01982
1 2.24 1.773 1.191 0.816 0.586 0.338 0.216 0.1066 0.0622 0.0402 0.0279 0.02034
0.5 2.50×105 6.44 2.44 1.325 0.837 0.419 0.249 0.1147 0.0650 0.0414 0.0285 0.0207
0 1.26×108 7.46 2.92 1.548 0.948 0.453 0.261 0.1177 0.0660 0.0418 0.0287 0.0208
–0.5 2.52×105 6.44 2.44 1.326 0.837 0.419 0.248 0.1147 0.0650 0.0414 0.0285 0.0207
–1 2.28 1.774 1.191 0.816 0.586 0.338 0.216 0.1066 0.0622 0.0402 0.0279 0.02034
–1.5 0.601 0.561 0.514 0.440 0.365 0.250 0.1750 0.0951 0.0580 0.0384 0.0270 0.01982
–2 0.293 0.282 0.272 0.255 0.230 0.1794 0.1372 0.0825 0.0529 0.0360 0.0257 0.01913
–3 0.1178 0.1166 0.1130 0.1113 0.1078 0.0965 0.0832 0.0592 0.0421 0.0305 0.0227 0.01738
–4 0.0639 0.0638 0.0618 0.0611 0.0605 0.0574 0.0527 0.0421 0.0325 0.0251 0.01952 0.01539
–5 0.0400 0.0400 0.0389 0.0385 0.0382 0.0372 0.0354 0.0303 0.0250 0.02032 0.01646 0.01336
–6 0.0272 0.0273 0.0267 0.0264 0.0262 0.0258 0.0250 0.0224 0.01937 0.01641 0.01374 0.01148
–7 0.01957 0.01969 0.01941 0.01912 0.01897 0.01876 0.01838 0.01701 0.01520 0.01326 0.01144 0.00980
A.4.3. CSM11 (E&Z BEBIG)
Source Description
This 137Cs source manufactured by E&Z BEBIG is used in manual and remote-controlled LDR
afterloading systems. The source (Figure 20) is composed of a cylindrical pollucite pellet, 0.85 mm
in diameter and 3.6 mm long. The pellet is encapsulated in stainless steel with total length of 5.2 mm
and with an outer diameter of 1.65 mm. The 137Cs radionuclide is uniformly distributed in the active
pellets. The source is asymmetric due to the hemispherical end.
Figure 20. Materials and dimensions (mm) of the E&Z BEBIG CSM11 source.[62]
110 HEBD report
Publications
The CSM11 source has been studied by Ballester et al.[62] and by Otal et al.[194] using both
Monte Carlo methods. Calculation guidelines described in Li et al.[17] and TG-43U1[2] have been
closely adhered to in both studies. Only calculated data have been published for this source, which
belongs in the category of conventionally encapsulated 137Cs and 192Ir similar in design to existing
ones where a single dosimetric study is sufficient.[17]
Ballester et al.[62] used GEANT3 MC code to generate an away-along table and TG-43
parameters. Electron transport was performed and a cutoff energy of 10 keV was taken for both
electron and photons. The origin of coordinates is the geometrical center of the source instead of the
center of the active part as recommended in this report. The reported dosimetric data are of poor
quality because they are too noisy. They obtained a = 1.096 ± 0.002 cGyh–1U–1.
Otal et al.[194] studied this source considering the same dimensions and composition materials
as Ballester et al.[62] but using the GEANT4 code and using track-length kerma estimator. In this case
authors considered the origin of coordinates at the center of the active part, as it is recommended in
this report. Parameters and simulation conditions were the same that in Ballester et al.[62] They
obtained a = 1.094 ± 0.002 cGyh–1U–1 and derived gL(r) and F(r,) along with an away-along
table. The data presented are of low noise.
Consensus Dataset
Because Ballester et al.[62] considered the origin of coordinates at the capsule center and the
their data have larger statistical uncertainties, CON = 1.094 ± 0.002 cGyh–1U–1 (see Table XLIV),
g (r) (see Table XLV), and CONF(r,) (see Table L) were taken from the study of Otal et al.[194] An
CON L
away-along table derived from the recommended consensus datasets is presented for TPS quality
assurance purposes (see Table LI).
Table L. F(r,) for the E&Z BEBIG CSM11 source. Extrapolated data are underlined.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 2.5 3 4 6 8 10
0 0.968 0.968 0.964 0.960 0.963 0.957 0.957 0.956 0.954 0.952 0.954 0.953 0.956
1 0.969 0.969 0.969 0.969 0.969 0.966 0.965 0.965 0.963 0.963 0.965 0.966 0.966
2 0.976 0.976 0.974 0.972 0.971 0.970 0.969 0.969 0.968 0.968 0.970 0.972 0.972
5 0.977 0.977 0.973 0.969 0.967 0.965 0.964 0.964 0.964 0.965 0.967 0.969 0.971
8 0.973 0.973 0.968 0.963 0.962 0.961 0.961 0.961 0.962 0.963 0.964 0.967 0.969
10 0.966 0.966 0.963 0.960 0.959 0.959 0.959 0.959 0.960 0.961 0.964 0.965 0.968
15 0.957 0.957 0.958 0.959 0.959 0.960 0.960 0.961 0.962 0.964 0.966 0.968 0.970
20 0.962 0.962 0.964 0.966 0.966 0.967 0.968 0.969 0.970 0.971 0.973 0.974 0.976
25 0.973 0.973 0.973 0.973 0.974 0.975 0.975 0.976 0.977 0.977 0.979 0.981 0.981
30 0.978 0.978 0.979 0.980 0.981 0.982 0.982 0.983 0.983 0.983 0.984 0.985 0.986
40 0.988 0.988 0.988 0.988 0.989 0.990 0.990 0.990 0.990 0.990 0.991 0.992 0.992
Table L (continued).
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 2.5 3 4 6 8 10
50 0.994 0.994 0.994 0.994 0.994 0.995 0.995 0.995 0.995 0.995 0.995 0.996 0.996
60 0.997 0.997 0.997 0.997 0.997 0.997 0.998 0.998 0.998 0.998 0.998 0.998 0.998
70 0.999 0.999 0.998 0.998 0.999 0.999 1.000 0.999 1.000 0.999 0.999 0.999 0.999
80 1.000 1.000 1.000 0.999 0.999 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1
100 1.000 1.000 1.000 0.999 0.999 1.000 0.999 0.999 1.000 0.999 1.000 0.999 1.000
110 1.000 1.000 0.999 0.998 0.998 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999
120 0.998 0.998 0.997 0.996 0.997 0.996 0.996 0.997 0.997 0.997 0.997 0.997 0.997
130 0.992 0.992 0.992 0.992 0.993 0.993 0.994 0.994 0.994 0.994 0.995 0.995 0.995
140 0.987 0.987 0.987 0.987 0.988 0.989 0.989 0.989 0.990 0.990 0.991 0.991 0.991
150 0.976 0.976 0.978 0.980 0.980 0.982 0.983 0.983 0.984 0.984 0.986 0.986 0.987
155 0.972 0.972 0.974 0.976 0.976 0.978 0.979 0.979 0.979 0.981 0.982 0.983 0.984
160 0.969 0.969 0.970 0.971 0.972 0.974 0.975 0.976 0.976 0.977 0.979 0.980 0.981
165 0.970 0.970 0.971 0.972 0.972 0.972 0.972 0.973 0.973 0.974 0.976 0.977 0.978
170 0.980 0.980 0.979 0.978 0.977 0.975 0.975 0.974 0.974 0.975 0.976 0.978 0.979
172 0.983 0.983 0.982 0.981 0.979 0.978 0.977 0.977 0.977 0.978 0.979 0.980 0.980
175 0.983 0.983 0.983 0.983 0.983 0.982 0.982 0.981 0.981 0.980 0.982 0.983 0.985
178 0.980 0.980 0.982 0.984 0.982 0.982 0.982 0.980 0.980 0.981 0.982 0.983 0.982
179 0.980 0.980 0.978 0.976 0.977 0.977 0.977 0.976 0.977 0.977 0.977 0.979 0.980
180 0.974 0.974 0.968 0.962 0.967 0.971 0.969 0.972 0.974 0.973 0.967 0.972 0.978
Table LI. QA away-along data [cGyh–1U–1] for the E&Z BEBIG CSM11 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01990 0.0202 0.0201 0.01994 0.01973 0.01922 0.01860 0.01707 0.01521 0.01328 0.01145 0.00981
6 0.0276 0.0280 0.0277 0.0274 0.0271 0.0262 0.0251 0.0224 0.0193 0.01640 0.01374 0.01149
5 0.0397 0.0402 0.0398 0.0392 0.0385 0.0369 0.0350 0.0301 0.0249 0.0203 0.01646 0.01338
4 0.0637 0.0644 0.0634 0.0620 0.0605 0.0566 0.0517 0.0411 0.0323 0.0251 0.01953 0.01541
3 0.1149 0.1154 0.1125 0.1089 0.1047 0.0939 0.0815 0.0586 0.0414 0.0305 0.0228 0.01742
2 0.263 0.260 0.248 0.233 0.214 0.1721 0.1345 0.0824 0.0527 0.0358 0.0258 0.01918
1.5 0.472 0.460 0.427 0.383 0.333 0.241 0.173 0.0956 0.0581 0.0381 0.0271 0.01989
1 1.090 1.018 0.874 0.701 0.547 0.336 0.218 0.1079 0.0626 0.0400 0.0280 0.0204
0.5 4.76 3.67 2.23 1.357 0.878 0.438 0.256 0.1167 0.0657 0.0411 0.0287 0.0207
0 6.07×108 15.86 4.29 1.938 1.094 0.486 0.27 0.1200 0.0668 0.0416 0.0289 0.0209
–0.5 4.78 3.68 2.23 1.356 0.878 0.437 0.26 0.1167 0.0657 0.0411 0.0287 0.0207
–1 1.095 1.033 0.875 0.700 0.547 0.335 0.217 0.1078 0.0626 0.0399 0.0280 0.0204
–1.5 0.479 0.468 0.431 0.384 0.333 0.241 0.1731 0.0955 0.0581 0.0381 0.0271 0.01988
–2 0.266 0.265 0.251 0.234 0.214 0.1720 0.1344 0.0823 0.0526 0.0358 0.0258 0.01918
–3 0.1173 0.1173 0.1142 0.1102 0.1055 0.0941 0.0816 0.0586 0.0414 0.0305 0.0228 0.01741
–4 0.0651 0.0653 0.0644 0.0629 0.0611 0.0569 0.0519 0.0411 0.0323 0.0251 0.01952 0.01540
–5 0.0404 0.0407 0.0404 0.0398 0.0390 0.0373 0.0351 0.0302 0.0249 0.0203 0.01645 0.01337
–6 0.0279 0.0283 0.0282 0.0279 0.0274 0.0265 0.0253 0.0225 0.01936 0.01638 0.01373 0.01148
–7 0.0202 0.0205 0.0204 0.0202 0.0200 0.01944 0.01877 0.01713 0.01523 0.01327 0.01144 0.00980
112 HEBD report
A.5. High Dose Rate 60Co sources
A.5.1. GK60M21 (E&Z BEBIG)
Source Description
This 60Co HDR source (E&Z BEBIG) is similar in shape and materials to other commercially
available 192Ir HDR sources. This source model is composed of a central cylindrical active core made of
metallic 60Co, 3.5 mm in length and with a diameter of 0.6 mm. This active core is covered by a
cylindrical 316L stainless steel cover of 1 mm external diameter. This 60Co HDR source is shown
schematically in Figure 21.
Figure 21. Materials and dimensions (mm) of the E&Z

BEBIG model GK60M21 source.[11]
Publications
The MC GEANT4 code was used by Ballester et al.[11] to obtain the dose rate distribution
following the Li et al.[17] prerequisites. Only the gamma part of the 60Co spectrum was considered. The
beta spectrum contribution to the dose was assumed to be negligible.[28] A cutoff energy of 10 keV was
used for both photons and electrons. Ballester et al., scored kerma and dose separately to account for
the electronic disequilibrium near the source due to the high energy of the photons emitted. For
points located at distances of less than 1 cm from the source they scored dose, while for distances
where electronic equilibrium is achieved they scored kerma. They derived TG-43U1 parameters[2]
and an away-along table.
Selvam and Bhola[195] reproduced the Ballester et al.[11] study but using the EGSnrc code. They
derived only an away-along table. The comparison of away-along tables from both studies reveals
consistency between both studies except at y = 0.25 cm and z = –0.25, z = 0, and z = 0.25 cm where
the Ballester et al.[11] data had an error.
Consensus Dataset
An average CON = (1.089 ± 0.055) cGyh–1U–1 was taken (see Table LIII). Selvam and
Bhola[195] data are taken as consensus for CONgL(r) (Table LII) because of higher resolution close to
the source and the previously noted error at r = 0.25 cm in the other published study. Ballester et
al.[11] data for F(r,) (Table LIV) is taken as consensus data because of the previous demonstration of
away-along table agreement. Derived from the consensus TG-43 dataset, an away-along dose rate
table is presented (cGyh–1U–1) for TPS quality assurance purposes (Table LV).
Table LII. Consensus radial dose function values for 60Co HDR sources.
Values inside the source are in italics. Extrapolated data are underlined.
gL(r)
E&Z BEBIG E&Z BEBIG
GK60M21 Co0.A86
r [cm] L = 0.35 cm L = 0.35 cm
0 0.830 0.830
0.1 0.830 0.830
0.15 0.961 0.961
0.2 1.037 1.037
0.25 1.072 1.072
0.3 1.077 1.077
0.35 1.066 1.066
0.4 1.050 1.050
0.45 1.037 1.037
0.5 1.028 1.028
0.6 1.019 1.019
0.65 1.018 1.018
0.75 1.011 1.011
1 1 1
1.5 0.992 0.992
2 0.984 0.984
3 0.968 0.968
4 0.952 0.952
5 0.935 0.936
6 0.919 0.919
8 0.884 0.884
10 0.849 0.849
Table LIII. Dose rate constant for HDR 60Co sources.
CON Statistical uncertainty CON/GL(r,)

Seed Name (Manufacturer) [cGy·h ·U-1] [cGycm2h–1U–1]
-1
(k = 1)
GK60M21 (E&Z BEBIG) 1.089 0.5% 1.100
Co0.A86 (E&Z BEBIG) 1.092 0.5% 1.103
114 HEBD report
Table LIV. F(r,) for the E&Z BEBIG 60Co HDR GK60M21 source. Values inside the source are in italics.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.894 0.894 0.923 0.951 0.931 0.931 0.934 0.932 0.928 0.926 0.927 0.939 0.936 0.941
1 0.898 0.898 0.925 0.953 0.934 0.933 0.934 0.935 0.934 0.933 0.934 0.940 0.940 0.943
2 0.895 0.895 0.924 0.952 0.937 0.937 0.937 0.939 0.940 0.942 0.943 0.945 0.945 0.947
3 0.898 0.898 0.925 0.953 0.938 0.939 0.939 0.939 0.940 0.942 0.945 0.946 0.947 0.949
4 0.898 0.898 0.926 0.954 0.938 0.938 0.938 0.938 0.940 0.942 0.944 0.946 0.947 0.949
5 0.898 0.898 0.927 0.956 0.941 0.940 0.939 0.941 0.942 0.944 0.945 0.946 0.947 0.949
6 0.899 0.899 0.929 0.958 0.943 0.943 0.942 0.944 0.944 0.946 0.947 0.948 0.949 0.952
8 0.909 0.909 0.934 0.959 0.946 0.947 0.948 0.949 0.951 0.951 0.952 0.953 0.954 0.958
10 0.914 0.914 0.938 0.962 0.951 0.952 0.953 0.954 0.955 0.957 0.957 0.959 0.959 0.961
15 0.930 0.930 0.950 0.969 0.967 0.968 0.967 0.969 0.969 0.969 0.969 0.970 0.971 0.971
20 0.671 0.671 0.966 0.983 0.977 0.978 0.978 0.979 0.979 0.980 0.979 0.980 0.981 0.980
25 0.719 0.719 0.983 0.984 0.984 0.984 0.984 0.985 0.985 0.984 0.985 0.985 0.985 0.986
30 0.769 0.769 0.989 0.992 0.988 0.989 0.989 0.989 0.989 0.989 0.989 0.989 0.989 0.989
40 0.862 0.862 0.997 0.995 0.993 0.995 0.994 0.994 0.994 0.994 0.994 0.994 0.994 0.994
50 0.918 0.918 1.000 1.000 0.997 0.997 0.997 0.998 0.998 0.997 0.997 0.997 0.997 0.997
60 0.957 0.957 0.999 1.001 0.998 0.998 0.997 0.998 0.998 0.998 0.998 0.998 0.998 0.998
70 0.974 0.974 0.999 1.001 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999
80 0.990 0.990 0.995 0.999 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 0.990 0.990 0.994 0.999 1.000 0.999 1.000 0.999 0.999 1.000 0.999 1.000 0.999 0.999
110 0.975 0.975 0.997 1.001 0.999 0.999 1.000 1.000 1.000 0.999 0.999 0.999 0.999 0.999
120 0.956 0.956 0.999 1.000 0.999 0.998 0.999 0.999 0.999 0.999 0.999 0.999 0.999 0.999
130 0.918 0.918 1.001 0.999 0.996 0.997 0.997 0.997 0.997 0.997 0.997 0.996 0.996 0.997
140 0.862 0.862 0.994 0.995 0.995 0.995 0.995 0.996 0.995 0.996 0.995 0.995 0.995 0.995
150 0.773 0.773 0.983 0.996 0.991 0.991 0.991 0.990 0.991 0.990 0.990 0.990 0.990 0.990
155 0.724 0.724 0.971 0.984 0.985 0.985 0.985 0.985 0.986 0.986 0.986 0.986 0.986 0.986
160 0.678 0.678 0.943 0.976 0.980 0.979 0.978 0.978 0.978 0.979 0.978 0.978 0.979 0.978
165 0.843 0.843 0.897 0.951 0.967 0.967 0.966 0.966 0.967 0.967 0.967 0.968 0.968 0.968
170 0.763 0.763 0.832 0.902 0.939 0.938 0.938 0.937 0.938 0.939 0.940 0.940 0.942 0.944
172 0.770 0.770 0.819 0.869 0.918 0.917 0.917 0.919 0.920 0.921 0.923 0.924 0.926 0.929
174 0.737 0.737 0.786 0.835 0.885 0.885 0.884 0.885 0.887 0.890 0.892 0.896 0.898 0.901
175 0.857 0.857 0.857 0.857 0.857 0.857 0.858 0.861 0.864 0.868 0.871 0.875 0.878 0.883
176 0.813 0.813 0.813 0.813 0.814 0.814 0.816 0.821 0.827 0.833 0.838 0.842 0.846 0.855
177 0.791 0.791 0.783 0.775 0.767 0.750 0.755 0.762 0.771 0.779 0.787 0.794 0.799 0.812
178 0.861 0.861 0.823 0.785 0.747 0.671 0.650 0.658 0.672 0.687 0.698 0.709 0.719 0.741
179 0.913 0.913 0.856 0.799 0.742 0.629 0.560 0.549 0.568 0.585 0.602 0.616 0.631 0.659
180 0.833 0.833 0.819 0.792 0.737 0.627 0.540 0.511 0.530 0.546 0.564 0.580 0.596 0.623
Table LV. QA away-along data[cGyh–1U–1] for the E&Z BEBIG 60Co GK60M21 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01901 0.01909 0.01904 0.01896 0.01889 0.01859 0.01809 0.01662 0.01478 0.01288 0.01109 0.00950
6 0.0260 0.0265 0.0263 0.0262 0.0261 0.0255 0.0245 0.0219 0.01882 0.01590 0.01331 0.01112
5 0.0381 0.0387 0.0385 0.0383 0.0379 0.0366 0.0346 0.0295 0.0243 0.01972 0.01595 0.0129
4 0.0608 0.0614 0.0612 0.0605 0.0595 0.0560 0.0512 0.0408 0.0316 0.0244 0.01894 0.0149
3 0.1106 0.1108 0.1099 0.1077 0.1038 0.0929 0.0804 0.0577 0.0410 0.0297 0.0221 0.0169
2 0.254 0.254 0.247 0.233 0.213 0.1708 0.1330 0.0809 0.0518 0.0352 0.0251 0.01859
1.5 0.458 0.454 0.429 0.384 0.333 0.239 0.1714 0.0939 0.0570 0.0375 0.0263 0.01928
1 1.055 1.024 0.881 0.703 0.547 0.333 0.215 0.1060 0.0614 0.0395 0.0273 0.01979
0.5 4.75 3.81 2.27 1.361 0.875 0.434 0.254 0.1148 0.0643 0.0407 0.0279 0.0201
0 4.20×108 16.45 4.35 1.941 1.089 0.483 0.270 0.1181 0.0654 0.0411 0.0281 0.0202
–0.5 4.22 3.78 2.27 1.361 0.875 0.434 0.254 0.1148 0.0643 0.0407 0.0278 0.0201
–1 0.836 1.021 0.882 0.704 0.547 0.334 0.215 0.1060 0.0614 0.0395 0.0272 0.01979
–1.5 0.308 0.445 0.430 0.385 0.333 0.240 0.1714 0.0939 0.0570 0.0376 0.0263 0.01927
–2 0.147 0.242 0.246 0.233 0.214 0.1711 0.1331 0.0809 0.0518 0.0352 0.0251 0.01858
–3 0.0606 0.1003 0.1075 0.1071 0.1037 0.0930 0.0805 0.0577 0.0410 0.0298 0.0221 0.01687
–4 0.0347 0.0524 0.0584 0.0596 0.0592 0.0560 0.0513 0.0409 0.0317 0.0244 0.01895 0.01492
–5 0.0225 0.0315 0.0360 0.0372 0.0374 0.0365 0.0346 0.0295 0.0243 0.0197 0.01594 0.01294
–6 0.01583 0.0205 0.0241 0.0251 0.0255 0.0253 0.0245 0.0219 0.01884 0.0159 0.01331 0.01112
–7 0.01175 0.01440 0.01701 0.01795 0.01833 0.01836 0.01805 0.01661 0.01479 0.0129 0.01110 0.00951
A.5.2. Co0.A86 (E&Z BEBIG)
Source Description
The geometric design and materials of the E&Z BEBIG 60Co model Co0.A86 source are shown
schematically in Figure 22. It is very similar to the E&Z BEBIG model GK60M21 source (Appendix
A.5.1), both in design and materials. The model Co0.A86 source differs from the model GK60M21 in
that it has a smaller active core (0.5 mm in diameter for this source vs. 0.6 mm in diameter for the
GK60M21) and a more rounded capsule tip. The model Co0.A86 source is composed of a central
cylindrical active core made of metallic 60Co, 3.5 mm in length and with a diameter of 0.5 mm. The
active core is covered by a cylindrical stainless steel capsule 0.15 mm thick with an external diameter of
1 mm.
Publications
Granero et al.[12] used GEANT4 MC code to obtain the dose rate distribution adhering to the Li et
al.[17] prerequisites. The same type of study described in Appendix A.5.1 for the GK60M21 source
model was done for the present source. Selvam and Bhola[195] also reproduced the Granero et al.[12]
study but using the EGSnrc code, obtaining only an away-along table. The comparison of away-
along tables from both studies reveals that at y = 0.25 cm and z = –0.25, z = 0, and z = 0.25 cm the
Granero et al.[12] data are underestimated. This is the same typo as in Ballester et al.[11] data for the
116 HEBD report
model GK60M21 source. However, some inconsistencies are observed in the Selvam and Bhola[195]
data because at large distances from the source their data are not symmetric.
Figure 22. Materials and dimensions (mm) of the E&Z BEBIG model
Co0.A86 source.[12]
Consensus Dataset
An average CON = 1.092 ± 0.011 cGyh–1U–1 was taken. Because of the error in Granero et
al.[12] data, Selvam and Bhola[195] data for CONgL(r) (Table LII) and Granero et al.[12] data for F(r,)
(Table LVI) were taken as consensus data. Derived from the consensus TG-43 dataset, an away-
along dose rate table is presented (cGyh–1U–1) for TPS quality assurance purposes (Table LVII).
Table LVI. F(r,) for the E&Z BEBIG 60Co HDR Co0.A86 source. Values inside the source are in italics.
r (cm)
(deg) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7 8 10
0 0.984 0.984 0.965 0.946 0.923 0.945 0.947 0.945 0.944 0.945 0.945 0.947 0.947 0.952
1 0.981 0.981 0.971 0.961 0.952 0.947 0.947 0.946 0.946 0.948 0.949 0.951 0.952 0.955
2 0.977 0.977 0.971 0.964 0.963 0.952 0.952 0.952 0.953 0.955 0.956 0.957 0.959 0.959
3 0.963 0.963 0.964 0.965 0.958 0.956 0.957 0.958 0.958 0.959 0.960 0.961 0.962 0.964
4 0.951 0.951 0.961 0.971 0.961 0.959 0.960 0.961 0.962 0.962 0.964 0.965 0.966 0.968
5 0.938 0.938 0.958 0.977 0.965 0.962 0.962 0.963 0.965 0.965 0.966 0.967 0.968 0.970
6 0.939 0.939 0.958 0.977 0.966 0.964 0.964 0.964 0.965 0.965 0.966 0.967 0.968 0.970
8 0.944 0.944 0.962 0.979 0.971 0.967 0.967 0.967 0.968 0.968 0.969 0.970 0.971 0.972
10 0.952 0.952 0.967 0.983 0.978 0.971 0.971 0.971 0.972 0.972 0.973 0.973 0.974 0.975
15 0.970 0.970 0.976 0.981 0.981 0.979 0.979 0.979 0.979 0.979 0.980 0.980 0.980 0.981
20 0.734 0.734 0.982 0.989 0.990 0.985 0.985 0.985 0.985 0.985 0.985 0.986 0.986 0.986
25 0.788 0.788 1.001 0.995 0.989 0.989 0.989 0.989 0.989 0.989 0.990 0.990 0.990 0.990
30 0.821 0.821 0.994 0.994 0.991 0.993 0.993 0.993 0.993 0.992 0.993 0.993 0.993 0.992
40 0.894 0.894 1.002 0.999 0.998 0.996 0.996 0.996 0.996 0.996 0.996 0.996 0.996 0.996
50 0.942 0.942 1.002 0.998 0.996 0.998 0.998 0.998 0.998 0.998 0.998 0.998 0.998 0.999
60 0.974 0.974 0.998 1.003 0.999 0.999 0.999 0.999 0.999 0.998 0.998 0.999 0.999 0.999
70 0.991 0.991 1.000 0.998 1.000 1.000 1.000 1.000 1.000 0.999 1.000 1.000 1.000 1.000
80 1.000 1.000 0.999 1.000 1.002 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
90 1 1 1 1 1 1 1 1 1 1 1 1 1 1
100 1.000 1.000 0.997 1.001 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000 1.000
110 0.995 0.995 1.002 1.000 0.998 1.000 1.000 1.000 1.000 0.999 0.999 1.000 0.999 1.000
120 0.982 0.982 0.999 1.002 0.999 0.999 0.999 0.999 0.999 0.998 0.998 0.998 0.999 0.998
130 0.957 0.957 1.002 0.995 0.996 0.999 0.999 0.998 0.998 0.998 0.997 0.998 0.998 0.998
140 0.913 0.913 1.006 0.997 0.992 0.996 0.995 0.995 0.995 0.995 0.995 0.995 0.995 0.995
150 0.843 0.843 0.996 0.990 0.988 0.991 0.991 0.990 0.990 0.990 0.990 0.991 0.991 0.991
155 0.806 0.806 0.995 0.984 0.988 0.987 0.986 0.986 0.987 0.986 0.986 0.987 0.987 0.987
160 0.735 0.735 0.968 0.980 0.979 0.980 0.981 0.981 0.981 0.981 0.981 0.982 0.982 0.982
165 0.939 0.939 0.953 0.966 0.970 0.969 0.969 0.969 0.970 0.970 0.970 0.971 0.972 0.973
170 0.925 0.925 0.940 0.955 0.959 0.954 0.954 0.955 0.956 0.957 0.958 0.960 0.961 0.962
172 0.923 0.923 0.934 0.944 0.954 0.944 0.944 0.946 0.947 0.949 0.950 0.951 0.952 0.954
174 0.917 0.917 0.926 0.936 0.945 0.934 0.934 0.936 0.937 0.939 0.941 0.942 0.944 0.947
175 0.971 0.971 0.960 0.949 0.938 0.927 0.928 0.930 0.932 0.934 0.936 0.938 0.939 0.942
176 0.973 0.973 0.960 0.947 0.934 0.922 0.923 0.925 0.928 0.929 0.931 0.934 0.936 0.939
177 0.966 0.966 0.954 0.942 0.931 0.919 0.919 0.921 0.924 0.926 0.928 0.930 0.932 0.936
178 0.991 0.991 0.971 0.952 0.932 0.913 0.914 0.918 0.920 0.922 0.924 0.925 0.929 0.933
179 1.005 1.005 0.981 0.957 0.932 0.908 0.908 0.911 0.913 0.915 0.918 0.918 0.921 0.926
180 0.996 0.996 0.975 0.953 0.931 0.909 0.907 0.907 0.909 0.912 0.915 0.914 0.914 0.921
118 HEBD report
Table LVII. QA away-along data [cGyh–1U–1] for the E&Z BEBIG 60Co Co0.A86 source.
y (cm)
z (cm) 0 0.25 0.5 0.75 1 1.5 2 3 4 5 6 7
7 0.01923 0.01941 0.01949 0.01941 0.01928 0.01889 0.01832 0.01675 0.01488 0.01295 0.01115 0.00955
6 0.0266 0.0269 0.0270 0.0268 0.0266 0.0259 0.0248 0.0220 0.01893 0.01598 0.01338 0.01118
5 0.0391 0.0395 0.0395 0.0391 0.0387 0.0371 0.0349 0.0297 0.0244 0.01981 0.01602 0.0130
4 0.0621 0.0629 0.0626 0.0617 0.0604 0.0565 0.0516 0.0411 0.0318 0.0245 0.01902 0.0150
3 0.1125 0.1138 0.1123 0.1093 0.1050 0.0936 0.0809 0.0580 0.0412 0.0299 0.0222 0.0169
2 0.259 0.260 0.251 0.235 0.215 0.1718 0.1336 0.0812 0.0520 0.0353 0.0252 0.01865
1.5 0.466 0.465 0.434 0.387 0.335 0.241 0.1721 0.0942 0.0572 0.0377 0.0264 0.01933
1 1.050 1.045 0.888 0.707 0.549 0.335 0.216 0.1064 0.0616 0.0396 0.0273 0.01985
0.5 4.99 3.87 2.28 1.366 0.878 0.436 0.255 0.1152 0.0645 0.0408 0.0279 0.0202
8
0 4.29×10 16.51 4.36 1.948 1.092 0.484 0.271 0.1185 0.0656 0.0413 0.0282 0.0203
–0.5 5.04 3.85 2.27 1.365 0.878 0.436 0.255 0.1153 0.0646 0.0409 0.0279 0.0202
–1 1.059 1.032 0.886 0.705 0.549 0.335 0.216 0.1064 0.0616 0.0396 0.0273 0.01986
–1.5 0.448 0.456 0.432 0.386 0.334 0.241 0.1721 0.0943 0.0572 0.0377 0.0264 0.01934
–2 0.248 0.253 0.248 0.234 0.215 0.1716 0.1336 0.0812 0.0520 0.0353 0.0252 0.01865
–3 0.1079 0.1098 0.1103 0.1081 0.1043 0.0934 0.0808 0.0579 0.0412 0.0299 0.0222 0.01693
–4 0.0597 0.0606 0.0610 0.0608 0.0597 0.0563 0.0515 0.0411 0.0318 0.0245 0.01901 0.01496
–5 0.0377 0.0382 0.0384 0.0384 0.0381 0.0368 0.0348 0.0297 0.0244 0.0198 0.01602 0.01300
–6 0.02577 0.0260 0.0261 0.0262 0.0262 0.0256 0.0247 0.0220 0.01891 0.0160 0.01337 0.01117
–7 0.01855 0.01877 0.01887 0.01892 0.01891 0.01867 0.01817 0.01670 0.01485 0.0129 0.01115 0.00954
APPENDIX B
REFERENCES FOR HIGH-ENERGY SOURCES NOT COMMERCIALLY AVAILABLE

AND WITHOUT CONSENSUS DATASETS
This appendix includes sources for which consensus datasets have not been produced. These
sources are no longer commercially available as of January 2010. The aim is to guide users still using
them in the clinic and in the case of retrospective dosimetry trials. Any manipulation of these
datasets is the responsibility of the individual user or company.
B.1. LDR-HDR-PDR 192Ir
Platinum-clad seed
These sources were manufactured by Alpha-Omega Services, Inc. (Bellflower, CA) and could
be obtained equidistantly spaced in nylon ribbons for interstitial implantation. The source is 3 mm
long and 0.5 mm in diameter. The construction incorporates a 0.3 mm diameter core of 10% Ir and
90% Pt surrounded by a 0.1 mm thick cladding of Pt. The dose distribution of this seed was studied
by Thomason and Higgins[180] with TLD measurements along the transverse axis. In a second
publication, Thomason et al.[182] made TLD measurements and performed MC calculations in an
unbounded liquid water phantom to produce dose distribution D(r,) tables. In three separate
publications, Mainegra et al.[178,179] and Capote et al.[177] gave TG-43 dosimetry parameters for this
source. Radial dose functions were obtained for a 20 cm high and 20 cm in diameter cylindrical
phantom. The absorbed dose distribution at close distances required in intravascular brachytherapy
applications taking into account the electron emission was studied by Patel et al.[196] for this source.
Ballester et al.[172] presented dosimetric results for this source using MC methods. The simulated
phantom was a 40 cm radius sphere. TG-43 parameters and a 2D rectangular dose rate table (away-
along table) were given. Data were obtained under full-scatter conditions and for an extended range,
with higher-spatial resolution in high-dose gradient areas.
Models IC W.4040 to I CW .4300, I C W.3040 to I CW.3300 , I R F.2 , I REC.1

These are wires 0.5 mm and 0.6 mm in total diameter, encapsulated with 0.1 mm Pt, with the
same composition as that of the 0.3 mm diameter wires. The ICW series sources were manufactured
by Amersham (UK); the 0.6 mm diameter wires may be single pins 7.3 cm in length (Models
ICW.4040 to ICW.4300) or double hairpins 13.1 cm in length (Models ICW.3040 to ICW.3300).
Different models cover a range of nominal reference kerma in air. The IRF series sources were
manufactured by CIS Bio International (France). These take the form of 0.5 mm diameter wires
(IRF.2, 14 cm long), single pins (Models IREC.1, 3 cm long, and IREL.1, 5 cm long), or double
length hairpins (Models IREC.1, 7.2 cm long, and IREL.1, 11.2 cm long). Pérez-Calatayud et al.[187]
presented dose rate tables in water in rectangular coordinates for sources 1 cm and 5 cm in length,
120 HEBD report
obtained by MC methods. The data are presented for 0° 90° because the sources are
symmetrical. TG-43 dose parameters are included for these two lengths. Attenuation coefficients to
be used with Sievert dose calculation models are provided, minimizing the differences with respect
to MC calculations and showing the points where significant deviations exist. The maximum
differences between the dose rate tables for wires of diameter 0.3 mm, 0.5 mm, and 0.6 mm are less
than 2%, and occur at distances closer than 3 mm from the source (D. Granero, private
communication).
VariSource classic
This source was used in the Varian HDR afterloading system. It had an active length of
10 mm, active diameter of 0.35 mm, total diameter of 0.61 mm, distance from active end to tip of 1
mm, and nitinol encapsulation. Meigooni et al.[197] presented an experimental study for this source
using LiF TLD chips and radiochromic film. Wang and Sloboda[86] presented complete MC-derived
dose rate tables in water in away-along tables up to 10 cm perpendicular to and along the source. The
data are presented for 0° 180°. TG-43 dose parameters are included. A 30 cm diameter sphere
was used in the simulations. Karaiskos et al.[198] presented MC results for TG-43 parameters and
functions. A spherical water phantom 30 cm in diameter was used in the simulations. Results are in
agreement with previous studies in the literature. Angelopoulos et al.[170] used the MC method to
obtain TG-43 dose parameters for this source, and compared it with the new Varian source. Lliso et
al.[199,200] proposed some analytical expressions to be used to represent TG-43 dose parameters,
thereby avoiding the use of tables for a set of HDR-PDR sources, including this Varian source. Wang
and Li[27] studied the dose rate distribution with MC methods up to radial distances of 1 cm,
accounting for the charged particle nonequilibrium and beta particle contribution, for intravascular
treatment planning applications.
Nucletron PDR old design

This source was used in the microSelectron PDR afterloading system (Nucletron). It has a
0.6 mm active length, 0.6 mm active diameter, 1.1 mm total diameter, 0.55 mm distance from active
end to tip, and stainless steel encapsulation. Williamson and Li[47] used MC to obtain dose rate tables
in water in a rectangular coordinate table, up to 7 cm perpendicular to and along the source, both
above and below the transverse plane, along with TG-43 dose parameters. A 30 cm diameter water
sphere was used in the simulations.
B.2 LDR 137Cs
Pellet
These sources can be configured in user-programmable trains consisting of active and inactive
pellets in the Selectron-LDR (Nucletron) remote afterloading system. They are spherical in shape
with active diameter 1.5 mm and external diameter 2.5 mm, and are encapsulated with stainless steel.
Pérez-Calatayud et al.[201] presented a one-dimensional dose rate table in water, up to 10 cm away

from the source, normalized to 1 U, obtained by MC in a 40 cm high and 40 cm in diameter water
cylinder phantom. TG-43 parameters are included, and a polynomial correction replacing
Meisberger’s one is proposed for use with the theoretical point source model.
CSM1
This source was manufactured by CIS Bio International (France). It was used in the Curietron
afterloader (E&Z BEBIG). It has a total length of 3.5 mm, active length of 1.6 mm, internal diameter
of 0.8 mm and external diameter of 1.75 mm. One end is flat and the other end is rounded; the active
length is not centered with respect to the total length. The capsule is stainless steel. Granero et al.[202]
obtained TG-43 parameters for this source from MC simulations, together with an away-along dose
rate table. Dose data were presented for 0° 180° because of source asymmetry. The simulation
was done in a 40 cm high and 40 cm in diameter water cylinder phantom.
CSM2
This source was manufactured by CIS Bio International (France). It was used for manual
afterloading and in the Curietron afterloader (E&Z BEBIG). It has the same dimensions and
composition materials as model CSM3 (manufactured by E&Z BEBIG, section A.4.1) but with the
central seed inactive. Williamson[141] presented a dose rate table in water in rectangular coordinates,
up to 5 cm perpendicular to and along the source, normalized to 1 U, obtained by the MC method.
The data are presented for 0° 90° because the source was assumed to be symmetrical. Liu et
al.[190] produced TG-43 datasets using the Sievert algorithm with effective active length and
attenuation coefficients obtained in the previous work of Williamson. The source is considered to be
linear with the radioactivity uniformly distributed along its central axis. Pérez-Calatayud et al.[191]
produced TG-43 datasets and an away-along dose rate table using MC, where source asymmetries
were considered. Also, the radial range of tables was extended and the angular resolution in the
anisotropy function was increased to include angles close to the source ends. The phantom was a
40 cm radius sphere.
CSM2a
This source was manufactured by CIS Bio International (France) and was used at the top in
vaginal dome applicators designed for manual afterloading. It has the same dimensions and
composition materials as model CSM3 (section A.4.1) but with the eyelet end seed inactive. Pérez-
Calatayud et al.[203] presented a dose rate table in water in rectangular coordinates, up to 10 cm
perpendicular to and along the source, normalized to 1 U, obtained by MC methods. The data are
presented for 0° 180° because the source is asymmetrical. The phantom was a cylinder 40 cm
high and 40 cm in diameter.
122 HEBD report
CDCS-J
This source was manufactured by Amersham (UK) and used in manual and automatic
afterloading systems. It has a total length of 20 mm, active length of 13.5 mm, internal diameter of
1.65 mm, and external diameter of 2.65 mm. Both ends are flat, one of them with an eyelet. The
capsule is stainless steel. Williamson[141] presented a dose rate table in water in rectangular
coordinates, up to 7 cm away from and along the source, normalized to 1 U, obtained by the MC
method, with data for 0° 180° due to the asymmetry. The phantom simulated was a liquid
water sphere with R = 15 cm which does not provide full scatter conditions within 1% for r 5 cm.
Effective active length and attenuation coefficients to be used with a Sievert dose calculation model
are provided as well, to minimize the differences relative to MC calculations, showing the points
where deviations are significant. Liu et al.[190] produced TG-43 datasets using the Sievert algorithm
with effective active length and attenuation coefficients obtained in the previous work of Williamson.[141]
6500/6D6C
This source was manufactured by 3M. It has a total length of 20 mm, active length of
13.8 mm, internal diameter of 1.19 mm and external diameter of 3.05 mm. Both ends are flat, one of
them with an eyelet. The capsule is stainless steel. In Williamson[141] this source model was studied,
and a detailed 2D dose rate distribution was obtained with MC methods. It takes into account the
asymmetry of the source, and a spherical water phantom of 15 cm radius was used. Liu et al.[190] have
also studied this source to obtain TG-43 functions and parameters, but supposing the source to be
symmetrical. They used the Sievert summation method with the effective parameters calculated by
Williamson in the previously cited work. Because the calculation of the 2D dose rate distribution
using the TG-43 parameters given in this work presents discrepancies up to 7% close to the
longitudinal axis with respect to the data given by Williamson for this source, Pérez-Calatayud et
al.[70] studied this source using the MC method, and presented dose rate distributions following the
TG-43 formalism and in a 2D rectangular dose rate table. The simulated phantom was a 40 cm
radius, liquid water sphere. With respect to the previous study the data radial range and angular grid
resolution were increased, and TG-43 data are now consistent with the away-along dose rate table
and in good agreement with the Williamson data.
Gold-matrix series 67-800

This source was manufactured by Radiation Therapy Resources. It has a total length of
20.9 mm, active length of 15 mm, internal diameter of 0.8 mm, and external diameter of 3 mm. As
for the previous source model, this source was first studied by Williamson[141] by means of MC
methods, giving a 2D away-along dose rate distribution in an unbounded liquid water phantom, but
making the approximation that the source is symmetrical with respect to its long axis. Liu et al.[190]
have also studied this source to obtain TG-43 functions and parameters. They used the Sievert
summation method with the effective parameters calculated by Williamson in the previously cited
work. The 2D away-along dose rate table calculated using the TG-43 parameters obtained by Liu et
al., does not reproduce the corresponding table calculated by Williamson within the required
accuracy (differences up to 6% exist between the two calculations). Perez-Calatayud et al.[70] studied
this source using the MC method, and presented dose rate distributions following the TG-43
formalism and in a 2D rectangular dose rate table. The simulated phantom was a 40 cm radius, liquid
water sphere. With respect to the previous study, the data radial range and the angular grid resolution
were increased, and TG-43 data are now consistent with the away-along dose rate table and in good
agreement with the Williamson data.
CDCS-M
This source was manufactured by Amersham (UK) and used in manual and automatic
afterloading systems. It has a total length of 21 mm, active length of 15 mm, internal diameter of
1.3 mm, and external diameter of 2.3 mm. Both ends are flat, one of them with an eyelet. The
capsule is stainless steel. Casal et al.[63] presented a dose rate table in water in rectangular
coordinates, obtained by the MC method, with data for 0° 180° due to the design asymmetry.
TG-43 parameters were also included. Differences with the CDCS-J model were observed, being
more significant at distances close to the source. The phantom used in the simulation was a cylinder
of water 40 cm high and 40 cm in diameter.
CDC.K1-K3 and CDC.K4

The CDC.K1-K3 source was manufactured by Amersham (UK) and used in manual and
automatic afterloading systems. It has a total length of 8 mm, active length of 2.1 mm, internal
diameter of 2.1 mm, and external diameter of 3.2 mm. Both ends are rounded; the active volume is a
sphere. The source is encapsuled in stainless steel. The CDC.K4 source was used in manual and
automatic afterloading systems. It has a total length of 8 mm, active length of 4.2 mm, internal
diameter of 2.1 mm, and external diameter of 3.2 mm. Both ends are rounded; the active volumes are
two spheres. Diffey and Klevenhagen[204] did a TLD study of these sources. In this publication the
ratio of absolute dose at different angles and the absolute dose along the transverse axis were
measured at distances between 1 cm and 5 cm from the source. Pérez-Calatayud et al.[68] presented
for both source models a dose rate table in water in rectangular coordinates, obtained by MC
methods. The data are presented for 0° 90° due to the symmetry. TG-43 parameters are
included. The simulated phantom consisted of a cylinder of water 40 cm high and 40 cm in diameter.
CDC 12015 to CDC 12035

These sources were manufactured by Amersham (UK) and used in manual and remote-
controlled afterloading systems. They have a total length of 5 mm, internal diameter of 1.1 mm and
external diameter of 1.8 mm. The active volume is composed of one or three spheres, each 1.1 mm in
diameter. The capsule is stainless steel. Pérez-Calatayud et al.[68] presented a dose rate table in water
in rectangular coordinates obtained by MC methods. The data are presented for 0° 90° due to
the symmetry. TG-43 parameters are also included. The phantom used in simulations was a cylinder
of water 40 cm high and 40 cm in diameter.
124 HEBD report
CDC.G and CDC.H

These sources were manufactured by Amersham (UK). They have a total length of 20 mm,
active length of 13.5 mm, Pt capsule thickness of 0.5 mm, and active diameters of 3.05 mm (CDC.G)
and 2.05 mm (CDC.H). Breitman[205] presented a dose rate table in water in rectangular coordinates
normalized to 1 mgRaeq using the interval method, which is a simplification of the Sievert integral.
In a comparison with experimental data obtained by Klevenhagen,[206] discrepancies are shown near
the longitudinal axis. Breitman also presented data for model CDC.A sources from Amersham.
These sources were available in different lengths to be used in interstitial techniques prior to the use
of iridium wires.
B.3 HDR 60Co
Ralstron Type-1, Type-2, and Type-3

These sources were manufactured by Shimazdu Corporation (Japan) and used in the Ralstron
remote afterloader. Their configuration consists of two active pellets (cylinders 1 mm 1 mm) either
in contact or 9 mm or 11 mm apart. All three models have a 3 mm external diameter. Papagiannis et
al.[10] used MC to obtain the dose rate in water, and reported rectangular coordinate dose rate tables
and TG-43 dose parameters. Selvam et al.[207] have reported a systematic error for y = 0.75 cm in the
away-along table of Papagiannis et al., for the type 2 source model.
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Dose Calculation for Photon-Emitting

High Energy Brachytherapy Source Dosimetry (HEBD)

DISCLAIMER: This publication is based on sources and

The AAPM does not endorse any products, manufacturers,

2012 by American Association of Physicists in Medicine

Date Change Comments

© 2012 by American Association of Physicists in Medicine

All rights reserved.

Jose Perez-Calatayud (Chair)

Keywords: brachytherapy, TG-43 formalism, high-energy brachytherapy sources, Monte Carlo,

II. PHYSICAL CHARACTERISTICS OF HIGH-ENERGY PHOTON-EMITTING

III. CONSIDERATIONS APPLYING THE TG-43U1 FORMALISM

IV. CONSENSUS DATASET METHODOLOGY .............................................................. 20

V. RECOMMENDATIONS ON DOSIMETRY CHARACTERIZATION

VI. RECOMMENDED DOSIMETRY DATASETS FOR HIGH-ENERGY

APPENDIX A: Detailed Recommended Dosimetry Datasets for High-Energy

A.1.9. M-19 (Source Production and Equipment)..................................................... 75

APPENDIX B: References for High-Energy Sources Not Commercially Available

REFERENCES .............................................................................................................................. 125

1. Reference polar coordinate system for high-energy photon-emitting sources

2. Materials and dimensions (mm) of the Nucletron mHDR-v1 source.[47] ..................... 46

3. Materials and dimensions (mm) of the Nucletron mHDR-v2 source.[93] ..................... 53

6. Materials and dimensions (mm) of the Varian Medical Systems GammaMed

7. Materials and dimensions (mm) of the Varian Medical Systems GammaMed

I. Physical properties of radionuclides considered in this report. Data have

II. Polynomial coefficients of the correction factors (CF) used to quantitatively

III. Interpolation and extrapolation recommendations for high-energy (low-energy)[3]

IV. Dose rate constant for HDR 192Ir sources................................................................. 50

V. Radial dose function values for HDR sources. Interpolated/extrapolated data

XXVI. Dose rate constant for PDR sources. ........................................................................ 83

XLIV. Dose rate constant of 137Cs sources........................................................................... 104

II. PHYSICAL CHARACTERISTICS OF HIGH-ENERGY PHOTON-

III. CONSIDERATIONS APPLYING THE TG-43U1 FORMALISM TO

1. Dosimetric modeling of seeds using the point-source approximation is facilitated by averaging

III.A. Phantom size effects

Sphere Cylinder Cube

III.B. Dose calculation grid size and interpolation accuracy

Table III. Interpolation and extrapolation recommendations for high-energy (low-energy)[3]

Parameter r < rmin rmin < r rmax r > rmax

A study by Pujades-Claumarchirant et al.[79] has been performed for high-energy sources to

III.C. Dosimetry parameter dependence on active length

= 1.12 GL ( r0 , 0 )  cGy h 1U 1  (4)

= 1.094 GL ( r0 , 0 )  cGy h 1U 1  , (5)

IV. CONSENSUS DATASET METHODOLOGY

1. For conventional encapsulated sources similar in design to existing or previously existing

1. Internal geometry and description of the source.

IV.A. Dose rate constant

IV.B. Radial dose function

IV.C. 2D anisotropy function

V. RECOMMENDATIONS ON DOSIMETRY CHARACTERIZATION

V.A. Preparation of dosimetry parameters

V.A.1. Air-kerma strength

V.A.2. Dose rate constant

V.A.3. Radial dose function

In addition to the TG-43U1 recommendations, investigators must consider using coupled

V.A.4. 2D Anisotropy function

The recommendations of the AAPM TG-43U1 report[2] are to be followed.

V.B. Reference data and conditions for brachytherapy dosimetry

V.B.1. Radionuclide data

The influence of photon spectrum choice on brachytherapy dosimetry parameters such as

V.B.2. Reference media

V.C. Methodological recommendations for experimental dosimetry

V.C.1. Detector choice

= 1.12 GL ( r0 , 0 ) cGy h 1U 1 (4)

= 1.094 GL ( r0 , 0 ) cGy h 1U 1 , (5)