Dosimetric Evaluation of High dose rate (HDR) Brachytherapy Planning Software

8th Health Sciences Research Assembly

SAFDAR KHAN, ABDUL QADIR JANGDA Department of Oncology The Aga khan university hospital Karachi
Introduction Result
Dose at reference points comparison. The graphs on left side shows doses when time is simulated on both planning software. The graphs on right side shows does when software take time independently.

Brachytherapy is the placement of sealed radionuclides close to the surface to be treated; the treatment area is accessible either externally or through body cavities. High dose rate (HDR) brachytherapy uses a quite intense source of radiation (typically 10 Curie source made of Iridium 192) delivered through temporarily placed applicators. Figure No.1 GammaMed Plus ix 3/24 ix HDR Afterloader. The purpose of this study was to compare two HDR brachytherapy planning software in terms of prescription dose and doses to organs at risk (OAR). Three patients with intra-cavity application were planned on both systems using orthogonal radiographs. The dose is specified at certain clinically useful reference points as per Manchester System.

Method
Figure No.2 Titanium Fletcher-style Applicator Set Defined Geometry CT Compatible. Orthogonal radiographs of three patients acquired and planned with BrachyVision and ABACUS planning software using Tandem and Ovoid applicator along with GammaMedplus ix afterloader brachytherapy machine as transporter of radioactive source. . Comparison made in terms of doses, 1) If dwell times kept identical . 2) Plan optimizations done using standard features of the software. Figure No.3 BrachyVision treatment plan for HDR brachytherapy treatment of the cervix. The does are measured on reference points and in rectum and bladder (OAR).

The doses to organs at risk are within 10% if optimization is done for the same dose to prescription point. There is slight difference between the dose calculations performed by the 2 treatment planning systems. These discrepancies are caused by the differences in the calculation methodology adopted by the two systems.

Conclusion
Both software come up with the doses at prescription points and at OAR within 10%. However BrachyVision offers , system supporting combined database, patient registration. Image acquisition via lm scanner, DICOM 3, ultrasound, or directly from an Acuity treatment planning, simulation & verication system Interactive planning and optimization Plan evaluation and analysis Sum up we can concluded that brackyvision is more Usability, exibility and freedom as compare to ABACUS.

Figure No.4 3D Model view of Brachyvision treatment plan

Figure No.6 Reference point A on both lateral sides is 2 cm from uterine canal and 2 cm from the mucous membrane of the lateral superior fornix of the vagina in the plane of the uterus.

Acknowledgement
Special thanks to the Medical Physics group at AKUH: Dr. Amjad Hussain(Sr. Medical Physicist), Abdul Qadir Jangda (Sr. Medical Physicist) and Asad yousf (Medical physicist) for their mentorship.

References
VARIAN BRACHYTHERAPY brachyvision treatment planning manual . ICRU 38 guidelines for referrence points. Online AAPM Task Group No. 43 data for brachy therapy. F.M Khan Physics of radiation therapy. Research paper by American Association of Medical Dosimetrists 2012 .

Contact
Safdar khan Trainee Medical physicist E-mail: safdar.mushkin@aku.edu

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