Highlights
- •Modern 3D brachytherapy treatment planning systems have become highly complex.
- •Meticulous commissioning of such systems is essential but somewhat overlooked.
- •Up-to-date commissioning items for GYN HDR brachytherapy planning are presented.
- •The template covers 43 recommended items to consider (including their rationale).
- •It can also serve as a guide for allocation of the required time and resources.
Abstract
Purpose
Correct commissioning of treatment planning systems (TPSs) is important for reducing
treatment failure events. There is currently no comprehensive and robust methodology
available for TPS commissioning in modern brachytherapy. This review aimed to develop
a comprehensive template for commissioning modern 3D-image-based brachytherapy TPSs
for high dose rate (HDR) gynaecological applications.
Methods
The literature relevant to TPS commissioning, including both external beam radiation
therapy (EBRT) and brachytherapy, as well as guidelines by the International Atomic
Energy Agency (IAEA), the American Association of Physicists in Medicine (AAPM), and
the European Society for Radiotherapy and Oncology (ESTRO) were searched, studied
and appraised. The applied relevant EBRT TPS commissioning tests were applied to brachytherapy.
The developed template aimed to cover all dosimetric and non-dosimetric issues.
Results
The essential commissioning items could be categorized into six parts: geometry, dose
calculation, plan evaluation tools, plan optimization, TPS output, and end-to-end
verification. The final template consists of 43 items. This paper presents the purpose
and role of each test, as well as tolerance limits, to facilitate the use of the template.
Conclusion
The information and recommendations available in a collection of publications over
many years have been reviewed in order to develop a comprehensive template for commissioning
complex modern 3D-image-based brachytherapy TPSs for HDR gynaecological applications.
The up-to-date and concise information contained in the template can aid brachytherapy
physicists during TPS commissioning as well as devising a regular quality assurance
program and allocation of time and resources.
Keywords
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Article info
Publication history
Published online: August 05, 2020
Accepted:
July 28,
2020
Received in revised form:
July 19,
2020
Received:
March 25,
2020
Identification
Copyright
© 2020 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
