eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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abstract:
Original paper

Dosimetric comparison of AcurosTM BV and AAPM TG-43 formalism for interstitial iridium-192 high-dose-rate brachytherapy

Roussakis Yiannis
1
,
Antorkas Georgios
1
,
Georgiou Leonidas
1
,
Strouthos Iosif
2
,
Karagiannis Efstratios
2
,
Zamboglou Constantinos
2
,
Ferentinos Konstantinos
2
,
Zamboglou Nikolaos
2
,
Anagnostopoulos Georgios
1

  1. Department of Medical Physics, German Oncology Center, University Hospital of the European University, Limassol, Cyprus
  2. Department of Radiation Oncology, German Oncology Center, University Hospital of the European University, Limassol, Cyprus
J Contemp Brachytherapy 2024; 16, 3
DOI: https://doi.org/10.5114/jcb.2024.140893
Online publish date: 2024/06/24
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Purpose:
The aim of this study was a retrospective dosimetric comparison of iridium-192 (192Ir) high-dose-rate (HDR) interstitial brachytherapy plans using model-based dose calculation algorithm (MBDCA) following TG-186 recommendations and TG-43 dosimetry protocol for breast, head-and-neck, and lung patient cohorts, with various treatment concepts and prescriptions.

Material and methods:
In this study, 59 interstitial 192Ir HDR brachytherapy cases treated in our center (22 breast, 22 head and neck, and 15 lung) were retrospectively selected and re-calculated with TG-43 dosimetry protocol as well as with AcurosTM BV dose calculation algorithm, with dose to medium option based on computed tomography images. Treatment planning dose volume parameter differences were determined and their significance was assessed.

Results:
For the breast planning target volume (PTV), TG-43 formalism calculated higher D90%, V95%, V100%, and V150% values than AcurosTM BV, ranging from 2.2% to 5.4% (mean differences), as it did for the head and neck cases, ranging from 2.5% to 4.7% and for the interstitial lung cases, ranging from 2.2% to 4.4%, showing statistical significance (p < 0.001). For the skin D0.1cm3, D0.2cm3, and D1cm3, the values were overestimated by TG-43, with a mean absolute differences of 1.4, 1.8, and 2.0 Gy, respectively for the breast, and 1.0 Gy for all DVH statistics for the head and neck cases compared with AcurosTM BV (p < 0.001). Ipsilateral lung V5Gy was also higher in TG-43-calculated plans, with a mean difference of 1.0% and 1.1% in the breast and lung implants, respectively. For the chest wall TG-43, the respective overestimation in D0.1cm3 and D1cm3 was 0.8 and 0.8 Gy for the breast, and 0.4 and 0.3 Gy for the interstitial lung cases, respectively.

Conclusions:
The TG-43 algorithm significantly overestimates the dose to PTVs and surrounding organs at risk (OARs) for breast, head and neck, and lung interstitial implants. TG-43 overestimation is in accordance with previous findings for breast and head and neck. To our knowledge, this is also exhibited for AcurosTM BV for the first time in interstitial lung HDR brachytherapy.

keywords:

HDR brachytherapy, AcurosTM BV, TG-43, heterogeneity correction, bounded anatomy

  
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