Development and international multicentre pilot testing of a postal dosimetry audit methodology for high dose rate brachytherapy

Abstract

Background and Purpose: Dosimetry audits are essential for reducing errors in brachytherapy. A postal dosimetry audit methodology was developed and tested in an international multicentre pilot, to assess the accuracy of the Reference Air Kerma Rate of 192Ir and 60Co brachytherapy sources. Materials and Methods: A compact phantom made of polymethyl methacrylate was developed to accommodate two catheters, a radiophotoluminescence dosimeter (RPLD) for dose measurements and a Gafchromic (RTQA2) film strip for source position verification. Deviations of the audit setup from TG-43 conditions were quantified experimentally and compared to previous Monte Carlo (MC) simulations. A measurement uncertainty budget was estimated for the RPLD analysis. The methodology was tested in an international pilot study consisting of 59 dosimeter sets among 48 centres from 11 countries. Results: The experimental correction factors showed good agreement with previous MC simulations, and the total correction factor accounting for non-water equivalence, lack of scatter and beam quality was found to be 1.029 ± 0.009 for 192Ir and 1.059 ± 0.007 for 60Co sources, to be employed in audit measurement. The total uncertainty budget was estimated to be 2.24 % (k = 1). In the multicentre study, the ratio between measured and reported user dose ranged from 0.968 to 1.049, with all irradiated dosimeter sets within ± 5 %, and 54 out of 59 within ± 3 %. Conclusions: The methodology was tested in an international multicentre pilot study and has shown good performance validating the uncertainty budget.

Keywords

• HDR brachytherapy
• Dosimetry audit
• Quality Assurance