2011 Joint AAPM/COMP Meeting
Silvia Pella
For more information about the American Association of Physicists in Medicine, visit aapm.org/

Brachytherapy is the first conformal radiation therapy. A sealed source is placed in or in
contact with the tumor providing dose to the tumor with small volumes of normal tissue
irradiated. It became more sophisticated with the usage of remote afterloader. With this,
our responsibility as physicists increased and became critical in ensuring an accurate and
precise treatment planning and delivery. The ability to deliver a correct treatment is
conditioned by the precision of the source placement at the dwell point/points predicted
by the treatment planning system (TPS). The introducing of the CT based planning gave
the possibility of reconstructing not only the correct shape of a treated volume but the
correct reconstruction of the applicators, the catheters, and localizing the first dwell
position (the stopping point) of the radioactive source that will deliver the treatment.

The first condition of delivering a good and accurate treatment is correct catheter and
applicators reconstruction, correct distance evaluation to each dwell position, and
extremely good and well organized quality control program before the applicators and
connectors are used and before the treatment plan is sent to the treatment console.

This lecture will provide an introduction into the understanding of High Dose Radiation
Therapy QA and commissioning of the applicators. It will provide detailed descriptions
of the remote afterloader, applicators, and all the quality assurance tools necessary for
organizing and running a safe and secure High dose radiation therapy program (HDR) in
a cancer center.

Learning Objective:

 Understanding the HDR process: technical and practical
 Understanding the importance of a well implemented quality assurance program
 Understanding the different aspects of commissioning and calibrating of the
radioactive source and the applicators used in HDR.
 Challenges and solutions of running a HDR program in a cancer center

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