Applications and Experiences of Quality Control by Ognyan Ivanov

By Ognyan Ivanov

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Typical examples of a gynecological intracavitary treatment and a 3D-dose distribution around it 4. The scope of the quality control process The emphasis in this chapter is to cover the physics aspects of a quality control program for HDR brachytherapy and to promote awareness of the tolerances and frequencies of the basic tests required. Those tests are based on the likelihood of a malfunction and the seriousness The Need for Quality Control in High Dose Rate Brachytherapy 15 or potential consequences of an unnoticed malfunction that would affect the patients and/or to the personnel involved in the clinical procedure if a malfunction occurs and is not identified during normal treatment applications.

1. Typical configuration of commercially available HDR treatment unit Since there are several types of HDR sources available in the market, Table 1 presents some of the main physical characteristics that are useful for entry-independent calculation analytical and numerical calculation methods. 9 Stainless steel Model: Table 1. Specific characteristics of the 192Ir high dose rate sources. Dimensions are in mm. Adapted from [3] 3. Main treatment sites High dose rate machines may have clinical indications in the treatment of a variety of different organs either as a primary treatment or as a complementary therapy.

19 The Need for Quality Control in High Dose Rate Brachytherapy Description Minimum requirements Test frequency Action level Safety systems Warning lights Daily/3M* - Room monitor Daily/3M* - Communication equipment Daily/3M* - Emergency stop 3M - Treatment interrupt 3M - Door interlock W - Power loss 3M - Applicator and catheter attachment W - Obstructed catheter W - Integrity of transfer tubes and applicators 3M - Timer termination Daily - Contamination test A - Leakage Radiation A - Emergency equipment (forceps, survey meter) Daily/3M* - Practicing emergency procedures 6M - Hand crank functioning *** A - Hand-held monitor 3M/A** - Source calibration SE/3M >5% Source position Daily/3M* >2 mm Length of treatment tubes 6M >1 mm Irradiation timer Date, time and source strength in treatment unit Transit time effect 6M >1 % Physics parameters Daily - 3M - (3M–quarterly; 6M–biannual; A–annual; SE–source exchange; W=weekly Adapted from [3] *Daily checks are assumed to be an implicit part of normal operation and registered in a logbook.

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