F-A Siebert¹*, C Kirisits², T Paulsen Hellebust³, D Baltas⁴, F Verhaegen⁵, S Camps⁶, B Pieters⁷, G Kovacs⁸, B Thomadsen⁹, (1) Clinic of Radiotherapy, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel,DE, (2) Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, AT, (3) Department of Medical Physics, Oslo University Hospital, Oslo,NO, (4) Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, DE, (5) Department of Radiation Oncology (MAASTRO), GROW, School for Oncology and Developmental Biology, Maastricht, NL, (6) Faculty of Electrical Engineering, University of Technology Eindhoven, Eindhoven, NL, (7) Academic Medical Center Amsterdam, Amsterdam, NL, (8) Interdisciplinary Brachytherapy Unit, University of Lubeck/University Hospital Schleswig-Holstein Campus Lubeck, Lubeck, DE, (9) University of Wisconsin, School of Medicine and Public Health, Department of Medical Physics, Madison, WI

(Sunday, 7/12/2020)   [Eastern Time (GMT-4)]

Room: AAPM ePoster Library

Purpose:
Ultrasound (US) is an important imaging modality in brachytherapy (BT). In particular for low-dose-rate (LDR) and high-dose-rate (HDR) prostate implants, transrectal US is widespread; but European guidelines for quality assurance (QA) or US in BT are lacking. The purpose of this study was to develop such guidelines.

Methods:
The BRAPHYQS and UroGEC working groups of GEC-ESTRO developed guidelines describing QA methods for US in BT. Existing literature was studied in detail for a comprehensive review of the state of the art, experiences of the working group members were summarized, QA procedures were systematically reviewed and tested.

Results:
The main aim of the guidelines is consideration of digital US systems and stepping devices as the basic imaging tool for guidance and navigation during implantation and for US-based treatment planning.
The guidelines are structured in 12 sections. After the introduction and general physical aspects of US, commercially-available US QA phantoms for BT are presented and described. General tests of the US device are shown in the next section. One section focuses on QA for stepping devices. This is of great importance as both in-out and rotational positions of the stepper are often linked to the treatment planning system for the purposes of image acquisition, needle guidance, and needle reconstruction and have direct impact to the treatment planning process. The template calibration for BT prostate treatment is described in detail using adequate water temperature as well as implant needle reconstruction. In the last sections, daily checks, and a summary QA sheet on test procedures including test frequency and limits are presented.

Conclusion:
The recommendations explain practical test procedures of US devices in BT. They will help to implement a QA program with standardized procedures to ensure performance at a high level of quality in daily clinical routine of US in BT.

Keywords

Brachytherapy, Ultrasonics, Quality Assurance

Taxonomy

TH- Brachytherapy: Calibration & Quality Assurance

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