A dosimetric intercomparison of brachytherapy facilities in Ireland, Scotland and the North of England

Background and purpose: A dosimetric intercomparison of brachytherapy remote afterloading units in Ireland, Scotland and the North of England has been carried out involving 9 radiotherapy centres, and sampling 5 HDR and 6 LDR units. Materials and methods: Absolute calibrations have been performed in air on both HDR and LDR sources. The results are expressed in terms of a ratio of local to calibrated value. Frequency distributions were obtained for the multi-source LDR units by individually measuring each source. Using these distributions the effect of non-uniform source strength on the dose rate at Manchester point A was assessed for a typical clinical brachytherapy insertion for carcinoma of the cervix. Both frequency and dose rate distribution curves were modeled using normal statistics and characterised in terms of the mean (μ) and standard deviation (σ). Results: Evaluation of the HDR units indicated a mean ratio of 1.008 (±0.01) while for LDR the mean ratio was 0.997 (±0.02). The LDR frequency distributions demonstrated a variation of σ values extending from 1.4 to 3.0% of μ. It was shown that this non-uniformity in source strength introduced an uncertainty in the treatment planning process of between 0.8 and 1.8% when compared to the assumption of uniform source strength. Conclusions: The results of this intercomparison indicate dosimetric consistency between centres for both LDR and HDR units. The distribution of LDR source strengths were within expected limits and the resultant dose rate distributions were considered clinically acceptable