Dose-rate to water calibrations for brachytherapy sources from the end-user perspective

Independent primary standards for brachytherapy photon-emitting source calibration in terms of dose-rate to water have been developed within the framework of the Euramet T2.J06 project. The introduction of dose-rate to water calibration presents an important change in clinical brachytherapy dosimetry that is expected to result to improved dosimetric accuracy. Nevertheless, as with any change in dosimetry for radiation therapy purposes, a phase-in period of well concerted actions aimed at precluding ambiguities and accidents at the end-user level is necessary. The overall uncertainty budget of clinical brachytherapy applications, as well as current trends in brachytherapy treatment planning system dose-calculation algorithms, also need to be considered for a realistic assessment of the net benefit of improving source calibration accuracy. (authors)