Vienna, Austria

ESTRO 2023

Session Item

May 13
16:45 - 17:45
Strauss 2
Asa Carlsson Tedgren, Sweden;
Frida Dohlmar, Sweden
Proffered Papers
17:06 - 17:15
GEC-ESTRO recommendations for commissioning a brachytherapy TPS
Marisol De Brabandere, Belgium


GEC-ESTRO recommendations for commissioning a brachytherapy TPS

Marisol De Brabandere1, Luc Beaulieu2, Mauro Carrara3, Catherine Dejean4, Claire Dempsey5, Chris Lee6, Joshua Mason7, Mark J Rivard8, Jose Perez-Calatayud9, Ryan Smith10, Jacco Steenhuijsen11, Renate Walter12, Geraldine Workman13, Anysja Zuchora14, Frank-Andre Siebert15

1University Hospital Leuven, Dept of Radiation Oncology , Leuven, Belgium; 2Université Laval, Faculty of Science and Engineering, Québec, Canada; 3IAEA, Division of Human Health, Vienna, Austria; 4Centre Antoine-Lacassagne, Dept. Medical Physics, Nice, France; 5Calvary Mater Newcastle, School of Health Sciences, Newcastle, Australia; 6Clatterbridge Cancer Centre, Department of Medical Physics, Liverpool, United Kingdom; 7Imperial College Healthcare NHS Trust, Dept. Radiation Oncology, London, United Kingdom; 8Alpert Medical School of Brown University, Dept. of Medical Physics, Providence, RI, USA; 9La Fe Hospital, Radiotherapy Department, Valencia, Spain; 10The Alfred Hospital, Dept. of Radiation Oncology, Melbourne, Australia; 11Catharina Hospital Eindhoven, Dept. of Radiation Oncology, Eindhoven, The Netherlands; 12University Hospital Augsburg, Dept. of Radiation Oncology, Augsburg, Germany; 13Northern Ireland Cancer Centre, Dept. of Radiation Oncology, Belfast, United Kingdom; 14University Hospital Galway, Medical Physics and Bioeengineering, Galway, Ireland; 15UKSH, Clinic of Radiotherapy / Campus Kiel, Kiel, Germany

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Purpose or Objective

Brachytherapy (BT) treatment planning systems (TPS) are indispensable tools for computing the dose distribution and treatment time of brachytherapy patient plans. For a safe treatment it is essential that source data, calculation parameters, and planning functionalities affecting the TPS output are modelled and/or validated properly. Currently there are only a few dedicated societal reports available to guide users through the commissioning process of a BT TPS. The GEC-ESTRO BRAPHYQS working group in cooperation with the AAPM is working on a report with practical recommendations for TPS commissioning for HDR/PDR BT as well as LDR seed implant BT TPS.

Material and Methods

The BRAPHYQS working group was extended with further experts in the field for this project. After extensive literature research and internal discussions, an outline and sections were defined. Due to the high availability and use worldwide, this report focuses on TG-43-based algorithms only; for advanced model-based dose calculation algorithms, the users are referred to existing reports such as TG-186. Five main subtopics have been defined to guide the commissioning process: (a) geometry and imaging, (b) source specification, (c) dose calculation accuracy and representation, (d) (library) applicator specification, and (e) output/data transfer and reporting.


A set of commissioning tests was designed and summarized in tables per topic, including the frequency, tolerance, and possible tools and resources to be used. A CT-based DICOM set of a phantom with well-defined structures was prepared, allowing users to test image import, display and manipulation, as well as geometric properties and functionalities of the TPS. This DICOM set will be made available through the GEC-ESTRO/BRAPHYQS website. A range of imaging modalities used in modern BT is covered such as CT, MRI, and US. Furthermore, a selection of extensive tests is described in greater detail within the Appendices. The recommended tests in this report can be used at the time of TPS commissioning as well as after software upgrades or for annual constancy checks.


BRAPHYQS is finalizing the recommendations to validate the calculational accuracy and performance of HDR/PDR and LDR BT TPSs. This report will provide a comprehensive set of practical tools (tables/checklists, phantom data, detailed tests) to ensure high quality BT dosimetry calculations. It is aimed to finalize and publish the report in 2023.