Five complete MR-conditionally approved ring sets, including fifteen tandems, and two additional rings, were commissioned at an institution intending to use them in an MRI planning environment with a Bravos HDR brachytherapy remote afterloader. Channel length, radiograph, autoradiograph, ring offset, and treatment interrupt measurements were performed, and applicators were assessed in both CT and MRI. During commissioning, one ring was found to be defective and was returned to the manufacturer for a replacement. The eventual complete applicator suite (including the replacement ring) was found to follow the manufacturer-provided specifications, including those delineated in vendor-provided 3D virtual models and those defined within the manufacturer's instructions for use documentation. Based on this work, an offset correction of -0.4 cm will be used for all tested rings using the Bravos system's internal distal dwell position correction feature during treatment preparation. This study reiterated the requirement for careful commissioning of each applicator intended for clinical service considering the intended use and the planned clinical environment and work processes.
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http://dx.doi.org/10.1002/acm2.14094 | DOI Listing |
Brachytherapy
November 2024
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA.
Purpose: High dose rate brachytherapy (HDR-BT) has been shown to be an effective treatment for prostate cancer, with treatment plan quality dependent on a number of factors. In this work, we report on the overall performance of our ultrasound (US)-based workflow and the impact of several treatment-specific variables.
Methods And Materials: Patients who underwent HDR-BT (boost, monotherapy, and retreatment) using Varian Bravos/US from 2021 to 2023 were sampled for this study.
Brachytherapy
November 2024
Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY.
Background And Purpose: The upgrade of major equipment can be disruptive to clinical operations and introduce risk as policy and procedures need to adapt to new technical possibilities and constraints. We describe here the transition from GammaMedPlus-iX to Bravos in a busy brachytherapy clinic, involving four afterloaders across two sites.
Material And Methods: Our clinic employs three high-dose-rate remote afterloaders in four dedicated treatment vaults at the main site and a fourth afterloader at a regional location.
J Appl Clin Med Phys
August 2024
Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
Purpose: The purpose of this study was to validate the use of a model-based dose calculation algorithm (MBDCA), Acuros BV, for high dose rate brachytherapy treatment planning for a community-based hospital with a Bravos afterloader. Based on published AAPM recommendations, this work details a practical approach for community-based clinics to complete initial validation of Acuros BV, in order to add a MBDCA to a TG-43 based brachytherapy treatment planning program.
Methods: Source dimensions and materials used in Acuros BV and TG-43 source models were compared to the physical source.
J Appl Clin Med Phys
November 2023
Radiation Oncology, University of Washington, Seattle, Washington, USA.
Five complete MR-conditionally approved ring sets, including fifteen tandems, and two additional rings, were commissioned at an institution intending to use them in an MRI planning environment with a Bravos HDR brachytherapy remote afterloader. Channel length, radiograph, autoradiograph, ring offset, and treatment interrupt measurements were performed, and applicators were assessed in both CT and MRI. During commissioning, one ring was found to be defective and was returned to the manufacturer for a replacement.
View Article and Find Full Text PDFEur J Endocrinol
March 2023
Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, United Kingdom.
Objective: Trauma-induced steroid changes have been studied post-hospital admission, resulting in a lack of understanding of the speed and extent of the immediate endocrine response to injury. The Golden Hour study was designed to capture the ultra-acute response to traumatic injury.
Design: We conducted an observational cohort study including adult male trauma patients <60 years, with blood samples drawn ≤1 h of major trauma by pre-hospital emergency responders.
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