Achieving Quality in Brachytherapy

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ISBN: 9780750305549 | 0750305541
Cover: Hardcover
Copyright: 1/1/1999

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Brachytherapy Quality Assurance describes all aspects of quality assurance as it pertains to brachytherapy. It discusses the rationales for the various items requiring tesing, & provides details from the tests performed. It is a detailed & comprehensive reference for practising radiation oncology physicists. Suitable for readers with some knowledge of brachytherapy procedures, the basics of the sources & equipment.

Preface	p. xiii
General Considerations in Quality Management in Brachytherapy	p. 1
Importance of quality assurance	p. 1
Principles of quality assurance	p. 2
Error	p. 8
Systematic error	p. 8
Random error	p. 8
Error reduction	p. 8
Error prevention	p. 8
Error detection	p. 11
Guidance in the use of tools	p. 12
Training	p. 13
Staffing	p. 16
Items not covered	p. 18
Terminology revisited	p. 19
Sources for information	p. 19
Human performance implications for quality management	p. 20
Summary	p. 20
Quality Management for Manual Loading, Low Dose Rate Brachytherapy Sources	p. 21
Sources for a permanent inventory	p. 21
Acceptance tests	p. 21
Periodic tests	p. 33
Sources ordered for particular patients	p. 36
Integrity	p. 37
Linear uniformity--wire (not seeds, which are too short to matter)	p. 37
Assay of source strength	p. 37
Penetration and dose distribution	p. 40
Summary	p. 41
Quality Management for a Treatment Plan	p. 42
Evaluating whether the plan contains errors	p. 42
Direct checks on the input data	p. 42
Does the plan make sense?	p. 52
Indirect checks on the input data	p. 53
Evaluating the appropriateness of the plan	p. 54
Concerns in evaluating the appropriateness of a treatment plan	p. 55
Tools	p. 59
Summary	p. 76
Quality Management for Manually Loaded, Low Dose Rate Applications	p. 78
Applications involving sources from a standing inventory	p. 78
Source loading	p. 78
Calculation of the removal time	p. 80
During the treatment	p. 81
At the removal	p. 82
Applications involving temporary sources ordered for the treatment	p. 82
Source loading	p. 82
Calculation of the removal time	p. 86
During the treatment	p. 87
At the removal	p. 88
Applications involving sources ordered for a permanent implant	p. 88
Source strength check	p. 88
Source position checks	p. 89
Implants using radium or caesium needles	p. 94
Summary	p. 95
Quality Management for High Dose Rate Units	p. 97
Periodic evaluations (at the beginning of each treatment day)	p. 98
Safety checks	p. 99
Dosimetry checks	p. 101
Initial checks	p. 114
Safety checks	p. 114
Dosimetry checks	p. 115
Ancillary device checks	p. 117
Acceptance testing and commissioning	p. 119
Operation	p. 119
Detection of obstructions	p. 119
Source retraction--automatic (emergency)	p. 120
Source retraction--manual	p. 120
Loss of source	p. 120
Checks during treatment	p. 120
Checks after treatment	p. 121
Summary	p. 121
Pulsed dose rate units	p. 122
Quality Management for High Dose Rate Treatment Plans	p. 126
Error prevention	p. 127
Protocols	p. 128
Forms	p. 128
Independent second person	p. 128
Error detection	p. 128
Independent physicist's review	p. 129
Physician's review	p. 144
Predelivery checks	p. 145
Indicators of 'reasonableness'	p. 147
Gynaecological intracavitary insertions	p. 147
Intraluminal insertions	p. 150
Interstitial implants	p. 152
When the checks fail	p. 155
Summary	p. 157
Some recommendations from the report of Task Group 59 of the American Association of Physicists in Medicine	p. 158
Quality Management for Low and Medium Dose Rate Remote Afterloaders	p. 161
Advanced remote afterloaders	p. 162
Checks per patient	p. 163
Periodic checks	p. 166
Basic remote afterloaders	p. 168
Checks per patient	p. 170
Periodic checks	p. 171
Procedural quality considerations with basic remote afterloaders	p. 174
Reported operational problems with LDR remote afterloaders	p. 175
Simple source loaders	p. 176
Dose rate considerations	p. 176
Summary	p. 178
Quality Management for Brachytherapy Appliances	p. 179
Intracavitary applicators	p. 179
Gynaecological appliances	p. 180
Intraluminal applicators	p. 192
Interstitial equipment	p. 193
Source-holding needles	p. 193
Catheters	p. 196
Flexible needles and fixed-length plastic tubes	p. 200
Templates	p. 200
Surface applicators	p. 204
Eye applicators	p. 205
Skin applicators	p. 206
Intraoperative applicators	p. 207
Summary	p. 207
Quality Management for Dosimetric Treatment Planning	p. 210
Localization	p. 211
Radiographic localization	p. 212
Sectional localization	p. 218
Ultrasound localization	p. 221
Source simulation	p. 222
Dose calculation	p. 225
Digitization	p. 227
Geometric reconstruction	p. 228
Dose calculation	p. 228
Plan output	p. 235
Summary	p. 237
Appendix 9A	p. 237
References	p. 240
Index	p. 247
Table of Contents provided by Syndetics. All Rights Reserved.

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Achieving Quality in Brachytherapy

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