In the past decade brachytherapy has progressed from the traditional surgical paradigm to modern 3D image based treatment planning systems (TPS) and dose delivery. The information available through patient imaging however, had not been fully exploited until recently since conventional treatment planning dosimetry, albeit robust and universally employed, relies on source specific data pre-calculated in a standard homogeneous water geometry. Hence it disregards patient specific radiation scatter conditions and the radiological differences of tissue or applicator materials from water.

In response to literature on the effect of these shortcomings (including work from our research team) contemporary TPSs, collectively referred to as model based dose calculation algorithms (MBDCAs), have been made available marking the breach of rapid developments in brachytherapy individualized treatment planning dosimetry.

Notwithstanding the benefit of MBDCAs in principle, tools for their clinical commissioning and acceptance testing are lacking, corrections of dose prescription standards might be necessary to conform to the new accuracy standards they convey, and the advantageous global uniformity of current clinical dosimetry practice is jeopardized.

A road map to tackle the above problems has been paved by the successful completion of an independent validation project appointed to the group supporting this proposal by the manufacturer of the first model based TPS. Based on experience gained, this proposal aims at multidisciplinary research to facilitate the smooth transition of the brachytherapy community to individualized treatment planning dosimetry. This will be realized not only by communicating research results, but also by converting research tools and expertise to end user oriented and freely distributed dosimetric QA tools.

The research project consists of 11 work packages categorized in three distinct actions:

 

    1. Impact assessment of introducing MBDCAs to clinical practice
    2. Development of end-user oriented QA tools for the commissioning and acceptance testing of MBDCA based TPSs
    3. Research in alternatives to universal MBDCAs for specific brachytherapy processes