Quality Control in Brachytherapy

Brachytherapy is applied in 19 radiotherapy institutions in The Netherlands and in 20 institutions in Belgium. Each institution has its own Quality Assurance (QA) programme to ensure safe and accurate dose delivery to the patient. Because of the various guidelines employed and differences in individual interpretation, a large variety of test frequencies, test methods and accuracy criteria of the QA tests are applied.

To investigate the QA protocols for HDR, PDR and LDR brachytherapy, a questionnaire was sent to all radiotherapy institutions in The Netherlands and Belgium. The questions concerned test frequencies, methods, time required for the tests, and action levels of safety systems and irradiation parameters in brachytherapy. The answers to the questions showed large variations in test frequencies and test methods, and smaller variations in accuracy criteria. Furthermore, there were large variations in time spent on QA, mainly due to differences in QC resources available.

In addition to the questionnaire, the accuracy of implant reconstruction and dose delivery was determined during site visits of 33 institutions and by performing measurements with dedicated phantoms. The average reconstruction accuracy was -0.07 mm (±0.4 mm, 1 SD) for 41 localizers. The average deviation of the measured dos from the prescribed dose was ±0.9% (±1.3%, 1 SD) for 21 HDR afterloading systems, 1.0% (± 2.3%, 1 SD0) for 12 PDR afterloaders, and 1.8% (± 2.5%, 1 SD) for 15 LDR afterloaders.

The data gathered from the responses of the questionnaires were compared with existing recommendations on QA of brachytherapy. From this information, a set of minimum requirements on QA-procedures of HDR, PDR and LDR brachytherapy has been formulated, suitable for the situation in The Netherlands and Belgium. The recommendations include test frequencies, action levels and test methods for safety systems and physical parameters.

The use of radionuclides has increased rapidly in the field of endovascular brachytherapy to reduce the occurrence of restenosis in patients who are treated for vascular stenosis. Because of this tendency, it was decided to include a number of basic recommendations for the field of endovascular brachytherapy in this report. Furthermore, QA aspects of the treatment planning specific to brachytherapy are described, such as brachytherapy sources, implant entry, dose calculation models and the data transfer.

Note that this report is partially superseded by NCS 30.

https://doi.org/10.25030/ncs-013

The NCS frequently publishes reports for fellow professionals in which recommendations are given for various quality control procedures or otherwise. The members of the NCS board and the members of the concerning subcommittee do not claim any authority exceeding that of their professional expertise. Responsibility on how the NCS recommendations are implemented lies with the user, taking into account the practice in his/her institution.

NCS Reports See all files

Radiation Protection and Dosimetry of the Eye Lens

NCS 31, May 2018

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Code of Practice for Quality Assurance of Brachytherapy with Ir-192 Afterloaders

NCS 30, May 2018

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An on-site dosimetry audit for high-energy electron beams

NCS 29, October 2018

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National Audit of Quality Assurance for IMRT and VMAT

NCS 28, March 2018

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Quality Assurance for Tomotherapy Systems

NCS 27, April 2017

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Human Exposure to Ionising Radiation for Clinical and Research Purposes

NCS 26, May 2016

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Process Management and Quality Assurance for Intracranial Stereotactic Treatment

NCS 25, October 2015

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Code of Practice for the Quality Assurance and Control for Volumetric Modulated Arc Therapy

NCS 24, February 2015

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Audit of High-Energy Photon Beams in Belgian and Dutch Radiotherapy Departments

NCS 23, December 2013

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Code of Practice for the Quality Assurance and Control for Intensity Modulated Radiotherapy

NCS 22, June 2013

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Diagnostische referentieniveaus in Nederland

NCS 21, June 2012 (in Dutch with an English summary)

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Dosimetry and quality control of brachytherapy with low-energy photon sources (125I)

NCS 20, April 2012

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Code of practice for personal dosimetry of professionals wearing protective clothing during radiolog

NCS 19, October 2008

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Code of Practice for the Absorbed Dose Determination in High Energy Photon and Electron Beams

NCS 18, January 2008

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Dosimetrie in de Radiologie: Stralingsbelasting van de Patiënt en Werknemers

NCS 17, March 2007

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Monte Carlo Treatment Planning, An Introduction

NCS 16, June 2006

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Quality assurance of 3-D treatment planning systems for external photon and electron beams

NCS 15, March 2005

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Quality control of sealded beta sources in brachytherapy

NCS 14, August 2004

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Quality Control in Brachytherapy

NCS 13 November 2000

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Determination and use of scatter correction factors of megavoltage photon beams

NCS 12, March 1998, seel also NCS 15.
No revision required

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Quality Control (QC) of Simulators and CT scanners and some basic QC methods for Treatment Planning

NCS 11, September 1997, revision before 2020

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Dosimetry of low and medium energy X-rays

NCS 10, July 1997

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Quality control of medical linear accelerators: current practice and minimum requirements

NCS 9, August 1996, revision before 2020

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Kwaliteitscontrole van Medische Lineaire Versnellers, methoden voor kwaliteitscontrole

NCS 8, December 1995 (in Dutch), revision before 2020

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Dosimetric aspects of Mammography

NCS 6, March 1993

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Code of practice for the dosimetry of high-energy electron beams

NCS 5, December 1989

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Proceedings of the Symposium on Thermoluminescence Dosimetry

NCS 3, October 1988

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Code of practice for the dosimetry of high-energy photon beams

NCS 2, December 1986

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Radiation dosimetry activities in the Netherlands

NCS 1, July 1986

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