QA of Afterloaders for Brachytherapy

Purpose of the NCS subcommittee is to devise a code of practice for Quality Assurance of Ir-192 afterloaders for HDR and PDR brachytherapy. The report will give a general treatment of the topic, but will focus on the types of afterloaders used in the Netherlands and Belgium, namely the different models manufactured by Elekta and Varian. First the subcommittee identifies critical steps in the whole process chain in the hospital, with expert users from both the Netherlands and Belgium, for the present-day afterloader systems. These steps are, among others, determination of the source strength, accuracy of the reconstructed source position and dose delivery throughout the treatment. The accuracy of tumour or other organ segmentation is not taken into account. While the applicators that are used during treatment are considered extensions of the afterloader, QA of applicators will be a part of the report as well.
The subcommittee had its first meeting 10 March 2014.

Topics covered are

  • Current status of afterloaders and treatments in the Netherlands and Belgium
  • QA of afterloaders
  • QA of sources (including well ionisation chambers)
  • QA of applicators
  • Safety and security

Topics not covered include

  • Treatment Planning Systems
  • LDR techniques
  • Afterloaders for other isotopes

The report will be in English and refer to the earlier NCS-reports on brachytherapy 4, 7, 13, 20. We anticipate that the project will be finished end of 2015, with a quarterly meeting with all subcommittee members. The meeting frequency will be altered if needed. No site visits are planned, other than the visits to the institutes of the members of this subcommittee.

Preliminary Report

Medical physicists in the Netherlands requested a rapid publication of the part of the report describing QA procedures to ascertain the quality of transfer tubes and applicators and their technical lifetime. Therefore, the NCS board decided to publish this pre-publication. Since it is a pre-publication and not a final report, it is only valid until the date indicated on the report. Please check for updates on a regular basis.


Members of this NCS subcommittee

  • Jacco Steenhuijsen (Catharina-ziekenhuis Eindhoven, Chairman,
  • Marja Harbers (Medisch Spectrum Twente, Enschede)
  • Aswin Hoffmann (Helmholtz-Zentrum Dresden-Rossendorf,
    Dresden Universitätsklinikum an der TU Dresden, Dresden, Germany)
  • Astrid de Leeuw (Universitair Medisch Centrum Utrecht)
  • Rita Reymen (GZA-Sint Augustinus Wilrijk/Antwerpen)
  • Alex Rijnders (Europa Ziekenhuizen, Brussel, representative of the NCS board)
  • Mirko Unipan (Maastro clinic, Maastricht)