Leitlinie zu Medizinphysikalischen Aspekten - Strahlentherapie ...

DGMP-Leitlinie zu Medizinphysikalischen Aspekten der intravaskulären Brachytherapie
Anhang 12.7 Zusammenfassung der Empfehlungen des AAPM TG 60 Reports
# AAPM TG 60 Recommendations: Intravascular Brachytherapy Physics
1. Source strength of catheter-based systems should be expressed in terms of air kerma in air for
gamma sources (air kerma strength) and dose rate in water at a reference distance of 2 mm for
beta emitters.
2. Dose distribution around a catheter-based brachytherapy source should be determined using the
AAPM Task group No. 43 protocol for photon sources and a modified version of the AAPM Task
group No. 43 protocol for beta sources.
3. Source strength of a catheter-based system should be traceable to a national standard at NIST or at
an ADCL.
4. The radial dose function, geometry function, and anisotropy function should be determined for
each specific source design of a commercial catheter-based system.
5. Clinical prescription for a catheter-based system should be expressed in terms of dose delivered at
a reference depth in water.
6. For a catheter-based system, depth of dose prescription for intracoronary applications should be at
a radial distance of 2 mm from the centre of the source and for peripheral vessels 2 mm larger
than the average lumen radius. Average lumen radius should be reported.
7. For optimal assessment of each clinical case, average, minimum, and maximum doses delivered
should be estimated in at least three planes perpendicular to the catheter and along its length.
8. The output of all commercial intravascular brachytherapy catheter-based systems should be specified
in terms of dose rate in water at a radial distance of 2 mm from the centre of the catheter.
9. The penetrating ability of all commercial intravascular brachytherapy catheter-based systems
should be specified in terms of radial dose function normalised at a distance of 2 mm and at radial
distances from 0.5 to 10 mm (or R90, 90% of the electron range for beta emitters), at 0.5 mm intervals,
with a reference depth of 2 mm.
10. Uniformity of dose delivered by catheter-based systems at points both along the source axis, at r =
2 mm, and around the circumference of a 2 mm radius circle centred on the source axis in a plane
perpendicular to it should be better than ±10 % (range of values from minimum to maximum in
the centred two-thirds of the treated length along the catheter axis).
11. For each catheter-based system, an atlas of 3-dimensional dose distributions should be generated
to estimate dose variation in the target.
12. Clinical prescription of radioactive stents should be in terms of: 1) stent diameter, nominal and
deployed; 2) stent length; stent type, brand, model; 4) radioisotope; and 5) activity.
13. The measured activity of a radioactive stent should be traceable to a national standard at NIST.
14. Activity for each radioactive stent to be used should be determined using an appropriate transfer
technique.
15. For radioactive stents, absolute doses at 0.5 mm radial distance from the stent in the midplace and
over time periods of 28 days should be reported.
16. The quality assurance program presented in the AAPM task group report should be followed under
the direction of a qualified medical physicist.
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