Commissioning of a new brachytherapy treatment

Commissioning a new brachytherapy treatment involves a series of steps to ensure that the treatment is delivered safely and effectively. Here are the general steps involved in commissioning a new brachytherapy treatment:

  1. Pre-commissioning checks: Before starting the commissioning process, perform pre-commissioning checks to ensure that all the necessary equipment and software are installed and functioning correctly.
  2. Treatment planning system (TPS) validation: Validate the TPS to ensure that it is functioning correctly and producing accurate treatment plans. This includes testing the TPS's ability to generate treatment plans, dose calculations, and dose distributions.
  3. Brachytherapy source calibration: Calibrate the brachytherapy sources to ensure that they are delivering the correct dose rate and activity. This involves measuring the source's activity and dose rate using a calibrated dosimeter.
  4. Treatment delivery system (TDS) validation: Validate the TDS to ensure that it is functioning correctly and delivering the treatment as planned. This includes testing the TDS's ability to accurately position the brachytherapy sources and deliver the treatment dose.
  5. Dose verification: Verify the dose delivered during the treatment by measuring the dose using a dosimeter or an electronic portal imaging device (EPID).
  6. Quality assurance (QA) testing: Perform QA testing to ensure that the treatment is being delivered correctly and safely. This includes testing the TPS, TDS, and dosimetry systems.
  7. Clinical commissioning: Perform clinical commissioning by treating a small number of patients with the new treatment to ensure that it is safe and effective.
  8. Post-commissioning checks: Perform post-commissioning checks to ensure that the treatment is being delivered correctly and safely. This includes monitoring the treatment's effectiveness and identifying any issues that may arise.

Some of the specific tests and checks that may be performed during the commissioning process include:

The commissioning process for a new brachytherapy treatment typically involves a team of experts, including radiation oncologists, medical physicists, and radiation therapists. The team works together to ensure that the treatment is delivered safely and effectively, and that the patient receives the best possible care.