Evidence map›Paper›PMID 40318089›Full record

ArticleJournal of applied clinical medical physics2025

Practical experience in commissioning ring applicators using ring applicator component type with bravos control software v1.2.

Xiuxiu He, Michael A Trager, Gil'ad N Cohen, Antonio L Damato, David Aramburu Núñez

Abstract read
In one paragraph

Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Xiuxiu HeDepartment of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.ORCID https://orcid.org/0000-0002-8559-9520
Michael A TragerDepartment of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
Gil'ad N CohenDepartment of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.ORCID https://orcid.org/0000-0003-4252-6855
Antonio L DamatoDepartment of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
David Aramburu NúñezDepartment of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

purposeThe Bravos v1.2 control software introduces a ring applicator component type (ACT) with channel length verification to address geometric characteristics and dosimetric discrepancies caused by source positioning inaccuracies. This study aims to commission the ring applicator and investigate the new ring ACT in Bravos 1.2. MATERIAL AND

methodsWe evaluated two commissioning methods for a CT/MRI-compatible titanium ring applicator across three Bravos afterloaders and compared the new ring ACT with the traditional rigid ACT. Modifications to Varian's standard commissioning method included: (1) Delivering film plans with a 0.5 cm step size instead of 1 cm; (2) Alternating 0.3 s and 1 s dwell positions for enhanced source positioning analysis; (3) Including both "odd" and "even" positions to replicate clinical conditions. Films for 30-, 45-, and 60-degree rings (3.2 cm diameter) were delivered using modified methods and manual offsets of 0.0 cm, 0.1 cm, and 0.2 cm. Discrepancies between delivered and planned positions were analyzed, and the optimal offset was validated using clinical plans. Dosimetric differences for various gross tumor volumes (GTVs) and organs at risk (OARs) were assessed.

resultsFilm analysis (216 films) identified 0.2 cm as the optimal offset for all rings and afterloaders, minimizing deviations between the planned and delivered dwell positions. The rigid ACT showed larger discrepancies. The optimal offset reduced physical dosimetric differences to < 1% for key clinical metrics (D95, D90, D2cc) across all angles, with negligible differences in EQD2 values.

conclusionA novel commissioning procedure was developed to determine an optimal offset for accurate source positioning and minimize dosimetric discrepancies with the ring ACT. This method improves accuracy compared to the rigid ACT and standardizes commissioning for Bravos afterloaders with the v1.2 control system.

Indexed as

BrachytherapyNeoplasmsPhantoms, ImagingRadiotherapy Planning, Computer-AssistedSoftwareHumansOrgans at RiskRadiotherapy DosageRadiotherapy, Intensity-ModulatedTomography, X-Ray ComputedCommissioningGYN intracavity brachytherapyring applicator

Identifiers

PMID40318089
PMCPMC12148761

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.