ArticleJournal of applied clinical medical physics2026
A Monte Carlo based dose verification tool for an HDR Ir-192 brachytherapy source and its evaluation on extremity malignancies.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTG-43 formalism dose calculation for brachytherapy with the homogeneous water-based assumption is widely used, which can lead to dose inaccuracy in treatment planning. PURPOSE: Extremity malignancies are also treated with high-dose-rate (HDR)
methodsBrachyPlanCheck was commissioned and validated in both a homogeneous water phantom and a heterogeneous breast phantom. The clinical evaluation included 8 patient-specific lower limb brachytherapy plans, comparing TG-43 and MC calculation using BrachyPlanCheck. Dosimetric differences were evaluated using dose comparisons, gamma index analysis, and dose-volume histogram (DVH) metrics for clinical target volume (CTV) and organ-at-risk (OAR), including bone and skin.
resultsIn commissioning Level 1, MC simulations using BrachyPlanCheck demonstrated point dose agreement within ± 0.9%. Gamma passing rates exceeded 99.9% with criteria 1 mm/1% in commissioning Level 2. In clinical evaluation, TG-43 calculation overestimated CTV V150 by up to 10.50% and CTV D90 by up to 7.25%. OAR doses were generally higher with TG-43, with mean differences of 1.09% for bone D1cc (p = 0.109), 1.38% for bone D0.1cc (p = 0.078), 7.30% for skin D2cc (p = 0.008), and 5.68% for skin D0.1cc (p = 0.008).
conclusionValidated by phantom and patient study, BrachyPlanCheck demonstrated robust performance for independent secondary dose verification. TG-43 calculation overestimated dose to CTV and OAR in extremity malignancy cases compared with BrachyPlanCheck.
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