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The vast majority of radiotherapy departments in Europe using brachytherapy (BT) perform temporary implants of high- or pulsed-dose rate (HDR-PDR) sources with photon energies higher than 50 keV. Such techniques are successfully applied to diverse pathologies and clinical scenarios. In this communication, we present the GEC-ESTRO recommendations on Calibration and Traceability of high energy HDR-PDR Photon-Emitting Brachytherapy Sources at the Hospital Level.

These recommendations are the result of Working Package 21 (WP-21) initiated within the BRAchytherapy PHYsics Quality Assurance System (BRAPHYQS) GEC-ESTRO working group with a focus on HDR-PDR source calibration. They provide guidance on the calibration of such sources, including practical aspects and issues not specifically accounted for in well-accepted societal recommendations, complementing the BRAPHYQS WP-18 report dedicated to low energy BT photon emitting sources (seeds).

Recommendations are offered on the preferred equipment for source assay (well-type chamber), the establishment of a redundancy program, the periodicity of assay, source model specific calibrations and source design constancy, contamination testing, source certification and of course assay tolerance. Key points are that the responsibility to assay sources remains with the medical physicist and administrators must provide the required resources, and that a tighter tolerance level of 3% difference between source assay and source certificate provided by the vendor is established for HE BT sources.

This report provides a European-wide standard in HDR-PDR BT source calibration at the hospital level to maintain high quality patient treatments.