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Let's Brach It Down!

R DuBose1*, D Brachman2*, R DuBose1*, R Barton3*, W Song4*, (1) Gibbs Cancer Center-SRHS, North Myrtle Beach, SC, (2) Gt Medical Technologies, Phoenix, AZ, (3) Landauer Medical Physics, Myrtle Beach, SC, (4) Virginia Commonwealth University, Henrico, VA


MO-A-Therapy Room-0 (Monday, 4/19/2021) 10:00 AM - 12:00 PM [Eastern Time (GMT-4)]

Brachytherapy’s intrinsic high target dose and rapid OAR dose fall off can offer specialized solutions for treating patients in the clinic. Appropriate brachytherapy planning can be challenging and requires considerable experience for best practice. In this session we will look at recent brachytherapy developments of interest to clinical medical physicists.

The first presentation will give an overview of brain brachytherapy using GammaTile. What exactly it is and the benefits compared to traditional brain brachytherapy. Patient selection criteria and results will also be discussed. Next will be a quick breakdown of the physicist’s role from tile estimate, ordering, check in, OR placement, and post planning. Afterwards clinical experience with GammaTile will be discussed including dose to staff and future clinical protocols openings.

The second presentation will cover the challenging clinical process of building and treating skin lesions using custom HDR molds. Patient selection and methodology discussed, including what materials are used and the thought process throughout building the molds. Next recent skin OAR and dosage recommendations will be reviewed within the context of our clinic’s experience. Custom eye shields and clinical examples with before and after photos will be presented also.

The third presentation will discuss Intensity Modulated and Anisotropic Sources (IMABS). Radiation sources used in brachytherapy conventionally provide isotropic dose distributions, which helps deliver high radiation dose to the tumors but often lead to dose spillage to OARs. IMABS utilizes high-density shields to provide at least one additional degree of freedom in the dose delivery process (e.g., directional beam) and can result in marked improvement in plan quality. To implement, however, requires rethinking of the entire treatment process from plan optimization to dose calculations to QA.

Learning Objectives:
1. Understand Gamma Tile treatments from a clinical medical physicist point of view.
2. How to create custom HDR skin treatment molds and recent HDR dose recommendations.
3. To review Intensity Modulated and Anisotropic Sources (IMABS) technology and its clinical implementation.


Brachytherapy, HDR


TH- Brachytherapy: General (most aspects)

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