A modified dose calculation formalism for electronic brachytherapy sources

PURPOSE: To propose a modification of the current dose calculation formalism introduced in the Task Group No. 43 Report (TG-43) to accommodate an air-kerma rate standard for electronic brachytherapy sources as an alternative to an air-kerma strength standard. METHODS: Electronic brachytherapy sources are miniature x-ray tubes emitting low energies with high-dose-rates. The National Institute of Standards and Technology (NIST) has introduced a new primary air-kerma rate standard for one of these sources, in contrast to air-kerma strength. A modification of the TG-43 protocol for calculation of dose-rate distributions around electronic brachytherapy sources including sources in an applicator is presented. It cannot be assumed that the perturbations from sources in an applicator are negligible, and thus, the applicator is incorporated in the formalism. The modified protocol mimics the fundamental methodology of the original TG-43 formalism, but now incorporates the new NIST-traceable source strength metric of air-kerma rate at 50 cm and introduces a new subscript, i, to denote the presence of an applicator used in treatment delivery. Applications of electronic brachytherapy sources for surface brachytherapy are not addressed in this Technical Note since they are well documented in other publications. RESULTS: A modification of the AAPM TG-43 protocol has been developed to accommodate an air-kerma rate standard for electronic brachytherapy sources as an alternative to an air-kerma strength standard. CONCLUSIONS: The modified TG-43 formalism allows dose calculations to be performed using a new NIST-traceable source strength metric and introduces the concept of applicator-specific formalism parameters denoted with subscript, i. (C) 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.