A dosimetry system for Ir-192 interstitial breast implants performed at the time of lumpectomy

Purpose: Ir-192 interstitial breast implants performed at the time of lumpectomy present a unique problem because they cannot be preplanned, and yet they are expected to produce a treatment dose rate (TDR) from 0.3 to 0.5 Gy/h using sources already procured, The purpose of this work is to describe a system of dosimetry that works within these constraints and has been used to perform more than 600 such implants. Methods and Materials: The underlying principle is to fix the ribbon spacing, the interplaner separation, and the linear activity (1 mCi/cm) so that the TDR will depend only on the area (L x W) implanted, The ribbons are spaced 1.5 cm and 2.0 cm apart in single plane and double implants, respectively, Idealized implants were used to study the TDR as a function of the implant dimensions, and to study the effects of varying the ribbon spacing and interplanar separation, Volume-dose histograms were generated to study the homogeneity of dose. Results: The TDRs of single plane implants range from 0.3 Gy/h for small 4 x 4 cm(2) implants to 0.4 Gy/h for large 10 x 10 cm(2) implants, The TDRs for double plane implants are similar for the same range of dimensions. Conclusions: Implants with a TDR between 0.3 and 0.5 Gy/h can be performed for a wide range of geometries without preplanning using fixed ribbons spacings of 1.5 and 2.0 cm for single and double plane implants, respectively, and a linear activity of 1 mCi/cm. Copyright (C) 1997 Elsevier Science Inc.