Physical derivation of nomograms in permanent prostate brachytherapy.
OBJECTIVE
To demonstrate the physical origin of nomograms in permanent prostate brachytherapy, by using the correlation between fractional integral target dose (FITD) and target volume.


METHODS
The integral dose (ID) E delivered by unit activity is given by the integration of 4pi r(2)D(r)/r(2)dr x 1.44T(1/2) using the point source model from AAPM TG43. If A is the total activity implanted, then total ID will be AxE. Integral target dose are obtained by multiplying the prostate volume V with mean dose D(mean) by definition, assuming prostate gland has a unity density. The FITD the target receives is defined as FITD=D(mean)V/AE by energy conservation in the target volume. From this equation, the total activity needed to achieve given dose for a target of volume V is obtained. Results are compared with existing nomograms for (125)I and (103)Pd, and available clinical data for (131)Cs.


RESULTS
Agreement within 10.0% for (125)I and (103)Pd compared with existing nomograms for gland sizes from 18 to 80 cc is observed. For (131)Cs, the agreement is within 8.0% compared with available clinical data.


CONCLUSIONS
It is shown that the correlation between the FITD and target volume can be used to obtain the total activity needed to achieve prescribed dose. This correlation is inherent rather than empirical. It suggests that the correlation between fraction of energy deposition in target and target volume is the underlying physical origin for nomograms used in permanent prostate brachytherapy.
Department of Radiation Oncology, Tuomey Healthcare System, 130 North Washington Street, Sumter, SC 29150, USA. texin.li@tuomey.com
Texin
T
Li
Betty L
BL
Fountain
Edward W
EW
Duffy
D000465:Algorithms; D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D008297:Male; D009716:Numerical Analysis, Computer-Assisted; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity