title: Recommendations of the American Association of Physicists in Medicine on dosimetry, imaging, and quality assurance procedures for 90Y microsphere brachytherapy in the treatment of hepatic malignancies.
abstract: Yttrium-90 microsphere brachytherapy of the liver exploits the distinctive features of the liver anatomy to treat liver malignancies with beta radiation and is gaining more wide spread clinical use. This report provides a general overview of microsphere liver brachytherapy and assists the treatment team in creating local treatment practices to provide safe and efficient patient treatment. Suggestions for future improvements are incorporated with the basic rationale for the therapy and currently used procedures. Imaging modalities utilized and their respective quality assurance are discussed. General as well as vendor specific delivery procedures are reviewed. The current dosimetry models are reviewed and suggestions for dosimetry advancement are made. Beta activity standards are reviewed and vendor implementation strategies are discussed. Radioactive material licensing and radiation safety are discussed given the unique requirements of microsphere brachytherapy. A general, team-based quality assurance program is reviewed to provide guidance for the creation of the local procedures. Finally, recommendations are given on how to deliver the current state of the art treatments and directions for future improvements in the therapy.
authors.affiliation: Medical Radiation Physics Inc., Milford, Ohio 45150, USA.
authors.forename: William A
authors.initials: WA
authors.lastname: Dezarn
authors.forename: Jeffery T
authors.initials: JT
authors.lastname: Cessna
authors.forename: Larry A
authors.initials: LA
authors.lastname: DeWerd
authors.forename: Wenzheng
authors.initials: W
authors.lastname: Feng
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Gates
authors.forename: James
authors.initials: J
authors.lastname: Halama
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Kennedy
authors.forename: Subir
authors.initials: S
authors.lastname: Nag
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Sarfaraz
authors.forename: Varun
authors.initials: V
authors.lastname: Sehgal
authors.forename: Reed
authors.initials: R
authors.lastname: Selwyn
authors.forename: Michael G
authors.initials: MG
authors.lastname: Stabin
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Thomadsen
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Williams
authors.forename: Riad
authors.initials: R
authors.lastname: Salem
mesh_terms: D000792:Angiography / Q000592:standards; D001918:Brachytherapy / Q000592:standards*; D006283:Health Physics; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008863:Microspheres; D049268:Positron-Emission Tomography; D011785:Quality Assurance, Health Care / Q000592:standards; D011874:Radiometry / Q000592:standards; D012955:Societies, Medical; D014057:Tomography, X-Ray Computed; D014481:United States; D015021:Yttrium Radioisotopes / Q000592:standards / Q000627:therapeutic use*
chemical_list: D015021:Yttrium Radioisotopes