title: Australasian brachytherapy audit: results of the 'end-to-end' dosimetry pilot study.
abstract: BACKGROUND
  We present the results of a pilot study to test the feasibility of a brachytherapy dosimetry audit.
  
  
  METHODS
  The feasibility study was conducted at seven sites from four Australian states in both public and private centres. A purpose-built cylindrical water phantom was imaged using the local imaging protocol and a treatment plan was generated to deliver 1 Gy to the central (1 of 3) thermoluminescent dosimeter (TLD) from six dwell positions.
  
  
  RESULTS
  All centres completed the audit, consisting of three consecutive irradiations, within a 2-h time period, with the exception of one centre that uses a pulsed dose rate brachytherapy unit. All TLD results were within 4.5% of the predicted value, with the exception of one subset where the dwell position step size was incorrectly applied.
  
  
  CONCLUSIONS
  While the limited data collected in the study demonstrated considerable heterogeneity in clinical practice, the study proved a brachytherapy dosimetry audit to be feasible. Future studies should include verification of source strength using a Standard Dosimetry Laboratory calibrated chamber, a phantom that more closely mimics the clinical situation, a more comprehensive review of safety and quality assurance (QA) procedures including source dwell time and position accuracy, and a review of patient treatment QA procedures such as applicator position verification.
authors.affiliation: Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. Annette.haworth@petermac.org
authors.forename: Annette
authors.initials: A
authors.lastname: Haworth
authors.forename: Lisa
authors.initials: L
authors.lastname: Wilfert
authors.forename: Duncan
authors.initials: D
authors.lastname: Butler
authors.forename: Martin A
authors.initials: MA
authors.lastname: Ebert
authors.forename: Stephen
authors.initials: S
authors.lastname: Todd
authors.forename: Joseph
authors.initials: J
authors.lastname: Bucci
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Duchesne
authors.forename: David
authors.initials: D
authors.lastname: Joseph
authors.forename: Tomas
authors.initials: T
authors.lastname: Kron
mesh_terms: D044362:Australasia; D001918:Brachytherapy / Q000592:standards*; D005240:Feasibility Studies; D006801:Humans; D008485:Medical Audit; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D011874:Radiometry / Q000592:standards*; D011879:Radiotherapy Dosage / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: 192Ir; HDR; brachytherapy; external audit