The AAPM TG-43 protocol for brachytherapy reference dosimetry has proven success
and is the standard dosimetry protocol used worldwide for clinical dose calculations.
While there have been a number of updates refining the approach, the basic formalism
based on superposition of single-source dose distributions in a fixed water sphere has
remained. The joint AAPM/ESTRO report on high-energy (> 50 keV) photon-emitting
brachytherapy source dosimetry further refines the basic TG-43 formalism. Specific to
high-energy radionuclide sources such as 192Ir, the report includes the following:
a) consensus datasets of brachytherapy dosimetry parameters and recommended
methods for evaluating these consensus datasets,
b) recommendations on dosimetry methods to characterize the source dose
distribution (based on experimental procedures and Monte Carlo methods of
radiation transport simulations), and
c) interpolation/extrapolation techniques for the 2D anisotropy function and radial
dose function, specific to high-energy sources, which differ from the low-energy
techniques in the 2004 and 2007 AAPM updates.
In addition to explaining this joint AAPM/ESTRO HEBD report, other advances are
discussed such as dose calculation methods using model-based dose calculation
algorithms as examined in the joint AAPM/ESTRO/ABG TG-186 report, and clinical
implementation of primary HDR 192Ir doserate-to-water calibrations.