| Preface | p. xiii |
| General Considerations in Quality Management in Brachytherapy | p. 1 |
| Importance of quality assurance | p. 1 |
| Principles of quality assurance | p. 2 |
| Error | p. 8 |
| Systematic error | p. 8 |
| Random error | p. 8 |
| Error reduction | p. 8 |
| Error prevention | p. 8 |
| Error detection | p. 11 |
| Guidance in the use of tools | p. 12 |
| Training | p. 13 |
| Staffing | p. 16 |
| Items not covered | p. 18 |
| Terminology revisited | p. 19 |
| Sources for information | p. 19 |
| Human performance implications for quality management | p. 20 |
| Summary | p. 20 |
| Quality Management for Manual Loading, Low Dose Rate Brachytherapy Sources | p. 21 |
| Sources for a permanent inventory | p. 21 |
| Acceptance tests | p. 21 |
| Periodic tests | p. 33 |
| Sources ordered for particular patients | p. 36 |
| Integrity | p. 37 |
| Linear uniformity--wire (not seeds, which are too short to matter) | p. 37 |
| Assay of source strength | p. 37 |
| Penetration and dose distribution | p. 40 |
| Summary | p. 41 |
| Quality Management for a Treatment Plan | p. 42 |
| Evaluating whether the plan contains errors | p. 42 |
| Direct checks on the input data | p. 42 |
| Does the plan make sense? | p. 52 |
| Indirect checks on the input data | p. 53 |
| Evaluating the appropriateness of the plan | p. 54 |
| Concerns in evaluating the appropriateness of a treatment plan | p. 55 |
| Tools | p. 59 |
| Summary | p. 76 |
| Quality Management for Manually Loaded, Low Dose Rate Applications | p. 78 |
| Applications involving sources from a standing inventory | p. 78 |
| Source loading | p. 78 |
| Calculation of the removal time | p. 80 |
| During the treatment | p. 81 |
| At the removal | p. 82 |
| Applications involving temporary sources ordered for the treatment | p. 82 |
| Source loading | p. 82 |
| Calculation of the removal time | p. 86 |
| During the treatment | p. 87 |
| At the removal | p. 88 |
| Applications involving sources ordered for a permanent implant | p. 88 |
| Source strength check | p. 88 |
| Source position checks | p. 89 |
| Implants using radium or caesium needles | p. 94 |
| Summary | p. 95 |
| Quality Management for High Dose Rate Units | p. 97 |
| Periodic evaluations (at the beginning of each treatment day) | p. 98 |
| Safety checks | p. 99 |
| Dosimetry checks | p. 101 |
| Initial checks | p. 114 |
| Safety checks | p. 114 |
| Dosimetry checks | p. 115 |
| Ancillary device checks | p. 117 |
| Acceptance testing and commissioning | p. 119 |
| Operation | p. 119 |
| Detection of obstructions | p. 119 |
| Source retraction--automatic (emergency) | p. 120 |
| Source retraction--manual | p. 120 |
| Loss of source | p. 120 |
| Checks during treatment | p. 120 |
| Checks after treatment | p. 121 |
| Summary | p. 121 |
| Pulsed dose rate units | p. 122 |
| Quality Management for High Dose Rate Treatment Plans | p. 126 |
| Error prevention | p. 127 |
| Protocols | p. 128 |
| Forms | p. 128 |
| Independent second person | p. 128 |
| Error detection | p. 128 |
| Independent physicist's review | p. 129 |
| Physician's review | p. 144 |
| Predelivery checks | p. 145 |
| Indicators of 'reasonableness' | p. 147 |
| Gynaecological intracavitary insertions | p. 147 |
| Intraluminal insertions | p. 150 |
| Interstitial implants | p. 152 |
| When the checks fail | p. 155 |
| Summary | p. 157 |
| Some recommendations from the report of Task Group 59 of the American Association of Physicists in Medicine | p. 158 |
| Quality Management for Low and Medium Dose Rate Remote Afterloaders | p. 161 |
| Advanced remote afterloaders | p. 162 |
| Checks per patient | p. 163 |
| Periodic checks | p. 166 |
| Basic remote afterloaders | p. 168 |
| Checks per patient | p. 170 |
| Periodic checks | p. 171 |
| Procedural quality considerations with basic remote afterloaders | p. 174 |
| Reported operational problems with LDR remote afterloaders | p. 175 |
| Simple source loaders | p. 176 |
| Dose rate considerations | p. 176 |
| Summary | p. 178 |
| Quality Management for Brachytherapy Appliances | p. 179 |
| Intracavitary applicators | p. 179 |
| Gynaecological appliances | p. 180 |
| Intraluminal applicators | p. 192 |
| Interstitial equipment | p. 193 |
| Source-holding needles | p. 193 |
| Catheters | p. 196 |
| Flexible needles and fixed-length plastic tubes | p. 200 |
| Templates | p. 200 |
| Surface applicators | p. 204 |
| Eye applicators | p. 205 |
| Skin applicators | p. 206 |
| Intraoperative applicators | p. 207 |
| Summary | p. 207 |
| Quality Management for Dosimetric Treatment Planning | p. 210 |
| Localization | p. 211 |
| Radiographic localization | p. 212 |
| Sectional localization | p. 218 |
| Ultrasound localization | p. 221 |
| Source simulation | p. 222 |
| Dose calculation | p. 225 |
| Digitization | p. 227 |
| Geometric reconstruction | p. 228 |
| Dose calculation | p. 228 |
| Plan output | p. 235 |
| Summary | p. 237 |
| Appendix 9A | p. 237 |
| References | p. 240 |
| Index | p. 247 |
| Table of Contents provided by Syndetics. All Rights Reserved. |
