eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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vol. 15
Original paper

Development of a multi-purpose quality control phantom for MRI-based treatment planning in high-dose-rate brachytherapy of cervical cancer

Abolfazl Kanani
Amir Owrangi
Mehran Yazdi
Ali Fatemi-Ardekani
4, 5, 6
Mohammad Amin Mosleh-Shirazi
1, 7

Ionizing and Non-Ionizing Radiation Protection Research Center (INIRPRC), School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, TX, USA
Signal and Image Processing Lab (SIPL), School of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
Department of Physics, Jackson State University (JSU), Jackson, Mississippi, USA
SpinTecx, Jackson, Mississippi, USA
Department of Radiation Oncology, Community Health Systems (CHS) Cancer Network, Jackson, Mississippi, USA
Physics Unit, Department of Radio-Oncology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
J Contemp Brachytherapy 2023; 15, 1: 57–68
Online publish date: 2023/02/10
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Suitable commissioning and quality control (QC) tests for high-dose-rate brachytherapy (HDR-BT) is necessary to ensure dosimetric and geometric accuracy of the treatment. This study aimed to present the methodology of developing a novel multi-purpose QC phantom (AQuA-BT) and examples of its’ application in 3D image-based (particularly magnetic resonance imaging [MRI]-based) planning for cervix BT.

Material and methods:
Design criteria led to a phantom with sufficient size waterproof box for dosimetry and capability for inserting other components inside the phantom for: (A) Validating dose calculation algorithms in treatment planning systems (TPSs) using a small-volume ionization chamber; (B) Testing volume calculation accuracy in TPSs for bladder, rectum, and sigmoid organs at risk (OARs) constructed by 3D printing; (C) Quantification of MRI distortions using 17 semi-elliptical plates with 4,317 control points to mimic a realistic female’s pelvis size; and (D) Quantification of image distortions and artifacts induced by MRI-compatible applicators using a specific radial fiducial marker. The utility of the phantom was tested in various QC procedures.

The phantom was successfully implemented for examples of intended QC procedures. The maximum deviation between the absorbed doses to water assessed with our phantom and those calculated by SagiPlan TPS was 1.7%. The mean discrepancy in volumes of TPS-calculated OARs was 1.1%. The differences between known distances within the phantom on MR imaging were within 0.7 mm compared with computed tomography.

This phantom is a promising useful tool for dosimetric and geometric quality assurance (QA) in MRI-based cervix BT.


HDR brachytherapy, phantom, quality assurance, commissioning, MRI-based planning

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