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

William A. Dezarn*, Jeffery T. Cessna, Larry A. Dewerd, Wenzheng Feng, Vanessa L. Gates, James Halama, Andrew S. Kennedy, Subir Nag, Mehrdad Sarfaraz, Varun Sehgal, Reed Selwyn, Michael G. Stabin, Bruce R. Thomadsen, Lawrence E. Williams, Riad Salem

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

139 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)4824-4845
Number of pages22
JournalMedical Physics
Volume38
Issue number8
DOIs
StatePublished - Aug 2011

Keywords

  • brachytherapy
  • dosimetry
  • imaging
  • liver
  • microsphere
  • radioembolization
  • yttrium

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging

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