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Recommendations of the American Association of Physicists in Medicine
regarding the Impact of Implementing the 2004 Task Group 43 Report on Dose Specification
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In March 2004, the recommendations of the American Association of Physicists in Medicine (AAPM) on the
were reported in Medical Physics [TG-43
Update: Rivard et al. , 31, 633–674
(2004)]. These recommendations include some minor
changes in the dose-calculation formalism and a major update of the dosimetry parameters for eight
widely used interstitial brachytherapy sources. A full implementation of these recommendations
could result in unintended changes in delivered dose without corresponding revisions in the prescribed
most published clinical experience with permanent brachytherapy is based upon two
widely used source models, the
Model 6711 and
Model 200 sources, in this report we present an analysis of
impact of the 2004 TG-43 dosimetry parameters on the history of dose delivery for these two
source models. Our analysis indicates that the currently recommended prescribed
dose of 125 Gy
for Model 200
implants planned using previously recommended
prescription: Williamson et al. , Med. Phys.27, 634–642
(2000)] results in a delivered dose of 120 Gy according to
calculations based on the 2004 TG-43 update. Further, delivered doses prior to October 1997
varied from 113 to 119 Gy for a prescribed dose of 115 Gy compared to 124 Gy estimated by the AAPM
2000 report. For
implants using Model 6711 seeds, there are no significant
changes (less than 2%). Practicing physicians should take these results into account when
selecting the clinically appropriate prescribed dose for
interstitial implant patients following implementation of
the 2004 TG-43 update dose-calculation recommendations. The AAPM recommends that the
review this report and consider whether the currently recommended dose level (125 Gy) needs to be
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