An anthropomorphic phantom for quality assurance and training in gynaecological brachytherapy.

BACKGROUND AND PURPOSE: An anthropomorphic water filled polymethylmethacrylate (PMMA) phantom designed to serve as a Quality Assurance (QA) tool and a training aid in brachytherapy of gynaecological tumours is investigated and presented. Several dosimetric parameters associated with the dose rate calculation can be verified with the aid of this phantom such as the source positioning, its imaging reconstruction from radiographs and the accuracy of the algorithm used for manual or computer dose rate calculation. MATERIAL AND METHODS: The phantom walls and the internal structure are 5mm thick and consist of PMMA, in the form of the abdomen taken from a female Alderson Phantom Marker points representing the organs of interest were determined from computed tomography scans of a patient of similar size. Three PMMA inserts designed to hold a Farmer type ionization chamber of 0.6 cm(3) were positioned at the points to represent the bladder, rectum and point A. The formalism proposed by the IAEA TRS-277 dosimetry protocol was used for the conversion of readings of the ionization chamber to dose rate values with a modification to take into account the dose rate gradient in the detector. Five 137Cs sources were used and the dose rate was evaluated by measurements and Monte Carlo simulations using the PENELOPE code. Four different treatment planning systems with different algorithms and source reconstruction techniques were also used in this investigation and compared with the manual dose rate calculations made using Karen and Breitman's tables. RESULTS: The dose rate calculations performed with Monte Carlo and the four treatment planning systems are in good agreement with the experimental results as well as with the manual calculations when the colpostat shielding and the tandem attenuation are taken into account. The comparison between experiment and calculations by the four treatment planning systems shows a maximum variation of 5.1% between the calculated and measured dose rate at the point A. CONCLUSIONS: This phantom is suitable for use during the acceptance tests of treatment planning systems and applicators, as educational tool, for dosimetric research problems and for the QA of brachytherapy sources.