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HDR BrachytherapyHDR Brachytherapy
Nicolas G. Zouain, MD
Department of Radiation Oncology
Roger Maris Cancer Center
History19051905
History
1920’s1920’s
Dose Rate
Low dose rate (LDR)0.4 to 2 Gy/hr
Medium dose rate (MDR)2 to 12 Gy/hr
High dose rate (HDR)> 12 Gy/hr but usually in the region of 150 Gy/hr ~ 2.5 Gy/min
Why Brachytherapy
Delivering the high dose of radiation to the tumor
Sparing of the surrounding normal tissues
Delivered in a short period of timeTumor repopulation
Limited to localized tumors
High Dose Inside of the Tumor
100%100%
25%25%
150%150%
HDR Afterloading Machine
Iridium-192Iridium-192
Prostate HDR Brachytherapy
Breast HDR Brachytherapy
Lungs HDR Brachytherapy
Esophagus HDR Brachytherapy
Cervix HDR Brachytherapy
Uterus HDR Brachytherapy
H&N HDR Brachytherapy
H&N HDR Brachytherapy
Rectal Brachytherapy
Rectal Brachytherapy
Rectal Brachytherapy
Templates
Trans Rectal Ultrasound
Ultrasound Stepper
Ultrasound Stepper Stabilizer
TRUS Guided Needles Insertion
MammoSite
MammoSite
Lumpectomy Cavity is Created
Troacar Used to CreatePathway to Cavity
Un-inflated MammoSite is Advanced into the CavityThrough the Troacar Path
MammoSite
MammoSite is Inflated toPosition the Tissue to
Receive Radiation Therapy
Design allows the 192IrSource to be Centrally Positioned within the
Applicator
The 192Ir Source is Delivered Into the MammoSite and
Radiation Therapy is Delivered Per the
Treatment Plan
MammoSite