Establishing high-quality prostate brachytherapy using a phantom simulator training program - Abstract

PURPOSE: To design and implement a unique training program that uses a phantom-based simulator to teach the process of prostate brachytherapy (PB) quality assurance and improve the quality of education.

METHODS AND MATERIALS: Trainees in our simulator program were practicing radiation oncologists, radiation oncology residents, and fellows of the American Brachytherapy Society. The program emphasized 6 core areas of quality assurance: patient selection, simulation, treatment planning, implant technique, treatment evaluation, and outcome assessment. Using the Iodine 125 (125I) preoperative treatment planning technique, trainees implanted their ultrasound phantoms with dummy seeds (ie, seeds with no activity). Pre- and postimplant dosimetric parameters were compared and correlated using regression analysis.

RESULTS: Thirty-one trainees successfully completed the simulator program during the period under study. The mean phantom prostate size, number of seeds used, and total activity were generally consistent between trainees. All trainees met the V100 >95% objective both before and after implantation. Regardless of the initial volume of the prostate phantom, trainees' ability to cover the target volume with at least 100% of the dose (V100) was not compromised (R=0.99 pre- and postimplant). However, the V150 had lower concordance (R=0.37) and may better reflect heterogeneity control of the implant process.

CONCLUSIONS: Analysis of implants from this phantom-based simulator shows a high degree of consistency between trainees and uniformly high-quality implants with respect to parameters used in clinical practice. This training program provides a valuable educational opportunity that improves the quality of PB training and likely accelerates the learning curve inherent in PB. Prostate phantom implantation can be a valuable first step in the acquisition of the required skills to safely perform PB.

Written by:
Thaker NG, Kudchadker RJ, Swanson DA, Albert JM, Mahmood U, Pugh TJ, Boehling NS, Bruno TL, Prestidge BR, Crook JM, Cox BW, Potters L, Moran BJ, Keyes M, Kuban DA, Frank SJ.   Are you the author?
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiation Oncology, Banner Health, Loveland/Greeley, Colorado; Department of Radiation Oncology, Bon Secours Health System, Norfolk, Virginia; Department of Radiation Oncology, Cancer Center for the Southern Interior, Kelowna, British Columbia, Canada; Department of Radiation Medicine, North Shore-LIJ Health System, New Hyde Park, New York; Chicago Prostate Center, Westmont, Illinois; Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Center, Vancouver, British Columbia, Canada.  

Reference: Int J Radiat Oncol Biol Phys. 2014 Aug 20. pii: S0360-3016(14)03408-7.
doi: 10.1016/j.ijrobp.2014.06.036

PubMed Abstract
PMID: 25151539 Prostate Cancer Section