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Mechanical evaluation of the Bravos afterloader system for HDR brachytherapy

  • Murillo Bellezzo
    Affiliations
    Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands

    Centro de Engenharia Nuclear, Instituto de Pesquisas Energéticas e Nucleares IPEN-CNEN/SP, São Paulo, Brazil
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  • José A. Baeza
    Affiliations
    Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Robert Voncken
    Affiliations
    Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Brigitte Reniers
    Affiliations
    Research group NuTeC, Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium
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  • Frank Verhaegen
    Affiliations
    Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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  • Gabriel P. Fonseca
    Correspondence
    Corresponding author. Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, 6201 BN, Maastricht, The Netherlands. Tel.: +31-0-88-4455782; fax: +31 88 44 55 667.
    Affiliations
    Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
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      Abstract

      Purpose

      The Bravos afterloader system was released by Varian Medical Systems in October of 2018 for high-dose-rate brachytherapy with 192Ir sources, containing new features such as the CamScale (a new device for daily quality assurance and system recalibration), channel length verification, and different settings for rigid and flexible applicators. This study mechanically evaluated the Bravos system precision and accuracy for clinically relevant scenarios, using dummy sources.

      Methods and Materials

      The system was evaluated after three sets of experiments: (1) The CamScale was used to verify inter- and intra-channel dwelling variability and system calibration; (2) A high-speed camera was used to verify the source simulation cable movement inside a transparent quality assurance device, where dwell positions, dwell times, transit times, speed profiles, and accelerations were measured; (3) The source movement inside clinical applicators was captured with an imaging panel while being exposed to an external kV source. Measured and planned dwell positions and times were compared.

      Results

      Maximum deviations between planned and measured dwell positions and times for the source cable were 0.4 mm for the CamScale measurements and 0.07 seconds for the high-speed camera measurements. Mean dwell position deviations inside clinical applicators were below 1.2 mm for all applicators except the ring that required an offset correction of 1 mm to achieve a mean deviation of 0.4 mm.

      Conclusions

      Features of the Bravos afterloader system provide a robust and precise treatment delivery. All measurements were within manufacturer specifications.

      Keywords

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