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Purpose: The purpose of this study was to determine the feasibility of online adaptive transrectal ultrasound (TRUS)-based high-dose-rate prostate brachytherapy (HDRPBT) through retrospective simulation of source positioning and catheter swap errors on patient treatment plans. Method: Source positioning errors (catheter shifts in 1 mm increments in the cranial/caudal, anterior/posterior, and medial/lateral directions up to ±6 mm) and catheter swap errors (between the most and least heavily weighted) were introduced retrospectively into DICOM treatment plans of 20 patients that previously received TRUS HDRPBT. Dose volume histogram (DVH) indices were monitored as errors were introduced sequentially into individual catheters, simulating potential errors throughout treatment. Whenever DVH indices were outside institution thresholds: prostate V100% <95%, urethra D0.1cc >118% and rectum Dmax >80%, the plan was adapted using remaining catheters (i.e., simulating previous catheters ....
High dose rate brachytherapy allows the delivery of radiation internally, with high-dose gradients creating a conformal distribution. The inherent drawback of this treatment exists within small uncertainties producing a large impact on safety and efficacy. Applicator displacement was ret-rospectively simulated for 29 cervical cancer treatments to determine a critical shift in applicator position. A 2 mm shift in the anterior and posterior directions was detrimental to the bladder and rectum, respectively and a 4 mm shift in all directions caused a critical reduction in HR-CTV cover-age. These findings indicate the importance of quality assurance practices that mitigate applicator displacement. Furthermore, the source localisation accuracy required for cervical brachytherapy was quantified. HDR gynaecological brachytherapy relies on 3D imaging, contouring, precise reconstruc-tion of applicator position and transfer of data to the afterloading device. To evaluate this process an end-to ....