TY - JOUR
T1 - Establishing high-quality prostate brachytherapy using a phantom simulator training program
AU - Thaker, Nikhil G.
AU - Kudchadker, Rajat J.
AU - Swanson, David A.
AU - Albert, Jeffrey M.
AU - Mahmood, Usama
AU - Pugh, Thomas J.
AU - Boehling, Nicholas S.
AU - Bruno, Teresa L.
AU - Prestidge, Bradley R.
AU - Crook, Juanita M.
AU - Cox, Brett W.
AU - Potters, Louis
AU - Moran, Brian J.
AU - Keyes, Mira
AU - Kuban, Deborah A.
AU - Frank, Steven J.
N1 - Funding Information:
This project was funded in part by a 2014 RSNA/AUR/APDR/SCARD [Radiological Society of North America/Association of University Radiologists/Association of Program Directors in Radiology/Society of Chairmen of Academic Radiology Departments] Radiology Education Research Development Grant (to N.G.T.). The manuscript was produced as a part of the E. Stephen Amis Fellowship in Quality and Safety of the American College of Radiology (to N.G.T.).
Publisher Copyright:
© 2014 Elsevier Inc.
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Purpose: To design and implement a unique training program that uses a phantombased 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.
AB - Purpose: To design and implement a unique training program that uses a phantombased 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.
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U2 - 10.1016/j.ijrobp.2014.06.036
DO - 10.1016/j.ijrobp.2014.06.036
M3 - Article
C2 - 25151539
AN - SCOPUS:84908025049
SN - 0360-3016
VL - 90
SP - 579
EP - 586
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -