Low-dose-rate iodine-125 seed air kerma strength measurement intercomparison

PURPOSE: The purpose of this study was to investigate the rate of compliance of air kerma strength (AKS) measurements of iodine-125 (1-125) seeds with international recommendations by departments in Australia and determine the potential impact of noncompliance. METHODS AND MATERIALS: To achieve this aim, we present an intercomparison of AKS measurements for a single I-125 seed performed by 11 radiotherapy departments in Australia. Measurements were performed at two sites, with each participating department traveling to one of the two host sites and measuring the AKS using their own equipment and local protocols. Each of the AKS measurements was compared with each other and the manufacturer-certified AKS. RESULTS: Nine of the 11 participating departments measured AKS fell within +/- 3% of the manufacturer's calibration certificate value, whereas all participating departments measured AKS within +/- 5% of the manufacturer's calibration certificate value. The total spread of the measured AKS among the 11 departments was 7.7%. Only two of the 11 participating departments complied with international recommendations and had their well chamber calibrated within the last 2 years. In addition, 2 of the 11 departments used a well chamber calibrated that was calibrated with a different seed model used during the intercomparison, whereas 4 of the 11 departments calibrated their well chamber "in-house" using a factory-calibrated seed provided by the seed manufacturer. CONCLUSIONS: A significant variation in the methods used and frequency of calibration of well chambers were observed among the participating departments. The results of this study support the international recommendations on frequency and methodology of well chamber calibration. Failure to follow these recommendations significantly increases the uncertainty in AKS measurement of I-125 seeds. Crown Copyright (C) 2020 Published by Elsevier Inc. on behalf of American Brachytherapy Society. All rights reserved.