Department of Radiation Oncology, Tufts University School of Medicine, Boston, Massachusetts, United States of America
While brachytherapy has been applied for over a century, there continue to be substantial advances in delivery techniques and medical devices. These include applying the radiation dose more accurately, more uniformly irradiating the target, delivering higher doses to the target and lower doses to healthy structures, or enhancing patient convenience such as quicker or out-patient treatments. Novel applicators, needle tracking technologies, and in vivo dosimetry methods are being investigated. New radionuclides being considered for brachytherapy include 57Co, 75Se, 101Rh, 144Ce, 153Gd, 169Yb, and 170Tm. These are considered due to their half-lives, radiation range, specific activity, and manufacturing feasibility. Other novel brachytherapy sources contain multiple radionuclides, sources with directional emissions to preferentially irradiate the target, sources that elute chemotherapy agents, or sources with dissolvable encapsulation. Electronic brachytherapy sources are becoming more widespread, and are being better integrated into the existing infrastructure of source calibrations, dose calculations, patient imaging, and treatment delivery. Examples will be presented to highlight the attributes and current hurdles for innovative brachytherapy sources and devices.
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