ICRU Brachytherapy Reports

The ICRU has published several resports on the use of brachytherapy; some aspects of them are in current use.

ICRU Report 38

ICRU Report 38 describes reporting techniques for cervical brachytherapy.
Importantly, it advises against the Manchester system's "Point A" as it 'lies within a high dose gradient'.
It advises reporting:

  • The width and height of the pear shaped volume generated by a tandem and ovoids applicator
  • The bladder point, located at the posterior aspect of a 10 mL catheter balloon within the bladder.
  • The rectal point, located at the point 5 mm posterior to the midpoint of the activity within the ovoids.
  • The pelvic wall points are located at the junction of a tangents drawn from the superior and medial part of the acetabulum
  • The lymphoid trapezoid of Fletcher describes points that correspond to the location of lymph nodes in the internal iliac, common iliac, and para-aortic nodes

Of these, the bladder point and rectal point are in common use; but point A and point B have remained firmly established.

ICRU Report 58

ICRU report 58 set out guidelines for reporting interstitial brachytherapy treatments. These included several concepts, such as:

  • Prescribed dose (dose prescribed by the oncologist)
  • Minimum Target Dose (minimum dose received by the CTV)
  • Mean Central Dose (the lowest dose between sources)
  • High Dose Volume (the volume receiving > 150% of the prescribed dose)
  • Low Dose Volume (the volume receiving > 90% of the prescribed dose)