ACR-ABS-ASTRO practice parameter for the performance of radionuclide-based high-dose-rate brachytherapy

Brachytherapy. 2021 Nov-Dec;20(6):1071-1082. doi: 10.1016/j.brachy.2021.08.009. Epub 2021 Sep 26.


Purpose: This practice parameter aims to detail the processes, qualifications of personnel, patient selection, equipment, patient and personnel safety, documentation, and quality control and improvement necessary for an HDR brachytherapy program.

Methods and materials: This practice parameter was revised collaboratively by the American College of Radiology (ACR), the American Brachytherapy Society (ABS), and the American Society for Radiation Oncology (ASTRO).

Results: Brachytherapy is a radiotherapeutic modality in which radionuclide or electronic sources are used to deliver a radiation dose at a distance of up to a few centimeters by surface, intracavitary, intraluminal, or interstitial application. Brachytherapy alone or combined with external beam radiotherapy plays an important role in the management and treatment of patients with cancer. High-dose-rate (HDR) brachytherapy uses radionuclides, such as iridium-192, at dose rates of ≥12 Gy/hr to a designated target point or volume, and it is an important treatment for a variety of malignant and benign conditions. Its use allows for application of high doses of radiation to defined target volumes with relative sparing of adjacent critical structures.

Conclusions: HDR brachytherapy requires detailed attention to personnel, equipment, patient and personnel safety, and continuing staff education. Coordination between the radiation oncologist and treatment planning staff and effective quality assurance procedures are important components of successful HDR brachytherapy programs.

Keywords: Brachytherapy; HDR brachytherapy; High-dose-rate brachytherapy; Radiation oncology; Radionuclides.

MeSH terms

  • Brachytherapy* / methods
  • Humans
  • Neoplasms*
  • Radiation Oncology*
  • Radioisotopes
  • Radiotherapy Dosage
  • Societies, Medical


  • Radioisotopes