MD Anderson (HDR GYN and HDR/LDR GU)

ABS 300-in-10 Brachytherapy Elective Rotation
Description, Goals and Objectives

The University of Texas MD Anderson Cancer Center serves as one of the 300 in 10 training sites for the American Brachytherapy Society (ABS) radiation oncology resident elective, a two-month, clinical experience for PGY4 and PGY5 residents.

The purpose of the rotation is to allow PGY4 and PGY5 radiation oncology residents focused time to strengthen skills and competence in the delivery of GU or GYN brachytherapy for cancer patients. The goal of the ABS two-month, clinical elective is to provide PGY4 and PGY5 radiation oncology residents with clinical, hands-on experience in the delivery of brachytherapy in GU and GYN in a high-volume clinical setting. Upon completion of the two-month rotation, residents will be competent in:

Communicating about brachytherapy (GU/GYN)

  • Communicating with the referring physician
  • Articulating treatment rationale in QA conference and planning clinic
  • Communicating the advancements in brachytherapy with MRI in every step of the quality assurance process and MRI-Assisted Radiosurgery (MARS) LDR brachytherapy workflow
  • Communicating with patients
    • Taking consent for treatment
    • Discussing prognosis

Selecting appropriate patients for brachytherapy (GU)

  • Identifying monotherapy, combination, and trimodality considerations for prostate cancer
  • Evaluating applicator choices for gyn brachytherapy
  • Identifying appropriate seed (I-125, Pd-103, and Cs-131) selections for prostate cancer

Perform MR and Ultrasound Simulation for Brachytherapy (GU)

  • Perform virtual MRI simulation for LDR brachytherapy

Perform and Evaluate MR and Ultrasound LDR Treatment Planning (GU)

  • Learn to perform modified peripheral loading (I-125)
  • Learn to perform modified uniform loading (Pd-103)
  • Learn to perform modified peripheral loading with rectal sparing (Cs-131)

Perform MARS LDR brachytherapy (GU)

  • Learn OR equipment and patient setup
  • Learn needle insertion technique
  • Learn pre-deployment technique
  • Learn deployment of radioactive sources/strands technique
  • Learn needle extraction technique
  • Learn post-implant quality assurance process/evaluation with CT and MRI

Perform brachytherapy insertions (GYN)

  • Placement of intracavitary implants for gyn brachytherapy
  • Consistently achieving good packing on intracavitary treatment
  • Perform applicator placement of hybrid interstitial applicators
  • Insertions of interstitial implants

Perform treatment planning for brachytherapy (GYN)

  • Performing image guided brachytherapy with CT and MRI based treatment plans
    • Plan needle placement
    • Selecting loadings and treatment times for various types of ICRT including HDR and PDR brachytherapy

Evaluate treatment plan/prescribe treatment (GYN)

  • Be able to discuss fractionation schemes
  • Understand dose constraints for brachytherapy and implications for short- and long-term toxicity
  • Be able to calculate EQD2s for fractionated HDR

Clinical care for brachytherapy patients (GU/GYN)

  • Preparation for brachytherapy procedures
  • Peri-operative management of complications
  • Removal of implants

Residents who join for the ABS clinical rotation will participate in weekly planning clinics (when applicable), GYN or GU service-specific didactics, division grand rounds, and other department- supported didactics for trainees.


ABS Fellowship Application: MD Anderson Cancer Center, HDR GYN and HDR/LDR GU

Accepting Applications