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DVHs are mandatory in brachytherapy due to the gradient of
dose and the high dose inside the implant
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Margin to the CTV is not convenient, therefore D90 > PD and
V100 > 90% are useful.
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V150 should not be over 1/3 of the implant (DNR or DHI)
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In prostate and cervix, DNR of 0.5 is allowed because they are
no functional organs.
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Natural DVH and quality parameters QI, UI, are useful for
comparison of different plans
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DVHs are needed to prescribe dose to a volume and to
evaluate the prescription to the CTV and OAR
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Take into account “aimed vs planned” prescription
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Without CTV, prescription is to an isodose. Select properly
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With a single line, prescription is to distance in mm.
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Follow the guidelines
Take home messages: