Table 3.

2018 practice patterns as determined by survey responses

	ABS, TG 129	Institution
		A	B	C	D	E	F	G	H	I
Planning program	FDA approved software	Eye physics plaque simulator	Pinnacle and eye physics plaque simulator	Eye physics plaque simulator	Eye physics plaque simulator	Eye physics plaque simulator	Eye physics plaque simulator	Eye physics plaque simulator	Varian eclipse brachyvision	Eye physics plaque simulator
Year changed to current method		2016	2013	2015	2016	2015	2013	1995	2013	2017
Imaging	Fundus image, ultrasonographs, and/or CT and MRI	Fundus image	Fundus image and CT	Fundus image ± CT/MRI	Fundus image	CT	Fundus image and OCT	Fundus image and CT	Ultrasound	Fundus image AND ultrasound AND CT
Fundus camera		Not reported	Wide field	Wide field and standard	Standard		Wide field and standard	Wide field and standard		Wide field
Plaque style		Eye physics	Eye physics	COMS style	COMS style	Eye physics	COMS style	Eye physics	COMS style	Eye physics and COMS style
Who chooses plaque size		Not reported	Ophthalmology	Ophthalmology	Ophthalmology	Medical physics	Ophthalmology and radiation Oncology	Medical physics	Ophthalmology	Ophthalmology
Plaque margin, mm	2–3 mm	3.27±1.00 (1.15–6.17)	3.62±1.02 (0.75–5.5)	2.42±0.40 (1.75–3.35)	3.40±1.00 (2–6.4)	2.34±1.46 (–2–3.5)	2.24±0.97 (0–7.7)	4.08±1.63 (0.29–5.53)	2.6±0.7 (1–3.6)	2.3±0.3 (1.6–3.3)
Margin no notch, mm		3.13 ±0.91 (1.15–6.17)	3.38±0.90 (0.75–4.5)	2.38±0.37 (1.75–3.2)	3.27±0.86 (2–5.3)	1.69±1.67 (–2–3.5)	2.27±1.01 (1–7.7)	3.52±2.05 (0.29–5.41)	2.6±0.7 (1–3.3)	2.3±0.3 (1.6–3.3)
Margin notch, mm		3.64±1.15 (2–5.75)	4.13±1.05 (2.25–5.5)	2.56±0.54 (2.15–3.35)	4.49±1.50 (2.7–6.4)	2.82±1.15 (2–5)	2.14±0.79 (0–3.5)	4.63±1.00 (3.04–5.53)	2.6±0.7 (1.5–3.6)	2.6±0.1 (2.5–2.8)
Plaque loading		Pre-loaded	Pre-loaded	Pre-loaded	In house	Pre-loaded	Pre-loaded	Pre-loaded	Pre-loaded	Pre-loaded
Isotope		I-125	I-125	I-125	I-125	I-125	I-125	I-125	I-126	I-127
Seed uniformity		Uniform	Uniform	Primarily uniform, 2 activities if needed for sparing or coverage	Primarily uniform, 2 activities if needed for sparing or coverage	Uniform	Uniform	Variable	Uniform	Uniform
Duration, h		96	168	72	100	96	100	168	120–168	89–96
Prescription dose, Gy	85	63	85	85, 75–80 to spare sclera	85	85	85	85	85	85
Dose rate, cGy/h	60–105a	66	51	118	85	89	85	51	50	88–100
Prescription point	Tumor apex	Tumor apex, add height to achieve coverage as needed	≥5 mm: tumor apex, <5 mm: 5 mm from inner sclera	Tumor apex ±1 mm, short tumors: beyond apex	≥5 mm: tumor apex, <5 mm: 1 mm beyond apex	≥5 mm: tumor apex, <5 mm: tumor apex + margin	Tumor apex, add height to achieve coverage as needed	≥5 mm: tumor apex, <5 mm: tumor apex + margin	≥5 mm: tumor apex, <5 mm: tumor apex + margin	≥3.5 mm: Tumor apex, <3.5 mm: 3.5 mm
Normal tissue constraints		None	None	Optic disc Dmax <45 Gy, macula Dmax <45 Gy	Sclera Dmax <400 Gy	Optic disc Dmax <50 Gy, macula Dmax <50 Gy	None	None	None	None
General corrections	Linear source model	Linear source model, 2-D anistropy function	Linear source model, 2-D anistropy function, air scatter correction	Linear source model, 2-D anistropy function	Linear source model, 2-D anistropy function, air scatter correction	Linear source model, 2-D anistropy function	None	Linear source model, 2-D anistropy function	None	Linear source model, 2-D anistropy function, air scatter correction
COMS corrections	Homogeneous water AND silastic carrier attenuation, lipped collimation, and shell collimationb		Silastic carrier attenuation, lipped collimation, shell collimation	Silastic carrier attenuation, lipped collimation, shell collimation	Silastic carrier attenuation, lipped collimation, shell collimation					Silastic carrier attentuation, lipped collimation, shell collimation
Eye physics corrections		Gold correction, slotted collimation	Gold correction, slotted collimation	Gold correction, slotted collimation		Slotted collimation		Gold correction, slotted collimation		Gold correction, slotted collimation

CT, computed tomography; COMS, Collaborative Ocular Melanoma Study.

^aAmerican Brachytherapy Society (ABS) dose rate recommendation is ≥60 cGy/h; American Association of Physicists in Medicine Task Group-43 (TG-43) recommendation is 42–105 cGy/h.

^bIt is recommended by the ABS and AAPM to use homogenous water for dose calculation but to simultaneously calculate heterogeneity corrected doses for comparison.