TABLE 12.

Example brachytherapy treatment plan report elements

Section	Recommended	Optional
General	Hospital/location Print date or date of service Planning system (version)	Page numbers Plan creation/revision date Planner/staff
Demographics	Patient name/MRN	Date of birth/gender
Prescription/Written directive on plan document	Target Anatomic Site Dose Fractionation Prescription method/Plan normalization method	Course/diagnosis identifier Planner/physician approval/date
Plan Summary	Isotope Initial calibration (date, time and source strength) current activity and decay factor Catheter connection channel identifiers First dwell position and offset Catheter (length/index) Source positions (step/space) and dwell time Total delivery time
Additional Plan info	Treatment date and time Ref points/points of interests Treatment unit name Applicator name, size
Dose calculation	Calculation method (eg, TG−43, TG−186, etc.)
Catheter 3D View	Catheter reconstruction view Applicator model name used for planning
Images with Isodose	Absolute isodose lines with selected target and OARs contours Prescription isodose level(s) Patient orientation
DVHs	Structure names Defined dose goals to each treatment volume and OARs DVHs