Last week, I attended a meeting of the Texas Radiation Advisory Board (TRAB), which reviews and evaluates state radiation policies, programs, and rules. The board also makes recommendations and provides technical advice on matters relating to development, use, and regulation of sources of radiation. At the meeting, there was an update from the Department of State Health Services (DSHS) regarding treatment techniques utilizing Electronically Generated Low-Energy Sources for Skin Radiation, or ELS. This technology is also referred to as electronic surface brachytherapy.
In 2009, the U.S. Food and Drug Administration (FDA) approved ELS for skin cancer treatment. These devices were preliminarily designed for intercavity treatments, such as on breast tissue, but the dermatological applications are relatively recent. The ESL devices are becoming more common, as there is a reimbursement code for the procedure.
DSHS is currently working with dermatological offices around the state to approve expanded utilization. DSHS rules relating to ESL devices were initially drafted for intercavity applications, so some modifications of the rule may be necessary. DSHS worked successfully with Texas dermatologists to grant conditional approval for use of these devices as a part of the application process, in advance of potentially revisiting the current rules.
Moreover, DSHS personnel sit on a task force at the national Conference of Radiation Control Program Directors, which serves as a collective resource pool for information relating to licensing, inspection, application, etc. of new technologies. When ESL utilization began to increase, the task force solicited the involvement of U.S. dermatologists to access their expertise on the subject.
DSHS will continue to keep TRAB up to date about the deployment of these devices and their implications for control of radioactive materials in Texas. However, since no radioactive materials are used by ESL devices, fewer increased controls will be necessary.
More information about electronic surface brachytherapy can be found HERE.