A virtual-accelerator-based verification of a Monte Carlo dose calculation algorithm for electron beam treatment planning in homogeneous phantoms

SBRT of lung tumours: Monte Carlo simulation with PENELOPE of dose distributions including respiratory motion and comparison with different treatment planning systems

The purpose of this work was to simulate with the Monte Carlo (MC) code PENELOPE the dose distribution in lung tumours including breathing motion in stereotactic body radiation therapy (SBRT). Two phantoms were modelled to simulate a pentagonal cross section with chestwall (unit density), lung (density 0.3 g cm(-3)) and two spherical tumours (unit density) of diameters respectively of 2 cm and 5 cm. The phase-space files (PSF) of four different SBRT field sizes of 6 MV from a Varian accelerator were calculated and used as beam sources to obtain both dose profiles and dose-volume histograms (DVHs) in different volumes of interest. Dose distributions were simulated for five beams impinging on the phantom. The simulations were conducted both for the static case and including the influence of respiratory motion. To reproduce the effect of breathing motion different simulations were performed keeping the beam fixed and displacing the phantom geometry in chosen positions in the cranial and caudal and left-right directions. The final result was obtained by combining the different position with two motion patterns. The MC results were compared with those obtained with three commercial treatment planning systems (TPSs), two based on the pencil beam (PB) algorithm, the TMS-HELAX (Nucletron, Sweden) and Eclipse (Varian Medical System, Palo Alto, CA), and one based on the collapsed cone algorithm (CC), Pinnacle(3) (Philips). Some calculations were also carried out with the analytical anisotropic algorithm (AAA) in the Eclipse system. All calculations with the TPSs were performed without simulated breathing motion, according to clinical practice. In order to compare all the TPSs and MC an absolute dose calibration in Gy/MU was performed. The analysis shows that the dose (Gy/MU) in the central part of the gross tumour volume (GTV) is calculated for both tumour sizes with an accuracy of 2-3% with PB and CC algorithms, compared to MC. At the periphery of the GTV the TPSs overestimate the dose up to 10%, while in the lung tissue close to the GTV PB algorithms overestimate the dose and the CC underestimates it. When clinically relevant breathing motions are included in the MC simulations, the static calculations with the TPSs still give a relatively accurate estimate of the dose in the GTV. On the other hand, the dose at the periphery of the GTV is overestimated, compared to the static case.

A virtual-accelerator-based verification of a Monte Carlo dose calculation algorithm for electron beam treatment planning in clinical situations

BACKGROUND AND PURPOSE

The introduction of Monte Carlo (MC) techniques for treatment planning and also for verification purposes will have considerable impact on the radiation therapy planning process. The aim of this work was to use a virtual accelerator to study the performance of a MC-based electron dose calculation algorithm, implemented in a commercial treatment planning system.

METHODS

The performance in phantoms containing air and bone as well as in patient-specific geometries (thorax wall, nose, parotid gland and spinal cord) has been studied.

RESULTS

The agreement between the virtual accelerator and the MC dose calculation algorithm is generally very good. A gamma-evaluation with criteria of 0.03 Gy/3 mm (per Gy at the depth of maximum dose) shows that, even for the worst cases, only a small volume of about 1.5% has gamma>1.0. In the worst case, with the 0.02 Gy/2 mm criteria, about 92% of the volume receiving more than 0.85 Gy per 100 monitor units (MU) has gamma-values <1.0. The corresponding value for the volume receiving more than 0.10 Gy/100 MU is about 98%. For the 18 MeV spinal-cord case, where a 6 x 20 cm2 insert is used, the TPS underestimates the dose outside the primary field due to inadequate modelling of the insert.

CONCLUSION

The possibility of dose calculations in typical patient cases makes the virtual accelerator a powerful tool for validation and evaluation of dose calculation algorithms present in treatment planning systems.

Coordinate transformations for BEAM/EGSnrc Monte Carlo dose calculations of non-coplanar fields received from a DICOM-compliant treatment planning system

The Monte Carlo (MC) method provides the most accurate to-date dose calculations in heterogeneous media and complex geometries, and this spawns increasing interest in incorporating MC calculations in the treatment planning quality assurance process. This process involves MC dose calculations for the treatment plans produced clinically. Commonly used in radiotherapy, MC codes are BEAMnrc and DOSXYZnrc, which transport particles in a coordinate system (c.s.) that has been established historically and does not correspond to the c.s. of treatment planning systems (TPSs). Relative rotations of these c.s. are not straightforward, especially for non-coplanar treatments. Transformation equations are therefore required to re-calculate a treatment plan using BEAM/DOSXYZnrc codes. This paper presents such transformations for beam angles defined in a DICOM-compliant treatment planning coordinate system. Verification of the derived transformations with two three-field plans simulated on a phantom using TPS as well as MC codes has been performed demonstrating exact geometrical agreement of the MC treatment fields' placement.