In x-ray phototherapy of brain tumours, the tumour is loaded with iodine and exposed to kilovoltage x-rays. Due to the high photoelectric cross sections of iodine, substantial photoelectric interactions occur. The flux of photoelectrons, characteristic x-rays and Auger electrons produce a localized dose enhancement. A modified computed tomography scanner, CTRx, can be used both for tumour localization and delivery of the dose enhancement therapy. Monte Carlo methods were employed to simulate the treatment of iodinated brain tumours with a CTRx. The calculated results reveal the effect of tumour iodine concentration on dose distribution, the degree of skull bone sparing with the application of multiple arcs, and the homogeneity of tumour dose distribution versus iodine concentration. A comparison with 10 MV stereotactic radiosurgery treatment shows the potential of CTRx treatment relative to conventional treatment modalities.

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The Monte Carlo code MCNP (Monte Carlo N-Particle) has a significant history dating to the early years of the Manhattan Project. More recently, MCNP has been used successfully to solve many problems in the field of medical physics. In radiotherapy applications MCNP has been used successfully to calculate the bremsstrahlung spectra from medical linear accelerators, for modeling the dose distributions around high dose rate brachytherapy sources, and for evaluating the dosimetric properties of new radioactive sources used in intravascular irradiation for prevention of restenosis following angioplasty. MCNP has also been used for radioimmunotherapy and boron neutron capture therapy applications. It has been used to predict fast neutron activation of shielding and biological materials. One area that holds tremendous clinical promise is that of radiotherapy treatment planning. In diagnostic applications, MCNP has been used to model X-ray computed tomography and positron emission tomography scanners, to compute the dose delivered from CT procedures, and to determine detector characteristics of nuclear medicine devices. MCNP has been used to determine particle fluxes around radiotherapy treatment devices and to perform shielding calculations in radiotherapy treatment rooms. This manuscript is intended to provide to the reader a comprehensive summary of medical physics applications of the MCNP code.

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