Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy

Kang, Dong‐Jin; Shin, Young-Joo; Jeong, Seonghoon; Jung, Jaejoon; Lee, Hakjae; Lee, Boram

doi:10.1186/s13014-020-01722-0

Cited by 6 publications

(4 citation statements)

References 55 publications

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“…Despite these uncertainties, the use of secondary cancer risk models is of increasing interest for clinical application. The models described here have also been implemented in a clinical workflow for estimating in-field secondary risk estimates by Kang et al (2021).…”

Section: Patient-specific Risk Resultsmentioning

confidence: 99%

A framework for in-field and out-of-field patient specific secondary cancer risk estimates from treatment plans using the TOPAS Monte Carlo system

Meyer,

Peters,

Tamborino

et al. 2024

Phys. Med. Biol.

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Objective: To allow the estimation of secondary cancer risks from radiation therapy treatment plans in a comprehensive and user-friendly Monte Carlo framework. Approach: Patient planning CTs were extended superior-inferior using the ICRP Publication 145 computational mesh phantoms and skeletal matching. Dose distributions were calculated with the TOPAS Monte Carlo system using novel mesh capabilities and the DICOM-RT interface. Finally, in-field and out-of-field cancer risk was calculated using both sarcoma and carcinoma risk models with two alternative parameter sets.Main results: The TOPAS Monte Carlo framework was extended to facilitate epidemiological studies on radiation-induced cancer risk. The framework is efficient and allows automated analysis of large datasets. Out-of-field organ dose was small compared to in-field dose, but the risk estimates indicate a non-negligible contribution to the total radiation induced cancer risk. Significance: The implementation of anatomical extension, mesh phantom capabilities, and cancer risk models into the TOPAS Monte Carlo system makes state-of-the-art out-of-field dose calculation and risk estimation accessible to a large pool of users while facilitating further refinement of risk models and sensitivity analysis of patient specific treatment options.

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Section: Patient-specific Risk Resultsmentioning

confidence: 99%

A framework for in-field and out-of-field patient specific secondary cancer risk estimates from treatment plans using the TOPAS Monte Carlo system

Meyer,

Peters,

Tamborino

et al. 2024

Phys. Med. Biol.

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“…The stent was fixed at angles of 0°, 45°, and 90°, respectively, to evaluate the angular dependence by calculating the dosimetric difference depending on the incident angle of the beam [ 8 ]. In addition, to evaluate the effect of dose perturbation by the stent in actual clinical practice, the dose perturbation was evaluated by virtualizing digital human phantom together with the stent [ 22 ]. The human phantom data was converted into metadata format and the dose was calculated with the MC engine through stoichiometric correction [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

“…In addition, to evaluate the effect of dose perturbation by the stent in actual clinical practice, the dose perturbation was evaluated by virtualizing digital human phantom together with the stent [ 22 ]. The human phantom data was converted into metadata format and the dose was calculated with the MC engine through stoichiometric correction [ 22 ]. In the case of photon beam, the two-half arc technique with one isocentre was used as the VMAT most used in clinical practice, and in the case of proton beam, the three-field technique was planned using the double scattering method.…”

Section: Methodsmentioning

confidence: 99%

Assessment of dose perturbations for metal stent in photon and proton radiotherapy plans for hepatocellular carcinoma

et al. 2022

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Background The present study aimed to investigate the dosimetric impact of metal stent for photon and proton treatment plans in hepatocellular carcinoma. Methods With computed tomography data of a water-equivalent solid phantom, dose perturbation caused by a metal stent included in the photon and proton treatment of hepatocellular carcinoma was evaluated by comparing Eclipse and RayStation treatment planning system (TPS) to a Monte Carlo (MC) based dose calculator. Photon and proton plans were created with anterior–posterior/posterior-anterior (AP/PA) fields using a 6 MV beam and AP/PA fields of a wobbling beam using 150 MeV and a 10 cm ridge filter. The difference in dose distributions and dosimetric parameters were compared depending on the stent's positions (the bile duct (GB) and intestinal tract (GI)) and angles (0°, 45°, and 90°). Additionally, the dose variation in the target volume including the stent was comparatively evaluated through dose volume histogram (DVH) analysis. And the comparison of clinical cases was carried out in the same way. Results Percentage differences in the dosimetric parameters calculated by MC ranged from − 7.0 to 3.9% for the photon plan and − 33.7 to 4.3% for the proton plan, depending on the angle at which the GB and GI stents were placed, compared to those without the stent. The maximum difference was observed at the minimum dose (Dmin), which was observed in both photon and proton plans in the GB and GI stents deployed at a 90° incidence angle. The parameter differences were greater in the proton plan than in photon plan. The target volume showed various dose variations depending on positions and angles of stent for both beams. Compared with no-stent, the doses within the target volume containing the GI and GB stents for the photon beam were overestimated in the high-dose area at 0°, nearly equal within 1% at 45°, and underestimated at 90°. These doses to the proton beam were underestimated at all angles, and the amount of underdose to the target volume increased with an increase in the stent angle. However, the difference was significantly greater with the proton plan than the photon plan. Conclusions Dose perturbations within the target volume due to the presence of the metal stent were not observed in the TPS calculations for photon and proton beams, but MC was used to confirm that there are dose variations within the target volume. The MC results found that delivery of the treatment beam avoiding the stent was the best method to prevent target volume underdose.

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“…It is well known that clinical treatment planning systems (TPS) do not provide an adequate estimation of the out-of-field dose (3,(10)(11)(12). Planning computerized tomographies (CT) only include the target volume and organs-at-risk (OARs) in proximity to the treatment field since, for radiation protection purposes and other considerations, they do not cover the full body.…”

Section: Introductionmentioning

confidence: 99%

Experimental Validation of an Analytical Program and a Monte Carlo Simulation for the Computation of the Far Out-of-Field Dose in External Beam Photon Therapy Applied to Pediatric Patients

et al. 2022

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BackgroundThe out-of-the-field absorbed dose affects the probability of primary second radiation-induced cancers. This is particularly relevant in the case of pediatric treatments. There are currently no methods employed in the clinical routine for the computation of dose distributions from stray radiation in radiotherapy. To overcome this limitation in the framework of conventional teletherapy with photon beams, two computational tools have been developed—one based on an analytical approach and another depending on a fast Monte Carlo algorithm. The purpose of this work is to evaluate the accuracy of these approaches by comparison with experimental data obtained from anthropomorphic phantom irradiations.Materials and MethodsAn anthropomorphic phantom representing a 5-year-old child (ATOM, CIRS) was irradiated considering a brain tumor using a Varian TrueBeam linac. Two treatments for the same planned target volume (PTV) were considered, namely, intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). In all cases, the irradiation was conducted with a 6-MV energy beam using the flattening filter for a prescribed dose of 3.6 Gy to the PTV. The phantom had natLiF : Mg, Cu, P (MCP-N) thermoluminescent dosimeters (TLDs) in its 180 holes. The uncertainty of the experimental data was around 20%, which was mostly attributed to the MCP-N energy dependence. To calculate the out-of-field dose, an analytical algorithm was implemented to be run from a Varian Eclipse TPS. This algorithm considers that all anatomical structures are filled with water, with the exception of the lungs which are made of air. The fast Monte Carlo code dose planning method was also used for computing the out-of-field dose. It was executed from the dose verification system PRIMO using a phase-space file containing 3x109 histories, reaching an average standard statistical uncertainty of less than 0.2% (coverage factor k = 1 ) on all voxels scoring more than 50% of the maximum dose. The standard statistical uncertainty of out-of-field voxels in the Monte Carlo simulation did not exceed 5%. For the Monte Carlo simulation the actual chemical composition of the materials used in ATOM, as provided by the manufacturer, was employed.ResultsIn the out-of-the-field region, the absorbed dose was on average four orders of magnitude lower than the dose at the PTV. For the two modalities employed, the discrepancy between the central values of the TLDs located in the out-of-the-field region and the corresponding positions in the analytic model were in general less than 40%. The discrepancy in the lung doses was more pronounced for IMRT. The same comparison between the experimental and the Monte Carlo data yielded differences which are, in general, smaller than 20%. It was observed that the VMAT irradiation produces the smallest out-of-the-field dose when compared to IMRT.ConclusionsThe proposed computational methods for the routine calculation of the out-of-the-field dose produce results that are similar, in most cases, with the experimental data. It has been experimentally found that the VMAT irradiation produces the smallest out-of-the-field dose when compared to IMRT for a given PTV.

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Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy

Cited by 6 publications

References 55 publications

A framework for in-field and out-of-field patient specific secondary cancer risk estimates from treatment plans using the TOPAS Monte Carlo system

A framework for in-field and out-of-field patient specific secondary cancer risk estimates from treatment plans using the TOPAS Monte Carlo system

Assessment of dose perturbations for metal stent in photon and proton radiotherapy plans for hepatocellular carcinoma

Experimental Validation of an Analytical Program and a Monte Carlo Simulation for the Computation of the Far Out-of-Field Dose in External Beam Photon Therapy Applied to Pediatric Patients

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