Platform for automatic patient quality assurance via Monte Carlo simulations in proton therapy

Marmitt, Gabriel Guterres; Pin, A.; Siang, Kelvin Ng Wei; Janssens, Guillaume; Souris, Kevin; Cohilis, Marie; Langendijk, Johannes A.; Both, Stefan; Knopf, Antje; Meijers, Artürs

doi:10.1016/j.ejmp.2019.12.018

Cited by 24 publications

(12 citation statements)

References 26 publications

(30 reference statements)

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“…In fact, time needed for patient QA could be dedicated for the actual patient treatment. Therefore, reduction in the number of measurements is widely discussed among medical physicists [9][10][11][12][13][14]. Supplementing or replacing patient QA measurements with dose distribution recalculation using a second, independent, dose-calculation engines can be beneficial for PBT facilities.…”

Section: Introductionmentioning

confidence: 99%

Commissioning of GPU–Accelerated Monte Carlo Code FRED for Clinical Applications in Proton Therapy

et al. 2021

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We present commissioning and validation of Fred, a graphical processing unit (GPU)–accelerated Monte Carlo code, for two proton beam therapy facilities of different beam line design: CCB (Krakow, IBA) and EMORY (Atlanta, Varian). We followed clinical acceptance tests required to approve the certified treatment planning system for clinical use. We implemented an automated and efficient procedure to build a parameter library characterizing the clinical proton pencil beam. Beam energy, energy spread, lateral propagation model, and a dosimetric calibration factor were parametrized based on measurements performed during the facility start-up. The Fred beam model was validated against commissioning and supplementary measurements performed with and without range shifter. We obtained 1) submillimeter agreement of Bragg peak shapes in water and lateral beam profiles in air and slab phantoms, 2) <2% dose agreement for spread out Bragg peaks of different ranges, 3) average gamma index (2%/2 mm) passing rate of >95% for >1000 patient verification measurements using a two-dimensional array of ionization chambers, and 4) gamma index passing rate of >99% for three-dimensional dose distributions computed with Fred and measured with an array of ionization chambers behind an anthropomorphic phantom. The results of example treatment planning study on >100 patients demonstrated that Fred simulations in computed tomography enable an accurate prediction of dose distribution in patient and application of Fred as second patient quality assurance tool. Computation of a patient treatment in a CT using 104 protons per pencil beam took on average 2′30 min with a tracking rate of 2.9×105p+/s. Fred was successfully commissioned and validated against the clinical beam model, showing that it could potentially be used in clinical routine. Thanks to high computational performance due to GPU acceleration and an automated beam model implementation method, the application of Fred is now possible for research or quality assurance purposes in most of the proton facilities.

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Section: Introductionmentioning

confidence: 99%

Commissioning of GPU–Accelerated Monte Carlo Code FRED for Clinical Applications in Proton Therapy

et al. 2021

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“…the recomputation of a plan exported by the TPS using an IDC system, only allows to check TPS dose computation errors, but cannot detect beam delivery failures or data transfer corruption. For this reason, several groups have worked on the combination of IDC systems with machine steering files and/or treatment log-files [7][8][9][10][11]. With respect to LIBT, for ions heavier than protons, much less literature is available.…”

Section: Introductionmentioning

confidence: 99%

The GATE-RTion/IDEAL Independent Dose Calculation System for Light Ion Beam Therapy

et al. 2021

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Patient specific quality assurance can be improved using an independent dose calculation system. In addition, the implementation of such a system may support light ion beam therapy facilities in reducing the needs for beam time, by substituting some of the experimental patient-specific quality assurance procedures by independent dose calculation. The GATE-RTion-based IDEAL system for light ion beam therapy was developed for this purpose. It was built in a DICOM-in, DICOM-out fashion, for easy integration into a state-of-the-art technology-based workflow for scanned ion beam therapy. This article describes the IDEAL system, followed by its clinical implementation at MedAustron for proton and carbon ion beams. Medical physics acceptance and commissioning steps are presented together with key results: for 3D proton and carbon ion reference boxes, 97% of the points agreed within 5% from the measurements. Experimental validation of stopping powers using real pig samples were between 1.8% and 3.8% for soft tissues. Finally, five clinical cases are described, i.e. two proton and three carbon ion treatments. Dosimetric benchmarking against TPS calculations are presented and discussed in details. As expected, the IDEAL software evidenced limitations arising from the pencil beam algorithm available in the TPS for carbon ions, especially in the presence of air cavities. The IDEAL system was found to satisfy the clinical requirements for independent dose calculation of scanned ion beam delivery systems and is being clinically implemented at MedAustron. The open-source code as well as the documentation was released on the OpenGATE collaboration website, thus allowing for long term maintenance and future upgrades based on a more widespread utilization.

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“… 9 Machine log file-based QA was investigated by several studies. 31 - 33 This function is currently under development at our clinic and will be added to the MC2InRS platform in the future. Finally, in our opinion, the calculation-measurement-combined approach would be more suitable for PBS secondary dose verification.…”

Section: Discussionmentioning

confidence: 99%

Fast MCsquare-Based Independent Dose Verification Platform for Pencil Beam Scanning Proton Therapy

Liu

Park

et al. 2021

Technol Cancer Res Treat

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Purpose: To commission MCsquare (a multi-cores CPU-based dose calculation engine) for pencil beam scanning (PBS) proton therapy, integrate it into RayStation treatment plan system (TPS) to create a dedicated platform for fast independent dose verification. Method: A MCsquare-based independent dose verification platform (MC2InRS) was developed to realize automatic dose re-calculation for clinical use, including data preparation, dose calculation, 2D/3D gamma analysis. MCsquare was commissioned based on in-air lateral dose profiles, integrated depth dose, and the absolute dose of different beam energies for Proteus®ONE. MC2InRS was validated with measurement data using various targets and depths in a water phantom. This study also investigated 15 clinical cases to demonstrate the feasibility and effectiveness of MC2InRS platform in clinic practice. Results: Between simulation and measurement, the distal range differences at 80% (R80) and 20% (R20) dose levels for each energy were below 0.05 mm, and 0.1 mm, respectively, and the absolute dose differences were below 0.5%. 29 out of 36 QA planes reached a 100% gamma passing rate (GPR) for 2%/2mm criteria, and a minimum of 98.3% gamma was obtained in water phantom between simulation and measurement. For the 15 clinical cases investigated, the average 2D GPR (2%/2mm) was 95.4%, 99.3% for MCsquare vs. measurement, MCsquare vs. TPS, respectively. The average 3D GPR (2%/2mm) was 98.9%, 95.3% for MCsquare vs. TPS in water, and computed tomography (CT), respectively. Conclusion: MC2InRS, a fast, independent dose verification platform, has been developed to perform dose verification with high accuracy and efficiency for Pencil Bream Scanning (PBS). Its potential to be applied in routine clinical practice has also been discussed.

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Platform for automatic patient quality assurance via Monte Carlo simulations in proton therapy

Cited by 24 publications

References 26 publications

Commissioning of GPU–Accelerated Monte Carlo Code FRED for Clinical Applications in Proton Therapy

Commissioning of GPU–Accelerated Monte Carlo Code FRED for Clinical Applications in Proton Therapy

The GATE-RTion/IDEAL Independent Dose Calculation System for Light Ion Beam Therapy

Fast MCsquare-Based Independent Dose Verification Platform for Pencil Beam Scanning Proton Therapy

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