benchmarking treatment planning dose calculations using a
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Benchmarking treatment planning dosecalculations using a Monte Carlo dose engine as
a potential activity of a primary standard lab
Nick Reynaert (LSDG, Belgium/Erasmus MC, The Netherlands)Hugo Palmans (NPL, UK)
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Monte Carlo treatment planning
Linac head modellingPatient modelling: CT data – media/densityconversion
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General purpose Monte Carlo codes used for MCTP
EGS4/EGSnrc (BEAMnrc/DOSXYZnrc)PENELOPE GEANTMCNP(X)
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MCTP dose engines
DOSXYZnrc/BEAMnrc engines (Leal et al, Spezi et al, Seco et al, Reynaert et al, …)MCDOSE, MCSIM (Ma et al)VMC, VMC++ (Kawrakow)XVMC (Fippel)Peregrine (Hartmann Siantar et al) DPM (Sempau et al)MCV (Siebers et al)…..
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LSDG: MCDEProject started in 2001DOSXYZnrc Component module for BEAMnrc(ctcreate included in patient CM)1
Independent scoring grid (as in e.g. Peregrine)2,3
Statistic stop (including OAR)4
Dicom interface (CT, linac data, contouring info)Fortran 95 dynamic memory allocationIMAT compatible5
Inverse optimization compatible6 (denoising7)Focussing on benchmarking (not on speed)
1 Reynaert et al, 2004, Phys. Med. Biol. 49 N235-N241; 2 De Smedt et al, 2004, Phys. Med. Biol. 494623-4635; 3 De Smedt et al, 2005, Phys. Med. Biol. 50, 4005-4019; 4 Vanderstraeten et al, 2007, IntJ Rad Onc Biol Phys (in progress); 5 Olteanu et al 2006 (EWG-MCTP workshop); 6 De Smedt et al,
2007, JPCS (in progress); 7 De Smedt et al, 2006, Med. Phys. 33, 1678-1687
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Linac modelling
18 MV model: problem with energy of initialelectrons: removal filters to limit number of tunable parameters: De Smedt et al, 2005, Phys. Med. Biol. 50 5935-5951
MLCE: Van de Walle et al, 2003, Phys. Med. Biol. 48 (3), 371-385
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CT calibration
EWG-MCTP project: Vanderstraeten et al, 2007, Phys. Med. Biol. 52, 539-562Stoichiometric calibration method (Schneideret al 1996 Phys Med Biol 41 111-124, Schneider et al 2000 Phys Med Biol 45 459-478)RMI phantom calibrated in 7 centres in EuropeDosimetric evaluation individual scanner dependence
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CT scanners
CT scanner Location Kph/KKN Kcoh/KKN
Siemens Somatom Plus 4 Ghent University Hospital, Belgium 4.24 × 10-5 a -1.77 × 10-3 a
Philips Gemini GXL PET/CT Ghent University Hospital, Belgium 1.99 × 10-5 9.26 × 10-4
Siemens Somatom Sensation Open University Hospital Tübingen, Germany 2.11 × 10-5 3.70 × 10-4
Siemens Somatom Sensation Open Velindre Cancer Centre, Cardiff, UK 2.30 × 10-5 3.49 × 10-5
Siemens Somatom Sensation Cardiac 64 Clinica Quadrantes, Lisbon, Portugal 2.65 × 10-5 -2.84 × 10-4
Toshiba Xvision/EX HUV Macarena, Seville, Spain 3.89 × 10-5 -8.37 × 10-4
GE HiSpeed QX/i Royal Marsden Hospital, London, UK 2.78 × 10-5 -3.98 × 10-4
GE ProSpeed Inselspital Radioonkologie, Bern,
Switzerland 1.11 × 10-5 4.79 × 10-3
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CT conversion
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CT conversion (final)
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QA: Phantom studies
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Why MC ?
Martens et al, 2002, Med. Phys. 29, 1528-1535
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Patient studies:
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Ethmoid patients: GUH
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Ethmoid patients
optic chiasm PTV
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GRATIS
Helax-TMS
Pinnacle
MCDE
retina optic nerve
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Helax-TMS
Pinnacle
MCDE
Paelinck et al 2006, Rad. Oncol. 81, 250-256
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Lung patients GUH
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Lungs
Vanderstraeten et al, 2006, Med. Phys. 33, 3149-3158
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Lung patients UCL
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Lung patients UCL
Sterpin et al, 2007, Med. Phys. In Press
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Stereotactic radiosurgery: radiochromic film dosimetry
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IMAT: Gel dosimetry (Y. De Deene et al)
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IMAT (bladder, small bowel)
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IMAT: dose profilest11
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Projects
Introduce MCDE as a “standard” in LSDG for Belgium and the Netherlands (QA service)
Euramet project proposal: 3D dosimetry for state of the art treatment modalities: ensuring traceability of MC dose engines
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Experimental benchmarking techniques
MU checks in one point: - ion chambers: ESTRO Quasimodo project,
FCCC (Ma et al)- alanine (e.g. NPL) - fricke (e.g. LNHB) - TLD
3D dosimetry: Gel dosimetry, film dosimetry: accuracy 3 % / 3 mm
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But, What about ….
Experimental techniques are not patientspecific (phantom)Is accuracy good enough to decide on TP system ?For ion chamber point measurements, MC needed for correction factorsTissue equivalence
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MC 3D dose verification
Patient specific 3D dosimetry verification of treatment planAccurate linac modelling (start from database)CT calibrationInterfacing (collaboration TP vendors)Traceability !Network !Establishment large database: post treatment follow-up
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LSDG
USER INTERFACE
Performed by individual institutes
MCDE
Dose calculation
engine
Patient CT scan and treatment parameters
Linac specific measurement set
Treatment unit specific verification session
@ each institute
MCDESmart commissioning
process
Patient dose accuracy parameters•3D (IMRT) dose comparison
•MC based TCP/NTCP values•MC based IMRT constraints
Patient specific extra options•MC predicted PDI
•3D MC dose distribution with 4D / cone beam CT•Toxicity and dose response studies
Multi-center analyses•Trends in quality of linac/TPS commissioning•Accuracy of dose calculation compared to other institutes
•Version testing
Treatment plan evaluation
MC modeling of Tomotherapy, Cyberknife,
MiniMLC, etc
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In vivo ?
EPID MC based 3D dose reconstructionCone beam CT data input for MC doseengine
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Summary
Accurate/well tuned MC dose engines can bea powerfull tool for QA of radiotherapytreatment planningNot to replace measurements, but tocomplement them !Traceability/network necessary standardlabaratories
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AcknowledgementsEWG-MCTP: M. Chin, M. Fippel, M. Fix, A. Leal, G. Lewis, G. Mora, J. Seco, J. Sempau, M. Soukup, E. Spezi
Ghent University: F. Crop, B. De Smedt, C. De Wagter, L. Olteanu, L. Paelinck, H. Palmans, H. Thierens, B. Vanderstraeten, J. Van de Walle
UCL: E. Sterpin, M. Tomsej, S. Vynckier
Erasmus MC: B. Heijmen, Y. Seppenwoolde