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Register a new userGeneralized coordinate transformations for Monte Carlo (DOSXYZnrc and VMC++) verifications of DICOM compatible radiotherapy treatment plans
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The International Electrotechnical Commission (IEC) has previously defined standard rotation operators for positive gantry, collimator and couch rotations for the radiotherapy DICOM coordinate system that is commonly used by treatment planning systems. Coordinate transformations to the coordinate systems of commonly used Monte Carlo (MC) codes (BEAMnrc/DOSXYZnrc and VMC++) have been derived and published in the literature. However, these coordinate transformations disregard patient orientation during the computed tomography (CT) scan, and assume the most commonly used head first, supine orientation. While less common, other patient orientations are used in clinics - Monte Carlo verification of such treatments can be problematic due to the lack of appropriate coordinate transformations. In this work, a solution has been obtained by correcting the CT-derived phantom orientation and deriving generalized coordinate transformations for field angles in the DOSXYZnrc and VMC++ codes. The rotation operator that includes any possible patient treatment orientation was determined using the DICOM Image Orientation tag (0020,0037). The derived transformations of the patient image and beam direction angles were verified by comparison of MC dose distributions with the Eclipse treatment planning system, calculated for each of the eight possible patient orientations.
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Monte Carlo (MC) methods provide the most accurate to-date dose calculations in heterogeneous media and complex geometries, and this spawns increasing interest in incorporating MC calculations into treatment planning quality assurance process. This involves MC dose calculations for clinically produced treatment plans. To perform these calculations, a number of treatment plan parameters specifying radiation beam and patient geometries need to be transferred to MC codes, such as BEAMnrc and DOSXYZnrc. Extracting these parameters from DICOM files is not a trivial task, one that has previously been performed mostly using Matlab-based software. This paper describes the DICOM tags that contain information required for MC modeling of conformal and IMRT plans, and reports the development of an in-house DICOM interface, through a library (named Vega) of platform-independent, object-oriented C++ codes. The Vega library is small and succinct, offering just the fundamental functions for reading/modifying/writing DICOM files in a C++ program. The library, however, is flexible enough to extract all MC required data from DICOM files, and write MC produced dose distributions into DICOM files that can then be processed in a treatment planning system environment. The library can be made available upon request to the authors.
We have previously described RapidBrachyMCTPS, a brachytherapy treatment planning toolkit consisting of a graphical user interface (GUI) and a Geant4-based Monte Carlo (MC) dose calculation engine. This work describes the tools that have recently bee
n added to RapidBrachyMCTPS, such that it now serves as the first stand-alone application for MC-based brachytherapy treatment planning. Notable changes include updated applicator import and positioning, three-plane contouring tools, and updated dose optimization algorithms that, in addition to optimizing dwell position and dwell time, also optimize the rotating shield angles in intensity modulated brachytherapy. The main modules of RapidBrachyMCTPS were validated including DICOM import, applicator import and positioning, contouring, material assignment, source specification, catheter reconstruction, EGSphant generation, interface with the MC code, and dose optimization and analysis tools. Two patient cases were simulated to demonstrate these principles, illustrating the control and flexibility offered by RapidBrachyMCTPS for all steps of the treatment planning pathway. RapidBrachyMCTPS is now a stand-alone application for brachytherapy treatment planning, and offers a user-friendly interface to access powerful MC calculations. It can be used to validate dose distributions from clinical treatment planning systems or model-based dose calculation algorithms, and is also well suited to testing novel combinations of radiation sources and applicators, especially those shielded with high-Z materials.
Purpose: A Monte Carlo (MC) beam model and its implementation in a clinical treatment planning system (TPS, Varian Eclipse) are presented for a modified ultra-high dose-rate electron FLASH radiotherapy (eFLASH-RT) LINAC. Methods: The gantry head without scattering foils or targets, representative of the LINAC modifications, was modelled in Geant4. The energy spectrum ({sigma}E) and beam source emittance cone angle ({theta}cone) were varied to match the calculated and Gafchromic film measured central-axis percent depth dose (PDD) and lateral profiles. Its Eclipse configuration was validated with measured profiles of the open field and nominal fields for clinical applicators. eFLASH-RT plans were MC forward calculated in Geant4 for a mouse brain treatment and compared to a conventional (Conv-RT) plan in Eclipse for a human patient with metastatic renal cell carcinoma. Results: The beam model and its Eclipse configuration agreed best with measurements at {sigma}E=0.5 MeV and {theta}cone=3.9+/-0.2 degrees to clinically acceptable accuracy (the absolute average error was within 1.5% for in-water lateral, 3% for in-air lateral, and 2% for PDD). The forward dose calculation showed dose was delivered to the entire mouse brain with adequate conformality. The human patient case demonstrated the planning capability with routine accessories in relatively complex geometry to achieve an acceptable plan (90% of the tumor volume receiving 95% and 90% of the prescribed dose for eFLASH and Conv-RT, respectively). Conclusion: To the best of our knowledge, this is the first functional beam model commissioned in a clinical TPS for eFLASH-RT, enabling planning and evaluation with minimal deviation from Conv-RT workflow. It facilitates the clinical translation as eFLASH-RT and Conv-RT plan quality were comparable for a human patient. The methods can be expanded to model other eFLASH irradiators.
The next great leap toward improving treatment of cancer with radiation will require the combined use of online adaptive and magnetic resonance guided radiation therapy techniques with automatic X-ray beam orientation selection. Unfortunately, by uniting these advancements, we are met with a substantial expansion in the required dose information and consequential increase to the overall computational time imposed during radiation treatment planning, which cannot be handled by existing techniques for accelerating Monte Carlo dose calculation. We propose a deep convolutional neural network approach that unlocks new levels of acceleration and accuracy with regards to post-processed Monte Carlo dose results by relying on data-driven learned representations of low-level beamlet dose distributions instead of more limited filter-based denoising techniques that only utilize the information in a single dose input. Our method uses parallel UNET branches acting on three input channels before mixing latent understanding to produce noise-free dose predictions. Our model achieves a normalized mean absolute error of only 0.106% compared with the ground truth dose contrasting the 25.7% error of the under sampled MC dose fed into the network at prediction time. Our models per-beamlet prediction time is ~220ms, including Monte Carlo simulation and network prediction, with substantial additional acceleration expected from batched processing and combination with existing Monte Carlo acceleration techniques. Our method shows promise toward enabling clinical practice of advanced treatment technologies.
Purpose: To investigate the validity of two Monte Carlo simulation absolute dosimetry approaches in the case of a small field dedicated `D-shaped collimator used for the retinoblastoma treatment with external photon beam radiotherapy. Methods: The Monte Carlo code {sc penelope} is used to simulate the linac, the dedicated collimator and a water phantom. The absolute doses (in Gy per monitor unit) for the field sizes considered are obtained within the approach of Popescu {it et al.} in which the tallied backscattered dose in the monitor chamber is accounted for. The results are compared to experimental data, to those found with a simpler Monte Carlo approximation for the calculation of absolute doses and to those provided by the analytical anisotropic algorithm. Our analysis allows for the study of the simulation tracking parameters. Two sets of parameters have been considered for the simulation of the particle transport in the linac target. Results: The change in the tracking parameters produced non-negligible differences, of about 10% or larger, in the doses estimated in reference conditions. The Monte Carlo results for the absolute doses differ from the experimental ones by 2.6% and 1.7% for the two parameter sets for the collimator geometries analyzed. For the studied fields, the simpler approach produces absolute doses that are statistically compatible with those obtained with the approach of Popescu {it et al.} The analytical anisotropic algorithm underestimates the experimental absolute doses with discrepancies larger than those found for Monte Carlo results. Conclusions: The approach studied can be considered for absolute dosimetry in the case of small, `D-shaped and off-axis radiation fields. However, a detailed description of the radiation transport in the linac target is mandatory for an accurate absolute dosimetry.
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