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Title: SU-F-T-122: 4Dand 5D Proton Dose Evaluation with Monte Carlo

Abstract

Purpose: We evaluated uncertainties in therapeutic proton doses of a lung treatment, taking into account intra-fractional geometry changes, such as breathing, and inter-fractional changes, such as tumor shrinkage and weight loss. Methods: A Monte Carlo study was performed using four dimensional CT image sets (4DCTs) and weekly repeat imaging (5DCTs) to compute fixed RBE (1.1) and variable RBE weighted dose in an actual lung treatment geometry. The MC2 Monte Carlo system was employed to simulate proton energy deposition and LET distributions according to a thoracic cancer treatment plan developed with a 3D-CT in a commercial treatment planning system, as well as in each of the phases of 4DCT sets which were recorded weekly throughout the course of the treatment. A cumulative dose distribution in relevant structures was computed and compared to the predictions of the treatment planning system. Results: Using the Monte Carlo method, dose deposition estimates with the lowest possible uncertainties were produced. Comparison with treatment planning predictions indicates that significant uncertainties may be associated with therapeutic lung dose prediction from treatment planning systems, depending on the magnitude of inter- and intra-fractional geometry changes. Conclusion: As this is just a case study, a more systematic investigation accounting for amore » cohort of patients is warranted; however, this is less practical because Monte Carlo simulations of such cases require enormous computational resources. Hence our study and any future case studies may serve as validation/benchmarking data for faster dose prediction engines, such as the track repeating algorithm, FDC.« less

Authors:
; ; ; ; ; ;  [1]
  1. UT MD Anderson Cancer Center, Houston, TX (United States)
Publication Date:
OSTI Identifier:
22642363
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED SIMULATION; COMPUTERIZED TOMOGRAPHY; FORECASTING; GEOMETRY; LUNGS; MONTE CARLO METHOD; PLANNING; RADIATION DOSE DISTRIBUTIONS

Citation Formats

Titt, U, Mirkovic, D, Yepes, P, Liu, A, Peeler, C, Randenyia, S, and Mohan, R. SU-F-T-122: 4Dand 5D Proton Dose Evaluation with Monte Carlo. United States: N. p., 2016. Web. doi:10.1118/1.4956258.
Titt, U, Mirkovic, D, Yepes, P, Liu, A, Peeler, C, Randenyia, S, & Mohan, R. SU-F-T-122: 4Dand 5D Proton Dose Evaluation with Monte Carlo. United States. doi:10.1118/1.4956258.
Titt, U, Mirkovic, D, Yepes, P, Liu, A, Peeler, C, Randenyia, S, and Mohan, R. 2016. "SU-F-T-122: 4Dand 5D Proton Dose Evaluation with Monte Carlo". United States. doi:10.1118/1.4956258.
@article{osti_22642363,
title = {SU-F-T-122: 4Dand 5D Proton Dose Evaluation with Monte Carlo},
author = {Titt, U and Mirkovic, D and Yepes, P and Liu, A and Peeler, C and Randenyia, S and Mohan, R},
abstractNote = {Purpose: We evaluated uncertainties in therapeutic proton doses of a lung treatment, taking into account intra-fractional geometry changes, such as breathing, and inter-fractional changes, such as tumor shrinkage and weight loss. Methods: A Monte Carlo study was performed using four dimensional CT image sets (4DCTs) and weekly repeat imaging (5DCTs) to compute fixed RBE (1.1) and variable RBE weighted dose in an actual lung treatment geometry. The MC2 Monte Carlo system was employed to simulate proton energy deposition and LET distributions according to a thoracic cancer treatment plan developed with a 3D-CT in a commercial treatment planning system, as well as in each of the phases of 4DCT sets which were recorded weekly throughout the course of the treatment. A cumulative dose distribution in relevant structures was computed and compared to the predictions of the treatment planning system. Results: Using the Monte Carlo method, dose deposition estimates with the lowest possible uncertainties were produced. Comparison with treatment planning predictions indicates that significant uncertainties may be associated with therapeutic lung dose prediction from treatment planning systems, depending on the magnitude of inter- and intra-fractional geometry changes. Conclusion: As this is just a case study, a more systematic investigation accounting for a cohort of patients is warranted; however, this is less practical because Monte Carlo simulations of such cases require enormous computational resources. Hence our study and any future case studies may serve as validation/benchmarking data for faster dose prediction engines, such as the track repeating algorithm, FDC.},
doi = {10.1118/1.4956258},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • It is shown how Monte Carlo methods can be used to evaluate multidimensional integrals that occur in Glauber scattering theory. A detailed discussion of the various Monte Carlo methods is given. The methods are used to obtain the proton-proton elastic scattering differential cross section, where the proton is composed of three quarks with hard cores. It is found that including a quark hard core has no effect on the differential cross section for a fixed rms quark distance. (auth)
  • Cited by 4
  • The Monte Carlo method provides the most accurate dose calculations on a patient computed tomography (CT) geometry. The increase in accuracy is, at least in part, due to the fact that instead of treating human tissues as water of various densities as in analytical algorithms, the Monte Carlo method allows human tissues to be characterized by elemental composition and mass density, and hence allows the accurate consideration of all relevant electromagnetic and nuclear interactions. On the other hand, the algorithm to convert CT Hounsfield numbers to tissue materials for Monte Carlo dose calculation introduces uncertainties. There is not a simplemore » one to one correspondence between Hounsfield numbers and tissue materials. To investigate the effects of Hounsfield number conversion for proton Monte Carlo dose calculations, clinical proton treatment plans were simulated using the Geant4 Monte Carlo code. Three Hounsfield number to material conversion methods were studied. The results were compared in forms of dose volume histograms of gross tumor volume and clinical target volume. The differences found are generally small but can be dosimetrically significant. Further, different methods may cause deviations in the predicted proton beam range in particular for deep proton fields. Typically, slight discrepancies in mass density assignments play only a minor role in the target region, whereas more significant effects are caused by different assignments in elemental compositions. In the presence of large tissue inhomogeneities, for head and neck treatments, treatment planning decisions could be affected by these differences because of deviations in the predicted tumor coverage. Outside the target area, differences in elemental composition and mass density assignments both may play a role. This can lead to pronounced effects for organs at risk, in particular in the spread-out Bragg peak penumbra or distal regions. In addition, the significance of the elemental composition effect (dose to water vs. dose to tissue) is tissue-type dependent and is also affected by nuclear reactions.« less
  • Purpose: Compare dose distributions for pediatric patients with ependymoma calculated using a Monte Carlo (MC) system and a clinical treatment planning system (TPS). Methods: Plans from ten pediatric patients with ependymoma treated using double scatter proton therapy were exported from the TPS and calculated in our MC system. A field by field comparison of the distal edge (80% and 20%), distal fall off (80% to 20%), field width (50% to 50%), and penumbra (80% to 20%) were examined. In addition, the target dose for the full plan was compared. Results: For the 32 fields from the 10 patients, the averagemore » differences of distal edge at 80% and 20% on central axis between MC and TPS are -1.9 {+-} 1.7 mm (p < 0.001) and -0.6 {+-} 2.3 mm (p= 0.13), respectively. Excluding the fields that ranged out in bone or an air cavity, the 80% difference was -0.9 {+-} 1.7 mm (p= 0.09). The negative value indicates that MC was on average shallower than TPS. The average difference of the 63 field widths of the 10 patients is -0.7 {+-} 1.0 mm (p < 0.001), negative indicating on average the MC had a smaller field width. On average, the difference in the penumbra was 2.3 {+-} 2.1 mm (p < 0.001). The average of the mean clinical target volume dose differences is -1.8% (p= 0.001), negative indicating a lower dose for MC. Conclusions: Overall, the MC system and TPS gave similar results for field width, the 20% distal edge, and the target coverage. For the 80% distal edge and lateral penumbra, there was slight disagreement; however, the difference was less than 2 mm and occurred primarily in highly heterogeneous areas. These differences highlight that the TPS dose calculation cannot be automatically regarded as correct.« less
  • Purpose: To evaluate the differences in dose-averaged linear energy transfer (LETd) maps calculated in water by means of different strategies found in the literature in proton therapy Monte Carlo simulations and to compare their values with dose-mean lineal energy microdosimetry calculations. Methods: The Geant4 toolkit (version 9.6.2) was used. Dose and LETd maps in water were scored for primary protons with cylindrical voxels defined around the beam axis. Three LETd calculation methods were implemented. First, the LETd values were computed by calculating the unrestricted linear energy transfer (LET) associated to each single step weighted by the energy deposition (including delta-rays)more » along the step. Second, the LETd was obtained for each voxel by computing the LET along all the steps simulated for each proton track within the voxel, weighted by the energy deposition of those steps. Third, the LETd was scored as the quotient between the second momentum of the LET distribution, calculated per proton track, over the first momentum. These calculations were made with various voxel thicknesses (0.2 – 2.0 mm) for a 160 MeV proton beamlet and spread-out Bragg Peaks (SOBP). The dose-mean lineal energy was calculated in a uniformly-irradiated water sphere, 0.005 mm radius. Results: The value of the LETd changed systematically with the voxel thickness due to delta-ray emission and the enlargement of the LET distribution spread, especially at shallow depths. Differences of up to a factor 1.8 were found at the depth of maximum dose, leading to similar differences at the central and distal depths of the SOBPs. The third LETd calculation method gave better agreement with microdosimetry calculations around the Bragg Peak. Conclusion: Significant differences were found between LETd map Monte Carlo calculations due to both the calculation strategy and the voxel thickness used. This could have a significant impact in radiobiologically-optimized proton therapy treatments.« less