A joint physics and radiobiology DREAM team vision - Towards better response prediction models to advance radiotherapy.

Radiotherapy developed empirically through experience balancing tumour control and normal tissue toxicities. Early simple mathematical models formalized this practical knowledge and enabled effective cancer treatment to date. Remarkable advances in technology, computing, and experimental biology now create opportunities to incorporate this knowledge into enhanced computational models.

Monte Carlo simulation of the Varian TrueBeam flattened-filtered beams using a surrogate geometry in PRIMO.

Background: Monte Carlo simulation of radiation transport for medical linear accelerators (linacs) requires accurate knowledge of the geometrical description of the linac head. Since the geometry of Varian TrueBeam machines has not been disclosed, the manufacturer distributes phase-space files of the linac patient-independent part to allow researchers to compute absorbed dose distributions using the Monte Carlo method. This approach limits the possibility of achieving an arbitrarily small statistical uncertainty.

Complete patient exposure during paediatric brain cancer treatment for photon and proton therapy techniques including imaging procedures.

Background: In radiotherapy, especially when treating children, minimising exposure of healthy tissue can prevent the development of adverse outcomes, including second cancers. In this study we propose a validated Monte Carlo framework to evaluate the complete patient exposure during paediatric brain cancer treatment.

Materials And Methods: Organ doses were calculated for treatment of a diffuse midline glioma (50.

Overcoming inter-observer planning variability in target volume contouring and dose planning for high-risk neuroblastoma - a European multicenter effort of the SIOPEN radiotherapy committee.

Background And Purpose: To establish an international quality standard for contouring and planning for high-risk neuroblastoma within the prospective High-Risk Neuroblastoma Study 2 of SIOP-Europe-Neuroblastoma (SIOPEN HR-NBL2), which includes a randomized question on dose escalation for residual disease.

Materials And Methods: Data on four patients with high-risk neuroblastoma were selected and distributed to the radiotherapy committee of the HR-NBL2 study for independent contouring and planning. Differences in contouring were analyzed using apparent and kappa-corrected agreement.

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.

Background: The 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.

Validation of a Monte Carlo Framework for Out-of-Field Dose Calculations in Proton Therapy.

Proton therapy enables to deliver highly conformed dose distributions owing to the characteristic Bragg peak and the finite range of protons. However, during proton therapy, secondary neutrons are created, which can travel long distances and deposit dose in out-of-field volumes. This out-of-field absorbed dose needs to be considered for radiation-induced secondary cancers, which are particularly relevant in the case of pediatric treatments.

Monte Carlo verification of the holder correction factors for the radiophotoluminescent glass dosimeter used by the IAEA in international dosimetry audits.

The International Atomic Energy Agency (IAEA), jointly with the World Health Organization (WHO), has operated a postal dosimetry audit program for radiotherapy centers worldwide since 1969. In 2017 the IAEA introduced a new methodology based on radiophotoluminescent dosimetry (RPLD) for these audits. The detection system consists of a phosphate glass dosimeter inserted in a plastic capsule that is kept in measuring position with a PMMA holder during irradiation.

Experiments and Monte Carlo simulations on multiple Coulomb scattering of protons.

Background And Purpose: Monte Carlo simulations as well as analytical computations of proton transport in material media require accurate values of multiple Coulomb scattering (MCS) angles. High-quality experimental data on MCS angles in the energy range for proton therapy are, however, sparse. In this work, MCS modeling in proton transport was evaluated employing an experimental method to measure these angles on a medical proton beamline in clinically relevant materials.

Monte Carlo simulation of conical collimators for stereotactic radiosurgery with a 6 MV flattening-filter-free photon beam.

Purpose: Conical collimators, or cones, are tertiary collimators that attach to a radiotherapy linac and are suited for the stereotactic radiosurgery treatment of small brain lesions. The small diameter of the most used cones makes difficult the acquisition of the dosimetry data needed for the commissioning of treatment planning systems. Although many publications report dosimetric data of conical collimators for stereotactic radiosurgery, most of the works use different setups, which complicates comparisons.

Single pencil beam benchmark of a module for Monte Carlo simulation of proton transport in the PENELOPE code.

Background And Purpose: PENH is a recently coded module for simulation of proton transport in conjunction with the Monte Carlo code PENELOPE. PENELOPE applies class II simulation to all type of interactions, in particular, to elastic collisions. PENH uses calculated differential cross sections for proton elastic collisions that include electron screening effects as well as nuclear structure effects.

Monte Carlo Computation of Dose-Volume Histograms in Structures at Risk of an Eye Irradiated with Heterogeneous Ruthenium-106 Plaques.

Background/aims: The aim of this work is to compare Monte Carlo simulated absorbed dose distributions obtained from Ru eye plaques, whose heterogeneous emitter distribution is known, with the common homogeneous approximation. The effect of these heterogeneities on segmented structures at risk is analyzed using an anthropomorphic phantom.

Methods: The generic CCA and CCB, with a homogeneous emitter map, and the specific CCA1364 and CCB1256 Ru eye plaques are modeled with the Monte Carlo code PENELOPE.

Monte Carlo Simulation of the Treatment of Uveal Melanoma Using Measured Heterogeneous Ru Plaques.

Background/aims: Ruthenium plaques are used for the treatment of ocular tumors. The aim of this work is the comparison between simulated absorbed dose distributions tallied in an anthropomorphic phantom, obtained from ideal homogeneous plaques, and real eye plaques in which the actual heterogeneous distribution of Ru was measured. The placement of the plaques with respect to the tumor location was taken into consideration to optimize the effectiveness of the treatment.

Treatment verification using Varian's dynalog files in the Monte Carlo system PRIMO.

Background: The PRIMO system is a computer software that allows the Monte Carlo simulation of linear accelerators and the estimation of the subsequent absorbed dose distributions in phantoms and computed tomographies. The aim of this work is to validate the methods incorporated in PRIMO to evaluate the deviations introduced in the dose distributions by errors in the positioning of the leaves of the multileaf collimator recorded in the dynalog files during patient treatment.

Methods: The reconstruction of treatment plans from Varian's dynalog files was implemented in the PRIMO system.

PENELOPE/PRIMO-calculated photon and electron spectra from clinical accelerators.

Background: The availability of photon and electron spectra in digital form from current accelerators and Monte Carlo (MC) systems is scarce, and one of the packages widely used refers to linacs with a reduced clinical use nowadays. Such spectra are mainly intended for the MC calculation of detector-related quantities in conventional broad beams, where the use of detailed phase-space files (PSFs) is less critical than for MC-based treatment planning applications, but unlike PSFs, spectra can easily be transferred to other computer systems and users.

Methods: A set of spectra for a range of Varian linacs has been calculated using the PENELOPE/PRIMO MC system.

DPM as a radiation transport engine for PRIMO.

Background: PRIMO is a dose verification system based on the general-purpose Monte Carlo radiation transport code PENELOPE, which implements an accurate physics model of the interaction cross sections and the radiation transport process but with low computational efficiency as compared with fast Monte Carlo codes. One of these fast Monte Carlo codes is the Dose Planning Method (DPM). The purpose of this work is to describe the adaptation of DPM as an alternative PRIMO computation engine, to validate its performance against PENELOPE and to validate it for some specific cases.

Absorbed dose distributions from ophthalmic Ru/ Rh plaques measured in water with radiochromic film.

Purpose: Brachytherapy with Ru/ Rh plaques offers good outcomes for small-to-medium choroidal melanomas and retinoblastomas. The dose measurement of the plaques is challenging, due to the small range of the emitted beta particles and steep dose gradients involved. The scarce publications on film dosimetry of Ru/ Rh plaques used solid phantoms.

Monte Carlo Estimation of Absorbed Dose Distributions Obtained from Heterogeneous Ru Eye Plaques.

Background: The distribution of the emitter substance in Ru eye plaques is usually assumed to be homogeneous for treatment planning purposes. However, this distribution is never homogeneous, and it widely differs from plaque to plaque due to manufacturing factors.

Methods: By Monte Carlo simulation of radiation transport, we study the absorbed dose distribution obtained from the specific CCA1364 and CCB1256 Ru plaques, whose actual emitter distributions were measured.

Computation of the electron beam quality [Formula: see text] factors for the NE2571, NE2571A and NE2581A thimble ionization chambers using PENELOPE.

The quality correction factor [Formula: see text] for electron beams was calculated for three thimble ionization chambers, namely, NE2571, NE2571A and NE2581A. The Monte Carlo code PENELOPE was used to estimate the overall correction factor f of these chambers for electron beams with nominal energies ranging between 6 and 22MeV, corresponding to a Varian Clinac 2100 C/D. A Co beam was used as reference quality Q.

Technical Note: Monte Carlo study of Ru/ Rh ophthalmic plaques including the Rh gamma spectrum.

Purpose: To assess the influence of the Rh gamma spectrum on the Monte Carlo simulation of Ru/ Rh ophthalmic plaques, which has been neglected without a quantitative estimation in all previous publications.

Methods: Simulations were run with the penelope 2014 Monte Carlo code for radiation transport. Depth-dose distributions in water were simulated for the plaque models CCA, CCC, CCX and CIA.

Monte Carlo systems used for treatment planning and dose verification.

General-purpose radiation transport Monte Carlo codes have been used for estimation of the absorbed dose distribution in external photon and electron beam radiotherapy patients since several decades. Results obtained with these codes are usually more accurate than those provided by treatment planning systems based on non-stochastic methods. Traditionally, absorbed dose computations based on general-purpose Monte Carlo codes have been used only for research, owing to the difficulties associated with setting up a simulation and the long computation time required.

Experimental HPGe coaxial detector response and efficiency compared to Monte Carlo simulations.

The peak efficiency for photons hitting the frontal surface of a medium volume n-type HPGe coaxial detector is mapped using acutely collimated beams of energies between 31 and 383 keV from a (133)Ba radioactive source. Simulated values obtained with the Monte Carlo radiation transport code penelope, using a model that respected actual detector dimensions and physical constants while varying dead-layer thicknesses, allowed us to fit the experimental results in the detector bulk but not near its rim. The spectra of a (137)Cs source were measured using the detector shielded from the natural background radiation, with and without a broad angle collimator.

Technical Note: Study of the electron transport parameters used in PENELOPE for the Monte Carlo simulation of Linac targets.

Purpose: The Monte Carlo simulation of electron transport in Linac targets using the condensed history technique is known to be problematic owing to a potential dependence of absorbed dose distributions on the electron step length. In the PENELOPE code, the step length is partially determined by the transport parameters C1 and C2. The authors have investigated the effect on the absorbed dose distribution of the values given to these parameters in the target.

A geometrical model for the Monte Carlo simulation of the TrueBeam linac.

Monte Carlo simulation of linear accelerators (linacs) depends on the accurate geometrical description of the linac head. The geometry of the Varian TrueBeam linac is not available to researchers. Instead, the company distributes phase-space files of the flattening-filter-free (FFF) beams tallied at a plane located just upstream of the jaws.

Technical note: Influence of the phantom material on the absorbed-dose energy dependence of the EBT3 radiochromic film for photons in the energy range 3 keV-18 MeV.

Purpose: Water is the reference medium for radiation therapy dosimetry, but for film dosimetry it is more practical to use a solid phantom. As the composition of solid phantoms differs from that of water, the energy dependence of film exposed within solid phantoms may also differ. The energy dependence of a radiochromic film for a given beam quality Q (energy for monoenergetic beams) has two components: the intrinsic energy dependence and the absorbed-dose energy dependence f(Q), the latter of which can be calculated through a Monte Carlo simulation of radiation transport.