Abstract
This work presents BrachyGuide, a brachytherapy‐dedicated software tool for the automatic preparation of input files for Monte Carlo simulation from treatment plans exported in DICOM RT format, and results of calculations performed for its benchmarking. Three plans were prepared using two computational models, the image series of a water sphere and a multicatheter breast brachytherapy patient, for each of two commercially available treatment planning systems: BrachyVision and Oncentra Brachy. One plan involved a single source dwell position of an 192Ir HDR source (VS2000 or mHDR‐v2) at the center of the water sphere using the TG43 algorithm, and the other two corresponded to the TG43 and advanced dose calculation algorithm for the multicatheter breast brachytherapy patient. Monte Carlo input files were prepared using BrachyGuide and simulations were performed with MCNP v.6.1. For the TG43 patient plans, the Monte Carlo computational model was manually edited in the prepared input files to resemble TG43 dosimetry assumptions. Hence all DICOM RT dose exports were equivalent to corresponding simulation results and their comparison was used for benchmarking the use of BrachyGuide. Monte Carlo simulation results and corresponding DICOM RT dose exports agree within type A uncertainties in the majority of points in the computational models. Treatment planning system, algorithm, and source specific differences greater than type A uncertainties were also observed, but these were explained by treatment planning system‐related issues and other sources of type B uncertainty. These differences have to be taken into account in commissioning procedures of brachytherapy dosimetry algorithms. BrachyGuide is accurate and effective for use in the preparation of commissioning tests for new brachytherapy dosimetry algorithms as a user‐oriented commissioning tool and the expedition of retrospective patient cohort studies of dosimetry planning.PACS numbers: 87.53.Bn, 87.53.Jw, 87.55.D‐, 87.55.Qr, 87.55.km, 87.55.K‐
Highlights
In response to the increasing body of literature on the shortcomings of TG43-based brachytherapy treatment planning systems (TPS),(1,2) advanced dose calculation algorithms beyond TG43 have been incorporated in commercially available TPSs
This paradigm shift renders the already acknowledged[7] need for augmenting QA procedures imperative, since data to support commissioning procedures are lacking.[8]. Besides acceptance testing, such procedures are required to warrant that the global uniformity of brachytherapy practice that helped establish an improved standard of care and greatly facilitates interinstitutional trials is maintained in the transition from the robust and universally employed TG43 formalism to different dosimetry algorithms or algorithm implementations
Isodose lines and the color map of percentage differences presented in Fig. 2(a) show that Monte Carlo (MC) and TPS results agree within ± 2% for the vast majority of points around the mHDR-v2 source
Summary
In response to the increasing body of literature on the shortcomings of TG43-based brachytherapy treatment planning systems (TPS),(1,2) advanced dose calculation algorithms beyond TG43 have been incorporated in commercially available TPSs. MC methods can be used in retrospective patient cohort studies to assess the impact of introducing advanced dose calculation algorithms for the treatment of specific brachytherapy sites In both cases, simulations would have to be performed in the geometry defined through images available in DICOM format using information parsed from plans exported in DICOM RT format. BrachyGuide is a brachytherapy dedicated software tool developed to expedite the fool-proof configuration of input files for such MC simulations, featuring a graphical user interface and a DICOM RT viewer It is named after the acronym of a research project for the preparation of user oriented QA tools and the evaluation of advanced brachytherapy dosimetry algorithms in patient cohorts. BrachyGuide has its merits including availability*, focus on HDR 192Ir brachytherapy dosimetry benchmarking, speed, and currently being the only DICOM RT interface to the widely used MCNP code[16] for brachytherapy
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