Purpose: To introduce egs_brachy, a new, fast, and versatile Monte Carlo code for brachytherapy applications. Methods: egs_brachy is an EGSnrc user-code based on the EGSnrc C++ class library (egs++). Complex phantom, applicator, and source model geometries are built using the egs++ geometry module. egs_brachy uses a tracklength estimator to score collision kerma in voxels. Interaction, spectrum, energy fluence, and phase space scoring are also implemented. Phase space sources and particle recycling may be used to improve simulation efficiency. HDR treatments (e.g. stepping source through dwell positions) can be simulated. Standard brachytherapy seeds, as well as electron and miniature x-ray tube sources are fully modelled. Variance reduction techniques for electron source simulations are implemented (Bremsstrahlung cross section enhancement, uniform Bremsstrahlung splitting, and Russian Roulette). TG-43 parameters of seeds are computed and compared to published values. Example simulations of various treatments are carried out on a single 2.5 GHz Intel Xeon E5-2680 v3 processor core. Results: TG-43 parameters calculated with egs_brachy show excellent agreement with published values. Using a phase space source, 2% average statistical uncertainty in the PTV ((2mm)3 voxels) can be achieved in 10 s for 100 125I or 103Pd seeds in a 36.2 cm3 prostate PTV, 31 s for 64 103Pd seeds in a 64 cm3 breast PTV, and 56 s for a miniature x-ray tube in a 27 cm3 breast PTV. Comparable uncertainty is reached in 12 s in a (1 mm)3 water voxel 5 mm away from a COMS 16mm eye plaque with 13 103Pd seeds. Conclusion: The accuracy of egs_brachy has been demonstrated through benchmarking calculations. Calculation times are sufficiently fast to allow full MC simulations for routine treatment planning for diverse brachytherapy treatments (LDR, HDR, miniature x-ray tube). egs_brachy will be available as free and open-source software to the medical physics research community. This work is partially funded by the Canada Research Chairs program, the Natural Sciences and Engineering Research Council of Canada, and the Ontario Ministry of Research and Innovation (Ontario Early Researcher Award).
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