Validation of Monte Carlo dose calculation algorithm for CyberKnife multileaf collimator. Issue 2 (1st December 2021)

• Record Type: Journal Article
• Authors: Gondré, Maude; Marsolat, Fanny; Bourhis, Jean; Bochud, François; Moeckli, Raphaël
• Is Part Of: Journal of applied clinical medical physics. Volume 23:Issue 2(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-12-01
• Subjects: commissioning -- CyberKnife -- Monte Carlo dose algorithm -- multileaf collimator; Medical physics -- Periodicals; Clinical medicine -- Periodicals; Health Physics; Clinical Medicine; Electronic journals; Periodicals; Periodicals; Fulltext; Internet Resources; 610.153
• DOI: 10.1002/acm2.13481
• Languages: English
• ISSNs: 1526-9914

Abstract

Abstract: Purpose: To commission and evaluate the Monte Carlo (MC) dose calculation algorithm for the CyberKnife equipped with a multileaf collimator (MLC). Methods: We created a MC model for the MLC using an integrated module of the CyberKnife treatment planning software (TPS). Two parameters could be optimized: the maximum energy and the source full width at half‐maximum (FWHM). The optimization was performed by minimizing the differences between the measured and the MC calculated tissue phantom ratios and profiles. MLC plans were calculated in the TPS with the MC algorithm and irradiated on different phantoms. The dose was measured using an A1SL ionization chamber and EBT3 Gafchromic films, and then compared to the TPS dose to obtain dose differences (Δ D ). Finally, patient‐specific quality assurances (QA) were performed with global gamma index criteria of 3%/1 mm. Results: The maximum energy and source FWHM showing the best agreement with measurements were 6.4 MeV and 1.8 mm. The output factors calculated with these parameters gave an agreement within ±1% with measurements. The Δ D showed that MC model systematically underestimated the dose with an average of −1.5% over all configurations tested. For depths deeper than 12 cm, the Δ D increased, up to −3.0% (maximum at 15.5 cm depth). Conclusions: The MC model for MLC of CyberKnife is clinically acceptable but underestimates the delivered dose by an average of −1.5%. Therefore, we recommend using the MC algorithm with the MLC only in heterogeneous regions and for shallow‐seated tumors.