Photon beam characterization and modelling for Monte Carlo treatment planning

Photon beams of 4, 6 and 15 MV from Varian Clinac 2100C and 2300C/D accelerators were simulated using the EGS4/BEAM code system. The accelerators were modelled as a combination of component modules (CMs) consisting of a target, primary collimator, exit window, flattening filter, monitor chamber, secondary collimator, ring collimator, photon jaws and protection window. A full phase space file was scored directly above the upper photon jaws and analysed using beam data processing software, BEAMDP, to derive the beam characteristics, such as planar fluence, angular distribution, energy spectrum and the fractional contributions of each individual CM. A multiple-source model has been further developed to reconstruct the original phase space. Separate sources were created with accurate source intensity, energy, fluence and angular distributions for the target, primary collimator and flattening filter. Good agreement (within 2%) between the Monte Carlo calculations with the source model and those with the original phase space was achieved in the dose distributions for field sizes of 4 cm x 4 cm to 40 cm x 40 cm at source surface distances (SSDs) of 80-120 cm. The dose distributions in lung and bone heterogeneous phantoms have also been found to be in good agreement (within 2%) for 4, 6 and 15 MV photon beams for various field sizes between the Monte Carlo calculations with the source model and those with the original phase space.     

Clinical implementation of a Monte Carlo treatment planning system.

The purpose of this study was to implement the Monte Carlo method for clinical radiotherapy dose calculations. We used the EGS4/BEAM code to obtain the phase-space data for 6-20 MeV electron beams and 4, 6, and 15 MV photon beams for Varian Clinac 1800, 2100C, and 2300CD accelerators. A multiple-source model was used to reconstruct the phase-space data for both electron and photon beams, which retained the accuracy of the Monte Carlo beam data. The multiple-source model reduced the phase-space data storage requirement by a factor of 1000 and the accelerator simulation time by a factor of 10 or more. Agreement within 2% was achieved between the Monte Carlo calculations and measurements of the dose distributions in homogeneous and heterogeneous phantoms for various field sizes, source-surface distances, and beam modulations. The Monte Carlo calculated electron output factors were within 2% of the measured values for various treatment fields while the heterogeneity correction factors for various lung and bone phantoms were within 1% for photon beams and within 2% for electron beams. The EGS4/DOSXYZ Monte Carlo code was used for phantom and patient dose calculations. The results were compared to the dose distributions produced by a conventional treatment planning system and an intensity-modulated radiotherapy inverse-planning system. Significant differences (>5% in dose and >5 mm shift in isodose lines) were found between Monte Carlo calculations and the analytical calculations implemented in the commercial systems. Treatment sites showing the largest dose differences were for head and neck, lung, and breast cases.     

Modelling of electron contamination in clinical photon beams for Monte Carlo dose calculation

The purpose of this work is to model electron contamination in clinical photon beams and to commission the source model using measured data for Monte Carlo treatment planning. In this work, a planar source is used to represent the contaminant electrons at a plane above the upper jaws. The source size depends on the dimensions of the field size at the isocentre. The energy spectra of the contaminant electrons are predetermined using Monte Carlo simulations for photon beams from different clinical accelerators. A 'random creep' method is employed to derive the weight of the electron contamination source by matching Monte Carlo calculated monoenergetic photon and electron percent depth-dose (PDD) curves with measured PDD curves. We have integrated this electron contamination source into a previously developed multiple source model and validated the model for photon beams from Siemens PRIMUS accelerators. The EGS4 based Monte Carlo user code BEAM and MCSIM were used for linac head sinulation and dose calculation. The Monte Carlo calculated dose distributions were compared with measured data. Our results showed good agreement (less than 2% or 2 mm) for 6, 10 and 18 MV photon beams.     

Comparison of EGS4 and MCNP4b Monte Carlo codes for generation of photon phase space distributions for a Varian 2100C

Monte Carlo based dose calculation algorithms require input data or distributions describing the phase space of the photons and secondary electrons prior to the patient-dependent part of the beam-line geometry. The accuracy of the treatment plan itself is dependent upon the accuracy of this distribution. The purpose of this work is to compare phase space distributions (PSDs) generated with the MCNP4b and EGS4 Monte Carlo codes for the 6 and 18 MV photon modes of the Varian 2100C and determine if differences relevant to Monte Carlo based patient dose calculations exist. Calculations are performed with the same energy transport cut-off values. At 6 MV, target bremsstrahlung production for MCNP4b is approximately 10% less than for EGS4, while at 18 MV the difference is about 5%. These differences are due to the different bremsstrahlung cross sections used in the codes. Although the absolute bremsstrahlung production differs between MCNP4b and EGS4, normalized PSDs agree at the end of the patient-independent geometry (prior to the jaws), resulting in similar dose distributions in a homogeneous phantom. EGS4 and MCNP4b are equally suitable for the generation of PSDs for Monte Carlo based dose computations.     

Dose discrepancies between Monte Carlo calculations and measurements in the buildup region for a high-energy photon beam

This study investigates a possible cause of reported significant dose discrepancies between Monte Carlo calculations and measurements in the buildup region for high-energy photon beams in large fields. A proposed hypothesis was that the discrepancy was caused by a source of electrons in the accelerator head that was not fully accounted for in the treatment head simulation. In this investigation, a lead foil is added just below the accelerator head in order to study this hypothesis. The lead foil effectively removes charged particles generated inside the accelerator head. The charged particles generated by the lead foil can be accounted for fully because the simple geometry can be simulated accurately. An 18 MV photon beam from a Varian Clinac-2100EX is measured using a WELLHOFER WP700 beam scanner with an IC-10 ionization chamber (cavity radius=3 mm). The BEAM Monte Carlo code is used in the incident beam simulations. Both EGS4/DOSXYZ and EGSnrc/DOSRZnrc are used in the dose calculations in a water phantom. The Monte Carlo calculated depth-dose curve is scaled so that it has the same values at 10 cm depth as the measured curve. It is found that the discrepancies between Monte Carlo calculations and measurements remain significant in the buildup region even after applying necessary corrections to the measured data. The discrepancies have only been modestly decreased with the lead foil in place compared to the 40 x 40 cm2 open field. At a depth of 1 cm, discrepancies of about 5% are still observed in the buildup region for the field with the lead foil. Therefore a new explanation for the unresolved discrepancy remains to be found.     

Comparison of dose calculation algorithms with Monte Carlo methods for photon arcs

The objective of this study is to seek an accurate and efficient method to calculate the dose distribution of a photon arc. The algorithms tested include Monte Carlo, pencil beam kernel (PK), and collapsed cone convolution (CCC). For the Monte Carlo dose calculation, EGS4/DOSXYZ was used. The SRCXYZ source code associated with the DOSXYZ was modified so that the gantry angle of a photon beam would be sampled uniformly within the arc range about an isocenter to simulate a photon arc. Specifically, photon beams (6/18 MV, 4 x 4 and 10 x 10 cm2) described by a phase space file generated by BEAM (MCPHS), or by two point sources with different photon energy spectra (MCDIV) were used. These methods were used to calculate three-dimensional (3-D) distributions in a PMMA phantom, a cylindrical water phantom, and a phantom with lung inhomogeneity. A commercial treatment planning system was also used to calculate dose distributions in these phantoms using equivalent tissue air ratio (ETAR), PK and CCC algorithms for inhomogeneity corrections. Dose distributions for a photon arc in these phantoms were measured using a RK ion chamber and radiographic films. For homogeneous phantoms, the measured results agreed well (approximately 2% error) with predictions by the Monte Carlo simulations (MCPHS and MCDIV) and the treatment planning system for the 180 degrees and 360 degrees photon arcs. For the dose distribution in the phantom with lung inhomogeneity with a 90 degrees photon arc, the Monte Carlo calculations agreed with the measurements within 2%, while the treatment planning system using ETAR, PK and CCC underestimated or overestimated the dose inside the lung inhomogeneity from 6% to 12%.     

Fast Monte Carlo dose calculation for photon beams based on the VMC electron algorithm.

A new Monte Carlo algorithm for 3D photon dose calculation in radiation therapy is presented, which is based on the previously developed Voxel Monte Carlo (VMC) for electron beams. The main result is that this new version of VMC (now called XVMC) is more efficient than EGS4/PRESTA photon dose calculation by a factor of 15-20. Therefore, a standard treatment plan for photons can be calculated by Monte Carlo in about 20 min. on a "normal" personal computer. The improvement is caused mainly by the fast electron transport algorithm and ray tracing technique, and an initial ray tracing method to calculate the number of electrons created in each voxel by the primary photon beam. The model was tested in comparison to calculations by EGS4 using several fictive phantoms. In most cases a good coincidence has been found between both codes. Only within lung substitute dose differences have been observed.     

Energy spectra, angular spread, fluence profiles and dose distributions of 6 and 18 MV photon beams: results of monte carlo simulations for a varian 2100EX accelerator

The purpose of this study is to provide detailed characteristics of incident photon beams for different field sizes and beam energies. This information is critical to the future development of accurate treatment planning systems. It also enhances our knowledge of radiotherapy photon beams. The EGS4 Monte Carlo code, BEAM, has been used to simulate 6 and 18 MV photon beams from a Varian Clinac-2100EX accelerator. A simulated realistic beam is stored in a phase space data file, which contains details of each particle's complete history including where it has been and where it has interacted. The phase space files are analysed to obtain energy spectra, angular distribution, fluence profile and mean energy profiles at the phantom surface for particles separated according to their charge and history. The accuracy of a simulated beam is validated by the excellent agreement between the Monte Carlo calculated and measured dose distributions. Measured depth-dose curves are obtained from depth-ionization curves by accounting for newly introduced chamber fluence corrections and the stopping-power ratios for realistic beams. The study presents calculated depth-dose components from different particles as well as calculated surface dose and contribution from different particles to surface dose across the field. It is shown that the increase of surface dose with the increase of the field size is mainly due to the increase of incident contaminant charged particles. At 6 MV, the incident charged particles contribute 7% to 21% of maximum dose at the surface when the field size increases from 10 x 10 to 40 x 40 cm2. At 18 MV, their contributions are up to 11% and 29% of maximum dose at the surface for 10 x 10 cm2 and 40 x 40 cm2 fields respectively. However, the fluence of these incident charged particles is less than 1% of incident photon fluence in all cases.     

Accuracy of dose measurements and calculations within and beyond heterogeneous tissues for 6 MV photon fields smaller than 4 cm produced by Cyberknife

For the small radiation field sizes used in stereotactic radiosurgery, lateral electronic disequilibrium and steep dose gradients exist in a large portion of these fields, requiring the use of high-resolution measurement techniques. These relatively large areas of electronic disequilibrium make accurate dosimetry as well as dose calculation more difficult, and this is exacerbated in regions of tissue heterogeneity. Tissue heterogeneity was considered insignificant in the brain where stereotactic radiosurgery was first used. However, as this technique is expanded to the head and neck and other body sites, dose calculations need to account for dose perturbations in and beyond air cavities, lung, and bone. In a previous study we have evaluated EBT Gafchromic film (International Specialty Products, Wayne, NJ) for dosimetry and characterization of the Cyberknife radiation beams and found that it was comparable to other common detectors used for small photon beams in solid water equivalent phantoms. In the present work EBT film is used to measure dose in heterogeneous slab phantoms containing lung and bone equivalent materials for the 6 MV radiation beams of diameter 7.5 to 40 mm produced by the Cyberknife (Accuray, Sunnyvale, CA). These measurements are compared to calculations done with both the clinically utilized Raytrace algorithm as well as the newly developed Monte Carlo based algorithm available on the Cyberknife treatment planning system. Within the low density material both the measurements and Monte Carlo calculations correctly model the decrease in dose produced by a loss of electronic equilibrium, whereas the Raytrace algorithm incorrectly predicts an enhancement of dose in this region. Beyond the low density material an enhancement of dose is correctly calculated by both algorithms. Within the high density bone heterogeneity the EBT film measurements represent dose to unit density tissue in bone and agree with the Monte Carlo results when corrected to dose to unit density tissue in bone. We conclude that EBT film is an appropriate dosimeter for measuring dose in heterogeneous materials and these measurements agree with Monte Carlo calculations of dose as implemented in the Cyberknife treatment planning system.     

An investigation of entrance surface dose calculations for diagnostic radiology using Monte Carlo simulations and radiotherapy dosimetry formalisms

Our aim in this work was to investigate the methodology used in the determination of the entrance surface dose (ESD) in diagnostic radiology. In kV x-rays for low-energy photons (tube potential up to 160 kV, HVL: 1-8 mm Al), the ESD is based on the use of the ratio of mass-energy absorption coefficients and backscatter factors. A full simulation of the photon and electron transport in a kilovoltage x-ray unit, using the Monte Carlo code BEAM/EGS4, was performed to obtain an accurate beam phase space for use in dose calculation. The modelled phase space was experimentally validated for the beam qualities (measured HVL: 3.3 mm Al-2.2 mm Cu) and showed good agreement between calculated and measured HVLs, air kerma and relative dose distributions. We have computed the conversion factors from air kerma to water or soft tissue absorbed dose at the surface of a phantom for beam qualities (HVL: 3.3-8.35 mm Al). The same model was also used to calculate the ESD in water and in soft tissue for the low-energy photon range considered. The results show that the numerical differences between the air kerma and the water kerma based backscatter factors are insignificant. The same conclusion was reached for the (mu(en)/rho) ratios, for soft tissue to air, evaluated using either the primary photon spectra or the spectra at the surface of a phantom. Furthermore, the good agreement obtained for the computation of the conversion factors with a full BEAM/EGS4 model confirms the previous studies which are based on different sources for the spectral distribution and different beam geometries (pencil beam or point source assumptions). On the other hand, the ESD in water or soft tissue is well described either with the B(air) or the B(w) formalism. Conversion factors from air kerma to ESD in these media are proposed in this work for several beam qualities in diagnostic radiology.     

Commissioning 6 MV photon beams of a stereotactic radiosurgery system for Monte Carlo treatment planning

The goal of this work is to implement a beam commissioning procedure to generate a multiple source model using a set of standard measurement data for possible Monte Carlo treatment planning in the clinic for a Cyberknife stereotactic radiosurgery system. The required measurement data include the central axis depth dose curve (PDD), the dose profile at dmax(= 1.5 cm) of 60 mm cone at 80 cm source-to-surface distance (SSD), and the cone output factors for cones of 5 mm to 60 mm at 80 cm source-to-axis distance (SAD). The employed dual source model has the same structure as the one that has been studied in our previous work while most of the parameters of each source are extracted from the measurement data rather than the beam phase space. The energy spectra will be extracted from the central axis PDD, the fluence distributions will be deconvoluted from the dose profile at dmax, and the source distributions will be determined from the measured cone output factors. Monte Carlo dose calculations in various water phantoms have been performed to verify the beam commissioning procedure. The agreement between the measurements and the commissioning results was within 2%/1 mm for the central axis PDDs and the dose profiles at various depths when an IC-3 chamber was used and within 2% for the cone output factors for various collimator sizes of 5 to 60 mm. Largest difference (9.5%) was observed for the 7.5 mm cone when an IC-10 chamber was used. The large differences can be attributed to the volumetric averaging effect of the IC-10 chamber, whose dimension is comparable to the field of the small cones. The overall agreement between the measurements and the commissioning results is clinically acceptable, which implies that our commissioning tool is adequate for clinical applications of Monte Carlo dose calculations for the Cyberknife stereotactic radiosurgery system.     

Comparison of measured and Monte Carlo calculated dose distributions from the NRC linac

We have benchmarked photon beam simulations with the EGS4 user code BEAM [Rogers et al., Med. Phys. 22, 503-524 (1995)] by comparing calculated and measured relative ionization distributions in water from the 10 and 20 MV photon beams of the NRC linac. Unlike previous calculations, the incident electron energy is known independently to 1%, the entire extra-focal radiation is simulated, and electron contamination is accounted for. The full Monte Carlo simulation of the linac includes the electron exit window, target, flattening filter, monitor chambers, collimators, as well as the PMMA walls of the water phantom. Dose distributions are calculated using a modified version of the EGS4 user code DOSXYZ which additionally allows scoring of average energy and energy fluence in the phantom. Dose is converted to ionization by accounting for the (L/rho)water(air) variation in the phantom, calculated in an identical geometry for the realistic beams using a new EGS4 user code, SPRXYZ. The variation of (L/rho)water(air) with depth is a 1.25% correction at 10 MV and a 2% correction at 20 MV. At both energies, the calculated and the measured values of ionization on the central axis in the buildup region agree within 1% of maximum ionization relative to the ionization at 10 cm depth. The agreement is well within statistics elsewhere. The electron contamination contributes 0.35(+/- 0.02) to 1.37(+/- 0.03)% of the maximum dose in the buildup region at 10 MV and 0.26(+/- 0.03) to 3.14(+/- 0.07)% of the maximum dose at 20 MV. The penumbrae at 3 depths in each beam (in g/cm2), 1.99 (dmax, 10 MV only), 3.29 (dmax, 20 MV only), 9.79 and 19.79, agree with ionization chamber measurements to better than 1 mm. Possible causes for the discrepancy between calculations and measurements are analyzed and discussed in detail.     

Dose measurements compared with Monte Carlo simulations of narrow 6 MV multileaf collimator shaped photon beams.

Small fields where electronic equilibrium is not achieved are becoming increasingly important in clinical practice. These complex situations give rise to problems and inaccuracies in both dosimetry and analytical/empirical dose calculation, and therefore require other than conventional methods. A natural diamond detector and a Markus parallel plate ionization chamber have been selected for clinical dosimetry in 6 MV photon beams. Results of simulations using the Monte Carlo system BEAM/EGS4 to model the beam geometry have been compared with dose measurements. A modification of the existing component module for multileaf collimators (MLCs) allowed the modeling of a linear accelerator SL 25 (Elekta Oncology Systems) equipped with a MLC with curved leaf-ends. A mechanical measurement method with spacer plates and a light-field edge detection technique are described as methods to obtain geometrical data of collimator openings for application in the Monte Carlo system. Generally a good agreement is found between measurements and calculations of depth dose distributions and deviations are typically less than 1%. Calculated lateral dose profiles slightly exceed measured dose distributions near the higher level of the penumbras for a 10x2 cm2 field, but agree well with the measurements for all other cases. The simulations are also able to predict variations of output factors and ratios of output factors as a function of field width and field-offset. The Monte Carlo results demonstrate that qualitative changes in energy spectra are too small to explain these variations and that especially geometrical factors affect the output factors and depth dose curves and profiles.     

Derivation of electron and photon energy spectra from electron beam central axis depth dose curves

A method for deriving the electron and photon energy spectra from electron beam central axis percentage depth dose (PDD) curves has been investigated. The PDD curves of 6, 12 and 20 MeV electron beams obtained from the Monte Carlo full phase space simulations of the Varian linear accelerator treatment head have been used to test the method. We have employed a 'random creep' algorithm to determine the energy spectra of electrons and photons in a clinical electron beam. The fitted electron and photon energy spectra have been compared with the corresponding spectra obtained from the Monte Carlo full phase space simulations. Our fitted energy spectra are in good agreement with the Monte Carlo simulated spectra in terms of peak location, peak width, amplitude and smoothness of the spectrum. In addition, the derived depth dose curves of head-generated photons agree well in both shape and amplitude with those calculated using the full phase space data. The central axis depth dose curves and dose profiles at various depths have been compared using an automated electron beam commissioning procedure. The comparison has demonstrated that our method is capable of deriving the energy spectra for the Varian accelerator electron beams investigated. We have implemented this method in the electron beam commissioning procedure for Monte Carlo electron beam dose calculations.     

Dosimetric characteristics of dynamic wedged fields: a Monte Carlo study.

We have developed a Monte Carlo (MC) technique using the EGS4/BEAM system to calculate dosimetric characteristics of dynamic wedges (DW) for photon beam radiotherapy. The simulation of DW was accomplished by weighting the history numbers of the electrons, which are incident on the target in accordance with the segmented treatment table. Calculations were performed for DW with wedge angles ranging from 15 degrees to 60 degrees as well as for open fields with different field sizes for both degrees 6 and 18 MV beams. The MC-calculated percentage depth dose (PDD) and beam profiles agreed with the measurements within +/- 2% (of the dose maximum along the beam axis) or +/- 2 mm in high dose gradient region. The DW slightly affects energy spectra of photons and contaminating electrons. These slight changes have no significant effects on PDD as compared to the open field. The MC-calculated dynamic wedge factors agree with the measurements within +/- 2%. The MC method enables us to provide more detailed beam characteristics for DW fields than a measurement method. This beam characteristic includes photon energy spectra, mean energy, spectra of contaminating electrons and effects of moving jaw on off-axis beam quality. These data are potentially important for treatment planning involving dynamic wedges.     

Commissioning stereotactic radiosurgery beams using both experimental and theoretical methods

The purpose of this investigation is to study the feasibility of using an alternative method to commission stereotactic radiosurgery beams shaped by micro multi-leaf collimators by using Monte Carlo simulations to obtain beam characteristics of small photon beams, such as incident beam particle fluence and energy distributions, scatter ratios, depth-dose curves and dose profiles where measurements are impossible or difficult. Ionization chambers and diode detectors with different sensitive volumes were used in the measurements in a water phantom and the Monte Carlo codes BEAMnrc/DOSXYZnrc were used in the simulation. The Monte Carlo calculated data were benchmarked against measured data for photon beams with energies of 6 MV and 10 MV produced from a Varian Trilogy accelerator. The measured scatter ratios and cross-beam dose profiles for very small fields are shown to be not only dependent on the size of the sensitive volume of the detector used but also on the type of detectors. It is known that the response of some detectors changes at small field sizes. Excellent agreement was seen between scatter ratios measured with a small ion chamber and those calculated from Monte Carlo simulations. The values of scatter ratios, for field sizes from 6 x 6 mm2 to 98 x 98 mm2, range from 0.67 to 1.0 and from 0.59 to 1.0 for 6 and 10 MV, respectively. The Monte Carlo calculations predicted that the incident beam particle fluence is strongly affected by the X-Y-jaw openings, especially for small fields due to the finite size of the radiation source. Our measurement confirmed this prediction. This study demonstrates that Monte Carlo calculations not only provide accurate dose distributions for small fields where measurements are difficult but also provide additional beam characteristics that cannot be obtained from experimental methods. Detailed beam characteristics such as incident photon fluence distribution, energy spectra, including composition of primary and scattered photons, can be independently used in dose calculation models and to improve the accuracy of measurements with detectors with an energy-dependent response. Furthermore, when there are discrepancies between results measured with different detectors, the Monte Carlo calculated values can indicate the most correct result. The data set presented in this study can be used as a reference in commissioning stereotactic radiosurgery beams shaped by a BrainLAB m3 on a Varian 2100EX or 600C accelerator.     

Optimization of accelerator target and detector for portal imaging using Monte Carlo simulation and experiment

Megavoltage portal images suffer from poor quality compared to those produced with kilovoltage x-rays. Several authors have shown that the image quality can be improved by modifying the linear accelerator to generate more low-energy photons. This work addresses the problem of using Monte Carlo simulation and experiment to optimize the beam and detector combination to maximize image quality for a given patient thickness. A simple model of the whole imaging chain was developed for investigation of the effect of the target parameters on the quality of the image. The optimum targets (6 mm thick aluminium and 1.6 mm copper) were installed in an Elekta SL25 accelerator. The first beam will be referred to as A16 and the second as Cu1.6. A tissue-equivalent contrast phantom was imaged with the 6 MV standard photon beam and the experimental beams with standard radiotherapy and mammography film/screen systems. The arrangement with a thin Al target/mammography system improved the contrast from 1.4 cm bone in 5 cm water to 19% compared with 2% for the standard arrangement of a thick, high-Z target/radiotherapy verification system. The linac/phantom/detector system was simulated with the BEAM/EGS4 Monte Carlo code. Contrast calculated from the predicted images was in good agreement with the experiment (to within 2.5%). The use of MC techniques to predict images accurately, taking into account the whole imaging system, is a powerful new method for portal imaging system design optimization.     

Monte Carlo modelling of a virtual wedge

Compared with a set of physical photon wedges, a non physical wedge (virtual or dynamic wedge), realized by a moving collimator jaw, offers an alternative that allows creation of a wedged field with any arbitrary wedge angle instead of the traditional four physical wedges (15 degrees, 30 degrees, 45 degrees and 60 degrees). It is commonly assumed that non-physical wedges do not alter the photon spectrum compared with physical wedges that introduce beam hardening and loss of dose uniformity in the unwedged direction. In this study, we investigated the influence of a virtual wedge on the photon spectra of a 6-10 MV Siemens MD2 accelerator with the Monte Carlo code EGS4/BEAM. Good agreement was obtained between calculated and measured lateral dose profiles at the depth of maximum dose and at 10 cm depth for 20 x 20 cm2 fields for 6 and 10 MV photon beams. By comparing Monte Carlo models of a physical wedge and the virtual wedge that was studied in this work, it is confirmed that the latter has an insignificant effect on the beam quality, whereas the former can introduce significant beam hardening.     

Description and dosimetric verification of the PEREGRINE Monte Carlo dose calculation system for photon beams incident on a water phantom

PEREGRINE is a three-dimensional Monte Carlo dose calculation system written specifically for radiotherapy. This paper describes the implementation and overall dosimetric accuracy of PEREGRINE physics algorithms, beam model, and beam commissioning procedure. Particle-interaction data, tracking geometries, scoring, variance reduction, and statistical analysis are described. The BEAM code system is used to model the treatment-independent accelerator head, resulting in the identification of primary and scattered photon sources and an electron contaminant source. The magnitude of the electron source is increased to improve agreement with measurements in the buildup region in the largest fields. Published measurements provide an estimate of backscatter on monitor chamber response. Commissioning consists of selecting the electron beam energy, determining the scale factor that defines dose per monitor unit, and describing treatment-dependent beam modifiers. We compare calculations with measurements in a water phantom for open fields, wedges, blocks, and a multileaf collimator for 6 and 18 MV Varian Clinac 2100C photon beams. All calculations are reported as dose per monitor unit. Aside from backscatter estimates, no additional, field-specific normalization is included in comparisons with measurements. Maximum discrepancies were less than either 2% of the maximum dose or 1.2 mm in isodose position for all field sizes and beam modifiers.