First Monte Carlo beam model for ultra-high dose rate radiotherapy with a compact electron LINAC.

BACKGROUND: FLASH radiotherapy based on ultra-high dose rate (UHDR) is actively being studied by the radiotherapy community. Dedicated UHDR electron devices are currently a mainstay for FLASH studies. PURPOSE: To present the first Monte Carlo (MC) electron beam model for the UHDR capable Mobetron (FLASH-IQ) as a dose calculation and treatment planning platform for preclinical research and FLASH-radiotherapy (RT) clinical trials. METHODS: The initial beamline geometry of the Mobetron was provided by the manufacturer, with the first-principal implementation realized in the Geant4-based GAMOS MC toolkit. The geometry and electron source characteristics, such as energy spectrum and beamline parameters, were tuned to match the central-axis percentage depth dose (PDD) and lateral profiles for the pristine beam measured during machine commissioning. The thickness of the small foil in secondary scatter affected the beam model dominantly and was fine tuned to achieve the best agreement with commissioning data. Validation of the MC beam modeling was performed by comparing the calculated PDDs and profiles with EBT-XD radiochromic film measurements for various combinations of applicators and inserts. RESULTS: The nominal 9 MeV electron FLASH beams were best represented by a Gaussian energy spectrum with mean energy of 9.9 MeV and variance (σ) of 0.2 MeV. Good agreement between the MC beam model and commissioning data were demonstrated with maximal discrepancy < 3% for PDDs and profiles. Hundred percent gamma pass rate was achieved for all PDDs and profiles with the criteria of 2 mm/3%. With the criteria of 2 mm/2%, maximum, minimum and mean gamma pass rates were (100.0%, 93.8%, 98.7%) for PDDs and (100.0%, 96.7%, 99.4%) for profiles, respectively. CONCLUSIONS: A validated MC beam model for the UHDR capable Mobetron is presented for the first time. The MC model can be utilized for direct dose calculation or to generate beam modeling input required for treatment planning systems for FLASH-RT planning. The beam model presented in this work should facilitate translational and clinical FLASH-RT for trials conducted on the Mobetron FLASH-IQ platform.

Feasibility study of entrance and exit dose measurements at the contra lateral breast with alanine/electron spin resonance dosimetry in volumetric modulated radiotherapy of breast cancer.

The Physikalisch-Technische Bundesanstalt has established a secondary standard measurement system for the dose to water, D W, based on alanine/ESR (Anton et al 2013 Phys. Med. Biol. 58 3259-82). The aim of this study was to test the established measurement system for the out-of-field measurements of inpatients with breast cancer. A set of five alanine pellets were affixed to the skin of each patient at the contra lateral breast beginning at the sternum and extending over the mammilla to the distal surface. During 28 fractions with 2.2 Gy per fraction, the accumulated dose was measured in four patients. A cone beam computer tomography (CBCT) scan was generated for setup purposes before every treatment. The reference CT dataset was registered rigidly and deformably to the CBCT dataset for 28 fractions. To take the actual alanine pellet position into account, the dose distribution was calculated for every fraction using the Acuros XB algorithm. The results of the ESR measurements were compared to the calculated doses. The maximum dose measured at the sternum was 19.9 Gy ± 0.4 Gy, decreasing to 6.8 Gy ± 0.2 Gy at the mammilla and 4.5 Gy ± 0.1 Gy at the distal surface of the contra lateral breast. The absolute differences between the calculated and measured doses ranged from -1.9 Gy to 0.9 Gy. No systematic error could be seen. It was possible to achieve a combined standard uncertainty of 1.63% for D W = 5 Gy for the measured dose. The alanine/ESR method is feasible for in vivo measurements.

Effective point of measurement for parallel plate and cylindrical ion chambers in megavoltage electron beams.

The presence of an air filled ionization chamber in a surrounding medium introduces several fluence perturbations in high energy photon and electron beams which have to be accounted for. One of these perturbations, the displacement effect, may be corrected in two different ways: by a correction factor pdis or by the application of the concept of the effective point of measurement (EPOM). The latter means, that the volume averaged ionization within the chamber is not reported to the chambers reference point but to a point within the air filled cavity. Within this study the EPOM was determined for four different parallel plate and two cylindrical chambers in megavoltage electron beams using Monte Carlo simulations. The positioning of the chambers with this EPOM at the depth of measurement results in a largely depth independent residual perturbation correction, which is determined within this study for the first time. For the parallel plate chambers the EPOM is independent of the energy of the primary electrons. Whereas for the Advanced Markus chamber the position of the EPOM coincides with the chambers reference point, it is shifted for the other parallel plate chambers several tenths of millimeters downstream the beam direction into the air filled cavity. For the cylindrical chambers there is an increasing shift of the EPOM with increasing electron energy. This shift is in upstream direction, i.e. away from the chambers reference point toward the focus. For the highest electron energy the position of the calculated EPOM is in fairly good agreement with the recommendation given in common dosimetry protocols, for the smallest energy, the calculated EPOM positions deviate about 30% from this recommendation.