Dosimetry benchmark for MBDCA
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1 Clinical implementation for advanced brachytherapy dose calculation algorithms beyond the TG-43 formalism: Dosimetry benchmark for MBDCA F. Ballester PhD University of Valencia, Spain
2 Disclosure Research support to the University of Valencia provided by: Nucletron BV Eckert & Ziegler BEBIG 2
3 Learning objectives Identify MBDCA commissioning processes for a safe and smooth integration into the clinic Provide practical examples for commissioning MBDCA treatment planing systems 3
4 Contents Background TPS commissioning: external vs. brachy What should be tested in a TPS based on MBDCAs? Current clinical scenarios TG-186 commisisoning recommendations Examples on MBDCA commissioning Conclusions 4
5 Commissioning: external vs. MBDCA brachy External RT TPS: CC, SC, MC, GBBS Literature & vendor doc: agreement with MC and EXP; for a linac user linac TPS implementation: pdd, oax, output, on user linac User comparison: TPS vs. EXP. In adition: MBDCA Brachy TPS: BV-Acuros, OncentraBrachy Literature & vendor doc: agreement with MC and EXP for sources and applicators? TPS implementation: libraries for sources, applicators, shields. User comparison: TPS vs. EXP? In adition: o TPS benchmark against MC o TPS benchmark vs. MC: WG task o IMRT: phantom measurements o Phantom measurements? o Dosimetric audits RPC o Dosimetric audits RPC? 5
6 TG-186 Guidance for early adopters of MBDCAs. MBDCA commissioning: level 1: MBDCA should fall back to TG-43 data in well controlled conditions (all water). 2% tolerance level 2: MBDCA should take into account material heterogeneities and scatter conditions ABS 2013, New Orleans 6
7 What should be tested? Applicators, sources and devices (TG-186 section IV.B.1.e) TG-186 recommendations: It is responsability of the user TPS vendors should provide analitical modelling schemes and visualization tools The manufacturers should disclose their geometries and material Prior to accepting a device it must also be verified by an independent investigator 7
8 Which test cases to check? It is not possible to validate MBDCA implementation for any possible combination of source + applicator + anatomy Test only scenarios relevant to your clinical practice AAPM/ESTRO/ABG MBDCA working group is developing a few registry test cases (see WE-C Wednesday 10:30AM - 12:30PM Room: 141) Test cases will be available at the RPC registry Developers of new test cases are encouraged to share their validated results through the RPC registry 8
9 Current clinical scenario MBDCA TPS available for HDR Ir-192 only Physis effects taken into account for MBDCA-based TPS and its significance in HDR: Scatter default 9
10 Current clinical scenario MBDCA TPS available for HDR Ir-192 only Physis effects taken into account for MBDCA-based TPS and its significance in HDR: Scatter default Shielding 10
11 Current clinical scenario MBDCA TPS available for HDR Ir-192 only Physis effects taken into account for MBDCA-based TPS and its significance in HDR: Scatter default Shielding Tissular Heterogeneity 11
12 MBDCAs commissioning level 1 Single source in water: MCNPX vs Brachyvision MCNPX ose distribution Dose differences (MCNPX BV) % VS2000 Ir-192 at the center of a 15 cm radius sphere Zourari et al % dose overestimation of TPS is attributed to: 1) an error in the source encapsulation thickness on the TPS 2) spatial discretization on the TPS Good example of commissioning level 1 12
13 MBDCAs commissioning level 1 Single source in water: MCNPX vs Brachivision Zourari et al 2010 MCNPX Dose distribution Dose differences (MCNPX BV) % VS2000 Ir-192 at 12.5 cm from the center of a 15 cm radius sphere Evaluation of scatter conditions Overall agreement between MC and TPS within statistical uncertainties 13
14 MBDCAs commissioning level 1 Single source in water: Mikell & Mourtada 2010 MC (150 mm cable) BV (1 mm cable) % BRACHYVISION-ACUROS against MCNPX Influence of source cable Differences should not have impact on clinical dosimetry in water 14
15 MBDCAs commissioning level 1 DICOM sphere water tests: source centre CCC vs. MCNP5 MBDCA-WG work in progress See WE-C Wednesday 10:30AM - 12:30PM Room:
16 MBDCAs commissioning level 1 DICOM sphere water tests: source displaced Brachyvision vs. MCNP5 MBDCA-WG work in progress See WE-C Wednesday 10:30AM - 12:30PM Room:
17 MBDCAs commissioning level 2 7 dwell positions plan in shielded applicator: MCNPX TG43 (%) TG-43 BV-ACUROS against MCNPX MCNPX BV (%) Zourari et al 2010 Monte Carlo TPS BV-Accuros comparable to MC accounting for shielding 17
18 MBDCAs commissioning level 2 Breast patient computational model: BV-ACUROS against MCNPX Zourari et al 2012 TPS TG43 - MC (%) TPS - MC (%) BV-Accuros comparable to MC patient dosimeetry accuracy 18
19 Courtesy F. Mourtada MBDCAs commissioning level 1 Applicator Geometry & Composition Verification Mikell et al. Brachytherapy 2013 Air pocket? Ti screw? Air? BV TPS Applicator Library - Solid Model In house MC model derived from physical verification and vendor CAD
20 Courtesy F. Mourtada MBDCAs commissioning level 1 Applicator Geometry & Composition Verification Mikell et al. Brachytherapy 2013 TG-53 In house MC model derived from physical verification and vendor CAD
21 MBDCAs commissioning level 2 Dosimetry comparison: GBBS / MCNP5 Mikell et al. Brachytherapy 2013 MC error 2% 3%
22 MBDCAs commissioning level 2 Dosimetry comparison: GBBS / MC At 2 cm from colpostat Mikell et al. Brachytherapy 2013
23 Conclusions MBDCA-based TPS implies the following assupmtions: Radioactive sources are sufficiently modelled Applicator models in TPS libraries are correctly implemented CT and MRI are properly converted to materia/densities Radiation transport algorithm sufficiently approximates a solution to the GBBS MBDCA-based TPS commissionig should validate them 23
24 Acknowledgements MBDCA WG members Luc Beaulieu, Chair Å. Carlsson Tedgren A. Haworth G. S. Ibbott F. Mourtada P. Papagiannis M.J. Rivard F.A. Siebert R. S. Sloboda R.M. Thomson F. Verhaegen Valencia University Group Javier Vijande, PhD José Pérez-Calatayud, PhD Cristian Candela-Juan, MSc Domingo Granero, PhD 24
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