Indrin Chetty Henry Ford Hospital Detroit, MI. AAPM Annual Meeting Houston 7:30-8:25 Mon 08/07/28 1/30

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Review of TG105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning D. W. O. Rogers, Carleton Laboratory for Radiotherapy Physics, Physics Dept, Carleton University, Ottawa Indrin Chetty Henry Ford Hospital Detroit, MI http://www.physics.carleton.ca/~drogers AAPM Annual Meeting Houston 7:30-8:25 Mon 08/07/28 1/30

Disclosure I used to work for, and still receive some royalty income from the National Research Council of Canada which has licensing agreements re Monte Carlo software with: Elekta Philips/ADAC NAS/NOMOS Nucletron Varian The following companies have provided support for my group at Carleton University: Nucletron Canada TomoTherapy Inc Philips/ADAC MDS Nordion Varian 2/30

Co-authors of TG-105 Med Phys 34 (2007) 4818-4853 3/30

Charge of TG-105 Develop an overview report on the Monte Carlo method and its application to radiotherapy treatment planning. Aims are: educational: provide an understanding of the MC method and how it is used in radiotherapy discuss issues associated with clinical implementation and experimental verification provide perspectives and possible methods on how to deal with the issues Not meant to be prescriptive or to provide specific guidance on clinical commissioning. 4/30

What is the Monte Carlo method? The Monte Carlo technique for the simulation of the transport of electrons and photons through bulk media consists of using knowledge of the probability distributions governing the individual interactions of electrons and photons in materials to simulate the random trajectories of individual particles. One keeps track of physical quantities of interest for a large number of histories to provide the required information about the average quantities * In principle, very straightforward application of radiation physics. Much easier to understand than convolution / superposition or EQTAR. Virtually no approximations of consequence. *TG105 quotes Rogers&Bielajew, 1990, in Dosimetry of Ionizing Radiation V3 http://www.physics.carleton.ca/~drogers/pubs/papers/rb90.pdf 5/30

10 MeV photon on lead along incident photon. positrons red electrons blue photons yellow incident incident NRC-CNRC CNRC 6

10 MeV electrons on water from right electrons blue photons yellow NRC-CNRC CNRC 7

Simple photon simulation say: Σ cm -1 = Σ Σ + total compton pair select 2 random numbers R1, R2 uniform between 0 and 1 whole careers devoted to doing this cycle length now 10 >40 8/30

Photon transport (cont) How far does photon go before interacting? X = -ln(r1) / Σ total cm is exponentially distributed [0, ) with a mean of 1/ Σ total 9/30

Photon transport (cont) After going x, what interaction occurs? if R2 < Σ compton Σ total then a compton scatter occurs otherwise a pair production event occurs 10/30

How is simulation used? score whatever data wanted average distance to interaction how many of each type energy deposited by each type etc more useful in complex cases 11/30

Condensed history technique for e- transport as electrons slow, they have many interactions Berger s grouping into condensed history steps made Monte Carlo transport of electrons feasible. individual scattering events grouped via multiple-scattering theories low-energy-loss events grouped into restricted stopping powers increases efficiency by decreasing time,t, (a lot) modern transport mechanics algorithms are very sophisticated in order to maximize step size while maintaining accuracy (to gain speed). 12/30

e- transport is much more complex hard collisions create secondaries eg δ-rays / brem soft collisions -grouped -multiple scatter -restricted energy loss condensed history technique: group many individual interactions into steps 13/30

Overview of the entire process target vacuum window flattening filter phase space plane 1 primary collimator ion chamber patientindependent components patientdependent structures jaws MLC phase space plane 2 phase space: position, energy, direction, type, latch (region of creation, interaction, etc.) 14/30

How do we get calculational efficiency? the efficiency of a calculation is given by s 2 is an estimate of the variance (σ 2 ) on a quantity of interest (Indrin to discuss s 2 ) T is the CPU timefor the calculation improve the efficiency by decreasing s 2 or T 15/30

Variance reduction techniques (VRTs) A VRT is a method which increases the efficiency for some quantity of interest by decreasing s 2 for a given N while not biasing the result. they often increase time per history VRTs may simultaneously make s 2 for some other quantity increase eg pathlength shrinking will improve the efficiency for dose near the surface but decrease the efficiency for dose at depth 16/30

Variance reduction techniques for a recent review, see Sheikh-Bagheri et al s 2006 AAPM summer school chapter http://www.physics.carleton.ca/~drogers/pubs/papers/sb06.pdf examples splitting (brem splitting: UBS, DBS; in-phantom) Russian roulette interaction forcing track repetition STOPS (simultaneous transport of particle sets) -enhanced cross sections (brem: BCSE) 17/30

Splitting, Roulette & particle weight 1 w i = 10 w f 10 w i = 1 w f Split! Roulette! from Sheikh-Bagheri s 2006 summer school lecture 18/30

Directional Brem Splitting trick is to only split when it pays off Scoring photon fluence in beam Kawrakow et al Med Phys 31 (2004) 2883 19/30

Tx head simulation using BEAMnrc with Directional Bremsstrahlung Splitting Todays commodity PCs are 5 times faster & BCSE => 2.6 times faster Ali Med Phys 34(2007)2143 from Sheikh-Bagheri et al. Efficiency Improvement Techniques and Statistical Considerations AAPM Summer School 2006 20/30

Other efficiency-improving techniques one can improve the efficiency by decreasing T usually implies an approximation being made must demonstrate the approximation does not lead to significant errors Examples range rejection: terminate an e- history if it cannot reach any boundary an approximation since no brem possible higher cutoff energies: terminate tracks sooner an approximation since energy deposited locally both are usually OK (within reason) 21/30

Monte Carlo in radiotherapy Monte Carlo calculations are the basis of much of clinical dosimetry for years. AAPM s dosimetry protocols TG-51(and earlier TG-21) external beam dosimetry TG-43 brachytherapy dosimetry TG-61 x-ray dosimetry 22/30

Monte Carlo transport: major general purpose codes Berger 1963/ ETRAN/ CYLTRAN/ ITS/ MCNP EGS3 1978/ EGS4/ PRESTA/ EGSnrc MCPT (photon only brachytherapy) PENELOPE 1995 GEANT3/GEANT4 BEAMnrc for modelling accelerators 23/30

Commercial codes available/under development PEREGRINE (North American Scientific/NOMOS) developed by Livermore National Lab photon beams only modified EGS4 electron transport beam modelling based on source models and BEAM code simulations of accelerators multiple processors for speed 24/30

Commercial codes available/under development (cont) VMC/XVMC/VMC++ developed by Kawrakow and Fippel new code, multiple variance reduction techniques various approaches to accelerator beam models VMC++ commercially available for electrons (Nucletron) VMC++ or XVMC for photon beams is in pipeline with Varian BrainLab CMS Elekta Nucletron 25/30

Commercial codes available/under development (cont) MMC - Macro Monte Carlo developed by Neuenswander et al uses pre-calculated distributions and runs a MC simulation based on the kugels. commercialized by Varian 26/30

Summary of ICCR timing/accuracy benchmarks Timing: 6 MV 10x10 cm 2, 5 mm 3 voxels, 2% uncertainty > D max /2 Accuracy: 18 MV, 1.5x1.5 cm 2, 5x5x2 mm 3 voxels(h 2 O,Al,lung slabs) P IV 3GHz abcde footnotes are longer than table in TG105! 27/30

Beam models a beam model, in this context, is any algorithm that delivers the location, direction and energy of particles to the patient dose-calculating algorithm. one type of beam model is a direct MC simulation of the accelerator head, but we refer to it as a beam simulation for clarity beam simulations can be done accurately if all the parameters are known - but they often are not 28/30

possible ways to specify a beam model -new linac simulation B A B direct phase space virtual source models From AAPM TG Report No. 105 B B A BEAM MODEL delivers PS particles C measurement-driven models C measured data 29/30

Thank you Now over to Indrin Chetty for the second part 30/30