Validation of a Monte Carlo-based dose calculation engine including the 1.5 T magnetic field for independent dose-check in MRgRT

Purpose: Adaptive MRgRT by 1.5 T MR-linac requires independent verification of the plan-of-the-day by the primary TPS (Monaco^TM) (M). Here we validated a Monte Carlo-based dose-check including the magnetostatic field, SciMoCa^TM (S).

Methods: M and S were validated first in water, by comparison with commissioning-dosimetry. PDD(2x2cm²) through a lung(air)-equivalent virtual-slab was then calculated. Clinical validation retrospectively included 161 SBRT plans, from five patients per-site: Pelvic-Nodes, Prostate, Liver, Pancreas, and Lungs. S-minus-M percentage differences (Δ%) were computed for target- and OARs-related dose-volume metrics. In-phantom dose verification per-patient was performed.

Results: γ(2 %,1mm)-passing-rates (PR%) of in-water-computed PDD and transverse-dose-profiles vs. commissioning-dosimetry were (99.1 ± 2.0)% for M, and (99.3 ± 1.5)% for S. Calculated output-factors (OF) were typically within 1 % from measurements, except for OF(1x1cm²) which was misestimated by -4.4 % and + 2.2 %, by M and S respectively. Dose spikes (valleys) on the PDD(2x2cm²) by S across the lung-equivalent virtual-slab were slightly reduced with respect to M. In clinical plans, S computed higher V95% (p <0.05*, for pancreas and lung) and D2% (p <0.05*, for all sites) for the target, while D%>2% resulted for duodenal D(1cm³), in Pancreas-SBRT, and for mean-lung-dose, in Lung-SBRT. All mostly due to the underestimated OF(1x1cm²) by M. In-phantom dose verifications showed an average 1% increase in PR% by S vs. M.

Conclusions: Beam-model quality in S resulted equivalent to M, thus making S useful both for an independent validation of the same beam-model in M, and for a daily validation of the M-based online approval decisions, without significantly delaying the clinical workflow (2-3 min).