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Background: Recent developments in alpha and beta emitting radionuclide therapy highlight the importance of developing efficient methods for patient-specific dosimetry. Traditional tabulated methods such as Medical Internal Radiation Dose (MIRD) estimate the dose at the organ level while more recent numerical methods based on Monte Carlo (MC) simulations are able to calculate dose at the voxel level. A precalculated MC (PMC) approach was developed in this work as an alternative to time-consuming fully simulated MC. Once the spatial distribution of alpha and beta emitters is determined using imaging and/or numerical methods, the PMC code can be used to achieve an accurate voxelized 3D distribution of the deposited energy without relying on full MC calculations., Purpose: To implement the PMC method to calculate energy deposited by alpha and beta particles emitted from the Ra-224 decay chain., Methods: The GEANT4 (version 10.7) MC toolkit was used to generate databases of precalculated tracks to be integrated in the PMC code as well as to benchmark its output. In this regard, energy spectra of alpha and beta particles emitted by the Ra-224 decay chain were generated using GAMOS (version 6.2.0) and imported into GEANT4 macro files. Either alpha or beta emitting sources were defined at the center of a homogeneous phantom filled with various materials such as soft tissue, bone, and lung where particles were emitted either mono-directionally (for database generation) or isotropically (for benchmarking). Two heterogeneous phantoms were used to demonstrate PMC code compatibility with boundary crossing events. Each precalculated database was generated step-by-step by storing particle track information from GEANT4 simulations followed by its integration in a PMC code developed in MATLAB. For a user-defined number of histories, one of the tracks in a given database was selected randomly and rotated randomly to reflect an isotropic emission. Afterward, deposited energy was divided between voxels based on step length in each voxel using a ray-tracing approach. The radial distribution of deposited energy was benchmarked against fully simulated MC calculations using GEANT4. The effect of the GEANT4 parameter StepMax on the accuracy and speed of the code was also investigated., Results: In the case of alpha decay, primary alpha particles show the highest contribution (>99%) in deposited energy compared to their secondary particles. In most cases, protons act as the main secondary particles in the deposition of energy. However, for a lung phantom, using a range cutoff parameter of 10 µm on primary alpha particles yields a higher contribution of secondary electrons than protons. Differences between deposited energy calculated by PMC and fully simulated MC are within 2% for all alpha and beta emitters in homogeneous and heterogeneous phantoms. Additionally, statistical uncertainties are less than 1% for voxels with doses higher than 5% of the maximum dose. Moreover, optimization of the parameter StepMax is necessary to achieve the best tradeoff between code accuracy and speed., Conclusions: The PMC code shows good performance for dose calculations deposited by alpha and beta emitters. As a stand-alone algorithm, it is suitable to be integrated into clinical treatment planning systems., (© 2023 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

The purpose of this work is to revisit the impediments and characteristics of fast Monte Carlo techniques for applications in radiation therapy treatment planning using new methods of utilizing pregenerated electron tracks. The limitations of various techniques for the improvement of speed and accuracy of electron transport have been evaluated. A method is proposed that takes advantage of large available memory in current computer hardware for extensive generation of precalculated data. Primary tracks of electrons are generated in the middle of homogeneous materials (water, air, bone, lung) and with energies between 0.2 and 18 MeV using the EGSnrc code. Secondary electrons are not transported, but their position, energy, charge, and direction are saved and used as a primary particle. Based on medium type and incident electron energy, a track is selected from the precalculated set. The performance of the method is tested in various homogeneous and heterogeneous configurations and the results were generally within 2% compared to EGSnrc but with a 40-60 times speed improvement. In a second stage the authors studied the obstacles for further increased speed-ups in voxel geometries by including ray-tracing and particle fluence information in the pregenerated track information. The latter method leads to speed increases of about a factor of 500 over EGSnrc for voxel-based geometries. In both approaches, no physical calculation is carried out during the runtime phase after the pregenerated data has been stored even in the presence of heterogeneities. The precalculated data are generated for each particular material and this improves the performance of the precalculated Monte Carlo code both in terms of accuracy and speed. Precalculated Monte Carlo codes are accurate, fast, and physics independent and therefore applicable to different radiation types including heavy-charged particles.

Since taken with megavoltage, forward-directed bremsstrahlung beams, the image quality of current portal images is inferior to that of diagnostic quality images produced by kilovoltage beams. In this paper, the beam quality of orthogonal bremsstrahlung beams defined as the 90 degrees component of the bremsstrahlung distribution produced from megavoltage electron pencil beams striking various targets is presented, and the suitability of their use for improved radiotherapy imaging is evaluated. A 10 MeV electron beam emerging through the research port of a Varian Clinac-18 linac was made to strike targets of carbon, aluminum, and copper. PDD and attenuation measurements of both the forward and orthogonal beams were carried out, and the results were also used to estimate the effective and mean energy of the beams. The mean energy of a spectrum produced by a carbon target dropped by 83% from 1296 keV in the forward direction to 217 keV in the orthogonal direction, while for an aluminum target it dropped by 77% to 412 keV, and for a copper target by 65% to 793 keV. An in-depth Monte Carlo study of photon yield and electron contamination was also performed. Photon yield and effective energy are lower for orthogonal beams than for forward beams, and the differences are more pronounced for targets of lower atomic number. Using their relatively low effective energy, orthogonal bremsstrahlung beams produced by megavoltage electrons striking low atomic number targets yield images with a higher contrast in comparison with forward bremsstrahlung beams.

A novel method for detecting out-of-plane patient rotation by comparing a single portal image to its reference image is presented. Out-of-plane rotation results in an apparent distortion of the anatomy in a portal image. This distortion can be mathematically predicted with the magnification varying at each point in the image. While scaling of points at equal depth is invariant under in-plane rotation or translation, and changes equally in both dimensions for an axial shift of the patient, a change of scaling in only one dimension can be ascribed to an out-of-plane rotation. For the two conditions that are used in this study, it is shown that out-of-plane rotation yields a different scaling of the image in two perpendicular directions and therefore it is feasible to calculate the scale factors as a function of out-of-plane rotation. Conversely the recovery of scale factors in two different directions at the same time would enable the magnitude of the out-of-plane rotation to be recovered. The properties of the Fourier transform of the image are used to align the portal image with the reference image (a simulator image or first approved portal image) prior to the recovery of the scale factors. Correlating the Fourier transform of the portal image on a log-scale with that of the reference image enables the scale factors to be automatically extracted from a single portal image. In the two approaches investigated, out-of-plane rotations of up to 41 degrees and 20 degrees (respectively) have been recovered with a maximum error of 2.4 degrees. This technique could be used to automatically detect patient roll or tilt prior to or during a treatment session.