Monte Carlo (MC) methods are increasingly being utilized to support several aspects of commissioning and clinical operation of ion beam therapy facilities. In this contribution two emerging areas of MC applications are outlined. The value of MC modeling to promote accurate treatment planning is addressed via examples of application of the FLUKA code to proton and carbon ion therapy at the Heide...

The combination of radiotherapy treatments and breast reconstruction, using temporary tissue expanders, generates several concerns due to the presence of a magnetic valve inside the radiation field. The objective of this work is to evaluate a radiotherapy treatment planning for a patient using a tissue expander. Isodose curve maps, obtained using radiochromic films, were compared to the ones ca...

In recent years one of the areas of interest in radiotherapy has been adaptive radiation therapy (ART), with the most efficient way of performing ART being the use of deformable image registration (DIR). In this paper we use the distances between points of interest (POIs) in the computed tomography (CT) and the cone beam computed tomography (CBCT) acquisition images and the inverse consistence ...

The purpose of this study was to evaluate the feasibility of assessing bladder and rectal point doses, using orthogonal radiographs without treatment planning, for vaginal cylinder applicator (VC), high-dose-rate (HDR) vaginal cuff brachytherapy (BT) after hysterectomy. Thirty-three VC HDR BT treatment plans from 31 postop- erative endometrial cancer patients were retrospectively analyzed. Sing...

The Hounsfield units into density conversion for a commercial treatment planning system (TPS) is discussed. The impact of an average calibration table provided by the manufacturer on computed doses was investigated when a customer calibration could not be included in the TPS. The maximum error determined on the computed monitor units per Gy was found to be about 2%, being below 1% on average. T...

A 3D treatment-planning system (TPS) for stereotactic intensity-modulated radiotherapy (IMRT) using a micro-multileaf collimator has been made available by Radionics. In this work, we report our comprehensive quality assurance (QA) procedure for commissioning this TPS. First, the accuracy of stereotaxy established with a body frame was checked to ensure accurate determination of a target positi...

An increasing number of patients undergoing proton radiotherapy have cardiac implantable electrical devices (CIEDs). We recently encountered a situation in which a high-voltage coil on a lead from an implanted cardiac defibrillator was located within the clinical treatment volume for a patient receiving proton radiotherapy for esophageal cancer. To study the effects of the lead on the dose deli...

Background: Accurate dose calculations in small beamlets and lung material have been a great challenge for most of treatment planning systems (TPS).  In the current study, the dose calculation accuracy of TiGRT TPS was evaluated for small beamlets in water and lung phantom by comparison to Monte Carlo (MC) calculations. Materials and Methods: The head of Siemens Oncor-impression linac...

Intensity-modulated radiotherapy (IMRT) has reduced the impact of acute and late toxicities associated with head and neck radiotherapy. Treatment planning system (TPS) advances in biological cost function based optimization (BBO) and improved segmentation techniques have increased organ at risk (OAR) sparing compared to conventional dose-based optimization (DBO). A planning study was undertaken...