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. 2021 Jun 12;16(1):108.
doi: 10.1186/s13014-020-01722-0.

Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy

Dong-Jin Kang  1 , Young-Joo Shin  2 , Seonghoon Jeong  3 , Jae-Yong Jung  1 , Hakjae Lee  4 , Boram Lee  5
Affiliations

Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy

Dong-Jin Kang et al. Radiat Oncol. .

Abstract

Background: The purpose of this study is to develop a clinical application program that automatically calculates the effect for secondary cancer risk (SCR) of individual patient. The program was designed based on accurate dose calculations using patient computed tomography (CT) data and Monte Carlo engine. Automated patient-specific evaluation program was configured to calculate SCR.

Methods: The application program is designed to re-calculate the beam sequence of treatment plan using the Monte Carlo engine and patient CT data, so it is possible to accurately calculate and evaluate scatter and leakage radiation, difficult to calculate in TPS. The Monte Carlo dose calculation system was performed through stoichiometric calibration using patient CT data. The automatic SCR evaluation program in application program created with a MATLAB was set to analyze the results to calculate SCR. The SCR for organ of patient was calculated based on Biological Effects of Ionizing Radiation (BEIR) VII models. The program is designed to sequentially calculate organ equivalent dose (OED), excess absolute risk (EAR), excess relative risk (ERR), and the lifetime attributable risk (LAR) in consideration of 3D dose distribution analysis. In order to confirm the usefulness of the developed clinical application program, the result values from clinical application program were compared with the manual calculation method used in the previous study.

Results: The OED values calculated in program were calculated to be at most approximately 13.3% higher than results in TPS. The SCR result calculated by the developed clinical application program showed a maximum difference of 1.24% compared to the result of the conventional manual calculation method. And it was confirmed that EAR, ERR and LAR values can be easily calculated by changing the biological parameters.

Conclusions: We have developed a patient-specific SCR evaluation program that can be used conveniently in the clinic. The program consists of a Monte Carlo dose calculation system for accurate calculation of scatter and leakage radiation and a patient-specific automatic SCR evaluation program using 3D dose distribution. The clinical application program that improved the disadvantages of the existing process can be used as an index for evaluating a patient treatment plan.

Keywords: Clinical application program; Monte Carlo; Secondary cancer risk; TPS.

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Conflict of interest statement

All of the authors participated in the design, execution, and analysis of this work and approved the final version of the manuscript. There are no conflicts of interest in connection with this work, and the material described is not under consideration for publication elsewhere.

Figures

Fig. 1
Fig. 1
Graphic user interface (GUI) for organ equivalent dose (OED), excess absolute risk (EAR), excess relative risk (ERR), lifetime attributable risk (LAR) calculation of secondary cancer risk (SCR) evaluation program
Fig. 2
Fig. 2
Procedure diagram for the automatic SCR evaluation program based on the Monte Carlo engine. TPS treatment planning system, CT computed tomography, SCR secondary cancer risk, DICOM digital imaging and communications in medicine, MLC multileaf collimator
Fig. 3
Fig. 3
Comparison of LAR and cumulative baseline cancer risk according to exposure age for OAR (treatment site). LAR lifetime attributable risk, OAR organs at risk
See this image and copyright information in PMC

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