title: Determination of the optimal statistical uncertainty to perform electron-beam Monte Carlo absorbed dose estimation in the target volume.
abstract: OBJECTIVE
  Monte Carlo based treatment planning system are known to be more accurate than analytical methods for performing absorbed dose estimation, particularly in and near heterogeneities. However, the required computation time can still be an issue. The present study focused on the determination of the optimum statistical uncertainty in order to minimise computation time while keeping the reliability of the absorbed dose estimation in treatments planned with electron-beams.
  
  
  METHODS
  Three radiotherapy plans (medulloblastoma, breast and gynaecological) were used to investigate the influence of the statistical uncertainty of the absorbed dose on the target volume dose-volume histograms (spinal cord, intramammary nodes and pelvic lymph nodes, respectively).
  
  
  RESULTS
  The study of the dose-volume histograms showed that for statistical uncertainty levels (1 S.D.) above 2 to 3%, the standard deviation of the mean dose in the target volume calculated from the dose-volume histograms increases by at least 6%, reflecting the gradual flattening of the dose-volume histograms.
  
  
  CONCLUSIONS
  This work suggests that, in clinical context, Monte Carlo based absorbed dose estimations should be performed with a maximum statistical uncertainty of 2 to 3%.
authors.affiliation: Medical Physics Department, institut Gustave-Roussy, 39 rue Camille-Desmoulins, Villejuif, France. isambert@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Isambert
authors.forename: L
authors.initials: L
authors.lastname: Brualla
authors.forename: M
authors.initials: M
authors.lastname: Benkebil
authors.forename: D
authors.initials: D
authors.lastname: Lefkopoulos
mesh_terms: D001822:Body Burden; D001940:Breast / Q000528:radiation effects; D003198:Computer Simulation; D004583:Electrons / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000528:radiation effects; D009010:Monte Carlo Method; D009929:Organ Size; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D013116:Spinal Cord / Q000528:radiation effects; D035501:Uncertainty