title: Monte Carlo based beam model using a photon MLC for modulated electron radiotherapy.
abstract: OBJECTIVE
  Modulated electron radiotherapy (MERT) promises sparing of organs at risk for certain tumor sites. Any implementation of MERT treatment planning requires an accurate beam model. The aim of this work is the development of a beam model which reconstructs electron fields shaped using the Millennium photon multileaf collimator (MLC) (Varian Medical Systems, Inc., Palo Alto, CA) for a Varian linear accelerator (linac).
  
  
  METHODS
  This beam model is divided into an analytical part (two photon and two electron sources) and a Monte Carlo (MC) transport through the MLC. For dose calculation purposes the beam model has been coupled with a macro MC dose calculation algorithm. The commissioning process requires a set of measurements and precalculated MC input. The beam model has been commissioned at a source to surface distance of 70 cm for a Clinac 23EX (Varian Medical Systems, Inc., Palo Alto, CA) and a TrueBeam linac (Varian Medical Systems, Inc., Palo Alto, CA). For validation purposes, measured and calculated depth dose curves and dose profiles are compared for four different MLC shaped electron fields and all available energies. Furthermore, a measured two-dimensional dose distribution for patched segments consisting of three 18 MeV segments, three 12 MeV segments, and a 9 MeV segment is compared with corresponding dose calculations. Finally, measured and calculated two-dimensional dose distributions are compared for a circular segment encompassed with a C-shaped segment.
  
  
  RESULTS
  For 15 × 34, 5 × 5, and 2 × 2 cm(2) fields differences between water phantom measurements and calculations using the beam model coupled with the macro MC dose calculation algorithm are generally within 2% of the maximal dose value or 2 mm distance to agreement (DTA) for all electron beam energies. For a more complex MLC pattern, differences between measurements and calculations are generally within 3% of the maximal dose value or 3 mm DTA for all electron beam energies. For the two-dimensional dose comparisons, the differences between calculations and measurements are generally within 2% of the maximal dose value or 2 mm DTA.
  
  
  CONCLUSIONS
  The results of the dose comparisons suggest that the developed beam model is suitable to accurately reconstruct photon MLC shaped electron beams for a Clinac 23EX and a TrueBeam linac. Hence, in future work the beam model will be utilized to investigate the possibilities of MERT using the photon MLC to shape electron beams.
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: D
authors: D
authors: Henzen
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: P
authors: P
authors: Manser
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: D
authors: D
authors: Frei
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: W
authors: W
authors: Volken
authors: Clinic for Radiation-Oncology, Lindenhofspital Bern, CH-3012 Berne, Switzerland.
authors: H
authors: H
authors: Neuenschwander
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: E J
authors: EJ
authors: Born
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: D
authors: D
authors: Vetterli
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: C
authors: C
authors: Chatelain
authors: Institute for Biomedical Engineering, ETH Zürich and Paul Scherrer Institut, CH-5234 Villigen, Switzerland.
authors: M F M
authors: MF
authors: Stampanoni
authors: Division of Medical Radiation Physics and Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, CH-3010 Berne, Switzerland.
authors: M K
authors: MK
authors: Fix
mesh_terms: D000465:Algorithms; D004583:Electrons / Q000627:therapeutic use*; D005240:Feasibility Studies; D008954:Models, Biological; D009010:Monte Carlo Method; D058958:Organs at Risk / Q000528:radiation effects; D017785:Photons / Q000627:therapeutic use*; D011879:Radiotherapy Dosage; D015203:Reproducibility of Results