title: Comprehensive evaluations of cone-beam CT dose in image-guided radiation therapy via GPU-based Monte Carlo simulations.
abstract: Cone beam CT (CBCT) has been widely used for patient setup in image-guided radiation therapy (IGRT). Radiation dose from CBCT scans has become a clinical concern. The purposes of this study are (1) to commission a graphics processing unit (GPU)-based Monte Carlo (MC) dose calculation package gCTD for Varian On-Board Imaging (OBI) system and test the calculation accuracy, and (2) to quantitatively evaluate CBCT dose from the OBI system in typical IGRT scan protocols. We first conducted dose measurements in a water phantom. X-ray source model parameters used in gCTD are obtained through a commissioning process. gCTD accuracy is demonstrated by comparing calculations with measurements in water and in CTDI phantoms. Twenty-five brain cancer patients are used to study dose in a standard-dose head protocol, and 25 prostate cancer patients are used to study dose in pelvis protocol and pelvis spotlight protocol. Mean dose to each organ is calculated. Mean dose to 2% voxels that have the highest dose is also computed to quantify the maximum dose. It is found that the mean dose value to an organ varies largely among patients. Moreover, dose distribution is highly non-homogeneous inside an organ. The maximum dose is found to be 1-3 times higher than the mean dose depending on the organ, and is up to eight times higher for the entire body due to the very high dose region in bony structures. High computational efficiency has also been observed in our studies, such that MC dose calculation time is less than 5 min for a typical case.
authors.affiliation: Center for Advanced Radiotherapy Technologies, University of California San Diego, La Jolla, CA 92037-0843, USA. Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA 92037-0843, USA.
authors.forename: Davide
authors.initials: D
authors.lastname: Montanari
authors.forename: Enrica
authors.initials: E
authors.lastname: Scolari
authors.forename: Chiara
authors.initials: C
authors.lastname: Silvestri
authors.forename: Yan Jiang
authors.initials: YJ
authors.lastname: Graves
authors.forename: Hao
authors.initials: H
authors.lastname: Yan
authors.forename: Laura
authors.initials: L
authors.lastname: Cervino
authors.forename: Roger
authors.initials: R
authors.lastname: Rice
authors.forename: Steve B
authors.initials: SB
authors.lastname: Jiang
authors.forename: Xun
authors.initials: X
authors.lastname: Jia
mesh_terms: D003196:Computer Graphics; D003198:Computer Simulation; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D015233:Models, Statistical; D009010:Monte Carlo Method; D019047:Phantoms, Imaging; D011829:Radiation Dosage; D011874:Radiometry / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity