RadCalc Monte Carlo user experience

The interview was originally published in the Spring Edition of EMP News by European Federation Of Organizations For Medical Physics – EFOMP.
 

Accuracy and safety are key elements in radiation therapy. The Monte Carlo calculation method is considered the most accurate. In addition to that RadCalc’s 3D Monte Carlo offers flexible implementation options that help to increase speed and productivity while maintaining uncompromised accuracy. The Lake Constance Radiation Oncology Center, Singen-Friedrichshafen has offers radiotherapy services for optimal patient treatment since 2007. Traditionally, calculations by the therapy planning system are verified using phantom-based measurements. This was further supported by the introduction of an iRT IQM detector in 2018 allowing for real-time verification during patient treatment. Recently RadCalc was introduced as a secondary check system to further enhance the already advanced QA process. RadCalc is used at the center for recalculating complex IMRT and VMAT plans. LAP is already known to the Lake Constance Radiation Oncology Center, Singen-Friedrichshafen through laser systems for patient marking and positioning. With the use of RadCalc, the cooperation will be further expanded. We asked Mike Froehlich, qualified radiation specialist in training about his experiences with RadCalc.

What advantage did you expect from the Monte Carlo recalculation?

Mike Froehlich: We wanted to use an independent second algorithm to verify the results of our well-known calculation system. Monte Carlo based calculations are the current most accurate way to do secondary checks.

Do you think software-based verification will replace phantom-based measurements?

Mike Froehlich: Phantom-based measurements cannot be abolished, we need real values, but software is important for process optimisation. We are now implementing RadCalc in our process landscape to help the physicists and save valuable time. A software-based solution brings added value. 

What experiences have you had with the use of RadCalc’s Monte Carlo?

Mike Froehlich: The basic installation of the software is intuitive and very easy to carry out according to current standards of a software installation. However, the first "quick runs" revealed some challenges. It turned out that our iRT IQM detector had to be implemented as well. With the help of expert support from Lueneburg and the USA, we were quickly able to achieve first results.

That is right, the feature was not yet considered in the software at the time of implementation and was then programmed accordingly. Did that work out well?

Mike Froehlich: In the meantime, it looks that we are on the right way. Other providers seem to have difficulties with it. By the way, the duration of the MC calculations is impressively short.

You also did the calculations remotely, didn't you?

Mike Froehlich: Yes, first on the remote workstation via the VPN connection with upload of anonymized patient plans. After implementing the proxy solution via our gateway, the entire system runs flawlessly. In my opinion, this is a clever method that enables efficient use of resources. 

What do you consider most challenging in patient QA/ secondary check these days?

Mike Froehlich: Patient QA must not become a self-fulfilling prophecy. We use the IQM software for online verification and want to investigate the combination of these systems what value contribution the systems can make to minimising errors thus maximising patient safety. The value of the evaluations should not end up as "meeting legal requirements". Together with the results of online-dosimetry (iQM), RadCalc´s MC and future exit-dosimetry we learn more about the edges of “accurancy” and weakpoints of the sub-systems. Goal is to tell the patients that they have received a secureand safe treatment. The full evaluation of our overall QA process including RadCalc will take place within the framework of a special project, which will start soon. So there is more to come…