A fast jaw-tracking model for VMAT and IMRT Monte Carlo simulations.

Modern radiotherapy techniques involve routine use of volumetric arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) with jaw-tracking - dynamic motion of the secondary collimators (jaws) in tandem with multi-leaf collimators (MLCs). These modalities require accurate dose calculations for the purposes of treatment planning and dose verification. Monte Carlo (MC) methods for radiotherapy dose calculation are widely accepted as capable of achieving high accuracy. This paper presents an efficiency-enhancement method for secondary collimator modeling, presented in the context of a tool for MC-based dose second checks. The model constitutes an accuracy trade-off in the source model for the sake of efficiency enhancement, but maintains the advantages of MC transport in patient heterogeneities. The secondary collimator model is called Flat-Absorbing-Jaw-Tracking (FAJT). Transmission through and scatter from the secondary collimators is neglected, and jaws are modeled as perfectly absorbing planes. To couple the motion of secondary collimators with MLCs for jaw-tracking, the FAJT model was built into the VCU-MLC model. Gamma-index analysis of the dose distributions from FAJT against the full BEAMnrc MC simulations showed over 99% pass rate for a range of open fields, two clinical IMRT, and one VMAT treatment plan, for 2%/2 mm criteria above 10%. Using FAJT, the simulation speed of the secondary collimators for open fields increased by a factor of 237, 1489, and 1395 for 4 × 4, 10 × 10, and 30 × 30 cm , respectively. In general, clinically oriented simulation times are reduced from "hours" to "minutes" on identical hardware. Results for nine representative clinical cases (seven with jaw-tracking) are presented. The average 2%/2 mm γ-test success rate above the 80% isodose was 96.8% when tested against the EPIDose electronic portal image-based dose reconstruction method and 97.3% against the Eclipse analytical anisotropic algorithm.