GATE as a GEANT4-based Monte Carlo platform for the evaluation of proton pencil beam scanning treatment plans

Active scanning delivery systems take full advantage of ion beams to best conform to the tumor and to spare surrounding healthy tissues; however, it is also a challenging technique for quality assurance. In this perspective, we upgraded the GATE/GEANT4 Monte Carlo platform in order to recalculate the treatment planning system (TPS) dose distributions for active scanning systems. A method that allows evaluating the TPS dose distributions with the GATE Monte Carlo platform has been developed and applied to the XiO TPS (Elekta), for the IBA proton pencil beam scanning (PBS) system. First, we evaluated the specificities of each dose engine. A dose-conversion scheme that allows one to convert dose to medium into dose to water was implemented within GATE. Specific test cases in homogeneous and heterogeneous configurations allowed for the estimation of the differences between the beam models implemented in XiO and GATE. Finally, dose distributions of a prostate treatment plan were compared. In homogeneous media, a satisfactory agreement was generally obtained between XiO and GATE. The maximum stopping power difference of 3% occurred in a human tissue of 0.9 g cm(-3) density and led to a significant range shift. Comparisons in heterogeneous configurations pointed out the limits of the TPS dose calculation accuracy and the superiority of Monte Carlo simulations. The necessity of computing dose to water in our Monte Carlo code for comparisons with TPSs is also presented. Finally, the new capabilities of the platform are applied to a prostate treatment plan and dose differences between both dose engines are analyzed in detail. This work presents a generic method to compare TPS dose distributions with the GATE Monte Carlo platform. It is noteworthy that GATE is also a convenient tool for imaging applications, therefore opening new research possibilities for the PBS modality.