BrachyGuide: a brachytherapy-dedicated DICOM RT viewer and interface to Monte Carlo simulation software

This work presents BrachyGuide, a brachytherapy-dedicated software tool for the automatic preparation of input files for Monte Carlo simulation from treatment plans exported in DICOM RT format, and results of calculations performed for its benchmarking. Three plans were prepared using two computational models, the image series of a water sphere and a multicatheter breast brachytherapy patient, for each of two commercially available treatment planning systems: BrachyVision and Oncentra Brachy. One plan involved a single source dwell position of an 192Ir HDR source (VS2000 or mHDR-v2) at the center of the water sphere using the TG43 algorithm, and the other two corresponded to the TG43 and advanced dose calculation algorithm for the multicatheter breast brachytherapy patient. Monte Carlo input files were prepared using BrachyGuide and simulations were performed with MCNP v.6.1. For the TG43 patient plans, the Monte Carlo computational model was manually edited in the prepared input files to resemble TG43 dosimetry assumptions. Hence all DICOM RT dose exports were equivalent to corresponding simulation results and their comparison was used for benchmarking the use of BrachyGuide. Monte Carlo simulation results and corresponding DICOM RT dose exports agree within type A uncertainties in the majority of points in the computational models. Treatment planning system, algorithm, and source specific differences greater than type A uncertainties were also observed, but these were explained by treatment planning system-related issues and other sources of type B uncertainty. These differences have to be taken into account in commissioning procedures of brachytherapy dosimetry algorithms. BrachyGuide is accurate and effective for use in the preparation of commissioning tests for new brachytherapy dosimetry algorithms as a user-oriented commissioning tool and the expedition of retrospective patient cohort studies of dosimetry planning.