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Updated: Dec 26, 2025

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Technical Note: Integrating an open source Monte Carlo code "MCsquare" for clinical use in intensity-modulated proton
Wei Deng1, James E Younkin1, Kevin Souris2
1Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ, 85054, USA.
The open-source Monte Carlo (MC) dose engine, MCsquare, was successfully commissioned and integrated for intensity-modulated proton therapy (IMPT). MCsquare demonstrates high accuracy and efficiency for clinical proton beam therapy, enabling future LET-guided robust optimization.
Area of Science:
- Medical Physics
- Radiation Oncology
- Computational Biology
Background:
- Proton therapy offers precise dose delivery, but accurate dose calculation is crucial for optimal treatment planning.
- Intensity-modulated proton therapy (IMPT) requires advanced dose engines for complex treatment plans.
- Open-source tools can accelerate research and development in radiation therapy.
Purpose of the Study:
- To commission and integrate the open-source Monte Carlo (MC) dose engine, MCsquare, for synchrotron-based proton therapy.
- To enhance MCsquare's functionalities and improve calculation efficiency for IMPT.
- To integrate MCsquare into existing in-house software and a web-based platform for clinical application.
Main Methods:
- Commissioning MCsquare using a double Gaussian beam model and experimental measurements (lateral profiles, depth dose, SOBPs).
- Integrating MCsquare into C++ dose calculation code and the DOSeCHECK web platform.
- Validating calculations against a GPU-accelerated MC (gMC) engine in 12 patient geometries.
- Implementing computed tomography (CT) resampling for efficiency and a linear energy transfer (LET)-based biological dose calculation.
Main Results:
- MCsquare calculations showed <2.5% difference from SOBP measurements in water.
- Dose distributions agreed well with gMC, with an average 3D gamma analysis (2%/2 mm) passing rate of 98.0 ± 1.0%.
- IMPT plan calculation time was efficient (2.3 ± 1.8 min) using CT resampling on a CPU workstation.
Conclusions:
- MCsquare was successfully commissioned and integrated for synchrotron proton beam therapy.
- The implemented CT resampling and LET-based biological dose calculation enhance MCsquare's capabilities.
- MCsquare is efficient and accurate for Monte Carlo-based and LET-guided robust optimization in future IMPT studies.
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