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@ARTICLE{Sitarz:294077,
      author       = {M. Sitarz and M. G. Ronga and F. Gesualdi and A. Bonfrate
                      and N. Wahl$^*$ and L. De Marzi},
      title        = {{I}mplementation and validation of a very-high-energy
                      electron model in the mat{R}ad treatment planning system.},
      journal      = {Medical physics},
      volume       = {52},
      number       = {1},
      issn         = {0094-2405},
      address      = {College Park, Md.},
      publisher    = {AAPM},
      reportid     = {DKFZ-2024-02098},
      pages        = {518-529},
      year         = {2025},
      note         = {2025 Jan;52(1):518-529},
      abstract     = {While electron beams of up to 20 MeV are commonly used in
                      radiotherapy, the use of very-high-energy electrons (VHEEs)
                      in the range of 100-200 MeV is now becoming a realistic
                      option thanks to the recent advancements in accelerator
                      technology. Indeed, VHEE offers several clinically
                      attractive features and can be delivered using various
                      conformation methods (including scanning, collimation, and
                      focussing) at ultra-high dose rates. To date, there is a
                      lack of research tools for fast simulation of treatment
                      plans using VHEE beams.This work aims to implement and
                      validate a simple and fast dose calculation algorithm based
                      on the Fermi-Eyges theory of multiple Coulomb scattering for
                      VHEE radiation therapy, with energies up to 200 MeV. A
                      treatment planning system (TPS) toolkit with VHEE modality
                      would indeed allow for further preclinical investigations,
                      including treatment plan optimization and evaluation, and
                      thus contribute to the gradual introduction of VHEE
                      radiotherapy in clinical practice.A VHEE pencil beam
                      scanning double Gaussian model was introduced into the
                      open-source TPS matRad environment along with new functions
                      and options dedicated to VHEE dose calculations. Various
                      geometries and field configurations were then calculated in
                      matRad (up to 200 MeV and 15 × 15 cm2, with complex bone or
                      lung heterogeneities) and the results were compared to Monte
                      Carlo simulations in the TOPAS/Geant4 toolkit. Two types of
                      beam model (divergent or focused) were also tested. Examples
                      of clinical treatment plans were computed, and the results
                      were compared between the two codes.VHEE modality was fully
                      implemented in matRad with GUI capabilities while preserving
                      all original TPS features. New relevant options such as the
                      importation of specific spot-lists or adjustment of the
                      lateral dose calculation cutoff to optimize the calculation
                      speed were validated. Single spot and square field dose
                      distributions were validated in water alone as well as in
                      clinically relevant inhomogeneities. Dose maps from the VHEE
                      model in matRad were in good agreement with TOPAS (2D gamma
                      index $[2\%/1$ mm] with passing rates superior to $90\%,$
                      $<6\%$ mean dose differences), except for large interface
                      heterogeneities.This work describes the implementation of a
                      simple but efficient VHEE simulation model in matRad. A few
                      configurations were studied in order to validate the model
                      against accurate Monte Carlo simulations, demonstrating its
                      usefulness for carrying out preliminary studies involving
                      VHEE radiotherapy.},
      keywords     = {Monte Carlo (Other) / VHEE (Other) / beam model (Other) /
                      radiotherapy (Other) / treatment planning system (Other)},
      cin          = {E040},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39419015},
      doi          = {10.1002/mp.17392},
      url          = {https://inrepo02.dkfz.de/record/294077},
}