A user-oriented procedure for the commissioning and quality assurance testing of treatment planning system dosimetry in high-dose-rate brachytherapy

Abstract Purpose To develop a user-oriented procedure for testing treatment planning system (TPS) dosimetry in high-dose-rate brachytherapy, with particular focus to TPSs using model-based dose calculation algorithms (MBDCAs). Methods and Materials Identical plans were prepared for three computational models using two commercially available systems and the same192 Ir source. Reference dose distributions were obtained for each plan using the MCNP v.6.1 Monte Carlo (MC) simulation code with input files prepared via automatic parsing of plan information using a custom software tool. The same tool was used for the comparison of reference dose distributions with corresponding MBDCA exports. Results The single source test case yielded differences due to the MBDCA spatial discretization settings. These affect points at relatively increased distance from the source, and they are abated in test cases with multiple source dwells. Differences beyond MC Type A uncertainty were also observed very close to the source(s), close to the test geometry boundaries, and within heterogeneities. Both MBDCAs studied were found equivalent to MC within 5 cm from the target volume for a clinical breast brachytherapy test case. These are in agreement with previous findings of MBDCA benchmarking in the literature. Conclusions The data and the tools presented in this work, that are freely available via the web, can serve as a benchmark for advanced clinical users developing their own tests, a complete commissioning procedure for new adopters of currently available TPSs using MBDCAs, a quality assurance testing tool for future updates of already installed TPSs, or as an admission prerequisite in multicentric clinical trials.