Clinical implementation of the Peregrine Monte Carlo dose calculations system for photon beam therapy

PEREGRINE is a 3D Monte Carlo dose calculation system designed to serve as a dose calculation engine for clinical radiation therapy treatment planning systems. Taking advantage of recent advances in low-cost computer hardware, modern multiprocessor architectures and optimized Monte Carlo transport algorithms, PEREGRINE performs mm-resolution Monte Carlo calculations in times that are reasonable for clinical use. PEREGRINE has been developed to simulate radiation therapy for several source types, including photons, electrons, neutrons and protons, for both teletherapy and brachytherapy. However the work described in this paper is limited to linear accelerator-based megavoltage photon therapy. Here we assess the accuracy, reliability, and added value of 3D Monte Carlo transport for photon therapy treatment planning. Comparisons with clinical measurements in homogeneous and heterogeneous phantoms demonstrate PEREGRINE's accuracy. Studies with variable tissue composition demonstrate the importance of material assignment on the overall dose distribution. Detailed analysis of Monte Carlo results provides new information for radiation research by expanding the set of observables