New capabilities of the Monte Carlo dose engine ARCHER-RT: Clinical validation of the Varian TrueBeam machine for VMAT external beam radiotherapy

Purpose The Monte Carlo radiation transport method is considered the most accurate approach for absorbed dose calculations in external beam radiation therapy. In this study, an efficient and accurate source model of the Varian TrueBeam 6X STx Linac is developed and integrated with a fast Monte Carlo photon-electron transport absorbed dose engine, ARCHER-RT, which is capable of being executed on CPUs, NVIDIA GPUs, and AMD GPUs. This capability of fast yet accurate radiation dose calculation is essential for clinical utility of this new technology. This paper describes the software and algorithmic developments made to the ARCHER-RT absorbed dose engine. Methods AMD's Heterogeneous-Compute Interface for Portability (HIP) was implemented in ARCHER-RT to allow for device independent execution on NVIDIA and AMD GPUs. Architecture-specific atomic-add algorithms have been identified and both more accurate single-precision and double-precision computational absorbed dose calculation methods have been added to ARCHER-RT and validated through a test case to evaluate the accuracy and performance of the algorithms. The validity of the source model and the radiation transport physics were benchmarked against Monte Carlo simulations performed with EGSnrc. Secondary dose-check physics plans, and a clinical prostate treatment plan were calculated to demonstrate the applicability of the platform for clinical use. Absorbed dose difference maps and gamma analyses were conducted to establish the accuracy and consistency between the two Monte Carlo models. Timing studies were conducted on a CPU, an NVIDIA GPU, and an AMD GPU to evaluate the computational speed of ARCHER-RT. Results Percent depth doses were computed for different field sizes ranging from 1.5 cm(2) x 1.5 cm(2) to 22 cm(2) x 40cm(2) and the two codes agreed for all points outside high gradient regions within 3%. Axial profiles computed for a 10 cm(2) x 10 cm(2) field for multiple depths agreed for all points outside high gradient regions within 2%. The test case investigating the impact of native single-precision compared to double-precision showed differences in voxels as large as 71.47% and the implementation of KAS single-precision reduced the difference to less than 0.01%. The 3%/3mm gamma pass rates for an MPPG5a multileaf collimator (MLC) test case and a clinical VMAT prostate plan were 94.2% and 98.4% respectively. Timing studies demonstrated the calculation of a VMAT plan was completed in 50.3, 187.9, and 216.8 s on an NVIDIA GPU, AMD GPU, and Intel CPU, respectively. Conclusion ARCHER-RT is capable of patient-specific VMAT external beam photon absorbed dose calculations and its potential has been demonstrated by benchmarking against a well validated EGSnrc model of a Varian TrueBeam. Additionally, the implementation of AMD's HIP has shown the flexibility of the ARCHER-RT platform for device independent calculations. This work demonstrates the significant addition of functionality added to ARCHER-RT framework which has marked utility for both research and clinical applications and demonstrates further that Monte Carlo-based absorbed dose engines like ARCHER-RT have the potential for widespread clinical implementation.