Monte Carlo calculation of monitor unit for electron arc therapy

Purpose: Monitor unit (MU) calculations for electron arc therapy were carried out using Monte Carlo simulations and verified by measurements. Variations in the dwell factor (DF), source-to-surface distance (SSD), and treatment arc angle (α) were studied. Moreover, the possibility of measuring the DF, which requires gantry rotation, using a solid water rectangular, instead of cylindrical, phantom was investigated. Methods: A phase space file based on the 9 MeV electron beam with rectangular cutout (physical size=2.6x21 cm2) attached to the block tray holder of a Varian 21 EX linear accelerator (linac) was generated using the EGSnrc-based Monte Carlo code and verified by measurement. The relative output factor (ROF), SSD offset, and DF, needed in the MU calculation, were determined using measurements and Monte Carlo simulations. An ionization chamber, a radiographic film, a solid water rectangular phantom, and a cylindrical phantom made of polystyrene were used in dosimetry measurements. Results: Percentage deviations of ROF, SSD offset, and DF between measured and Monte Carlo results were 1.2%, 0.18%, and 1.5%, respectively. It was found that the DF decreased with an increase in α, and such a decrease in DF was more significant in the α range of 0 deg. - 60 deg. than 60 deg. - 120 deg. Moreover, for a fixed α, the DF increased with an increase in SSD. Comparing the DF determined using the rectangular and cylindrical phantom through measurements and Monte Carlo simulations, it was found that the DF determined by the rectangular phantom agreed well with that by the cylindrical one within ±1.2%. It shows that a simple setup of a solid water rectangular phantom was sufficient to replace the cylindrical phantom using our specific cutout to determine the DF associated with the electron arc. Conclusions: By verifying using dosimetry measurements, Monte Carlo simulations proved to be an alternative way to perform MU calculations effectively for electron arc therapy. Since Monte Carlo simulations can generate a precalculated database of ROF, SSD offset, and DF for the MU calculation, with a reduction in human effort and linac beam-on time, it is recommended that Monte Carlo simulations be partially or completely integrated into the commissioning of electron arc therapy.