Validation of Monaco Treatment Planning System for Intensity-Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT®) on ELEKTA Infinity™ Linear Accelerator

The objective of this study is to evaluate the dosimetric precision of the Monte Carlo (MC) algorithm to validate the Monaco® (Elekta) treatment planning system for the two radiotherapy techniques IMRT and VMAT® on the Infinity™ Elekta linear accelerator. Several irradiation plans were created on the Monaco® treatment planning system (TPS) and calculated by the integrated MC algorithm for its validation. The same plans were applied experimentally using the Matrixx Evolution 2D array with its appropriate phantom. All measurements were performed by superimposition with those calculated on the Infinity™ linear accelerator (ELEKTA). The calculated and measured dosimetric data were overlaid to make the comparison of what is realistic and what was simulated using the MyQA (IBA) software associated with the Matrixx. Good agreement was observed between calculated and measured data using 3%, 3mm distance to agreement (DTA) and low dose threshold 5% criteria. Global gamma analysis passing rates for all tests are greater than 95%. An agreement less than 2 mm is shown for open fields and homogenous dose test. However, there was increase in the agreement criteria above 3 mm for chair and pyramid test as a result of high gradient dose regions especially at the edge of target volumes. Results obtained from this study allowed, in one hand to confirm the accuracy of our MC model dose calculation with Monaco® TPS, and in the other hand, the use of the matrix detector as a standard tool for IMRT/VMAT® patient quality control.