Monte Carlo investigation of the dosimetric effect of the Autoscan ultrasound probe for guidance in radiotherapy

The aim of this study was to quantify the dosimetric effect of the Autoscan™ ultrasound probe, which is a 3D transperineal probe used for real-time tissue tracking during the delivery of radiotherapy. CT images of an anthropomorphic phantom, with and without the probe placed in contact with its surface, were obtained (0.75 mm slice width, 140 kVp). CT datasets were used for relative dose calculation in Monte Carlo simulations of a 7-field plan delivered to the phantom. The Monte Carlo software packages BEAMnrc and DOSXYZnrc were used for this purpose. A number of simulations, which varied the distance of the radiation field edge from the probe face (0 mm to 5 mm), were performed. Perineal surface doses as a function of distance from the radiation field edge, with and without the probe in place, were compared. The presence of the probe was found to result in an increase in perineal surface dose, relative to the maximum dose. The maximum increase in surface dose was 18.15%, at a probe face to field edge distance of 0 mm. However increases in surface dose fall-off rapidly as this distance increases, agreeing within Monte Carlo simulation uncertainty at distances ≥ 5 mm. Using data from three patient volunteers, a typical probe face to field edge distance was calculated to be ≈20 mm. Our results therefore indicate that the presence of the probe is unlikely to adversely affect a typical patient treatment, since the dosimetric effect of the probe is minimal at these distances.