ArticleJournal of applied clinical medical physics2026
Commissioning and clinical implementation of Monaco treatment planning system on a compact pencil beam scanning proton therapy system.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTreatment planning system (TPS) requires comprehensive commissioning and validation prior to clinical use to ensure accurate dose calculation and safe clinical implementation. PURPOSE: To enable clinical use of the Monaco proton TPS, we commissioned it on a single-room compact proton therapy system and implemented a clinically integrated workflow using daily synthetic CT (sCT) to track fractional dose delivery.
methodsThe Monte Carlo (MC) dose calculation algorithm in Monaco TPS (version 6.1) was commissioned on an IBA Proteus ONE system. Commissioning included data acquisition, beam modeling, and model validation. Data included in-air spot profiles for 70-227 MeV at five planes (+20 cm and +10 cm upstream, isocenter, -10 cm and -20 cm downstream), integral depth-dose curves in water, and absolute monitor unit calibration. Model validation comprised: percent depth-dose in water for monoenergetic beams using a 10 × 10 cm
resultsDistal range (R90, R80, R20) differences between Monaco and measurement were within 1 mm for 70-227.7 MeV. Output differences for all standard cube plans were within 3%. For the IROC brain phantom, the TLD-to-Monaco MC dose ratio was 1.00, with gamma passing rates of 94% (coronal) and 98% (sagittal). sCT-based evaluation showed 99% CTV receiving ≥98% of the prescribed dose across the course.
conclusionsMonaco's proton MC beam model and dose calculation algorithm were commissioned and validated on IBA Proteus ONE for clinical use. The first patient (November, 2024) was successfully treated, with daily dose delivery accuracy monitored via an in-house sCT platform.
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