Commissioning and clinical implementation of Monaco treatment planning system on a compact pencil beam scanning proton therapy system.

Authors

• Xiangkun Xu, Corewell Health East
• Xiaoda Cong, Corewell Health East
• Jian Liang, Corewell Health East
• An Qin, Corewell Health East
• Shupeng Chen, Corewell Health East Resident
• Xiaoqiang Li, Corewell Health East
• Weili Zheng, Corewell Health East
• Peilin Liu, Corewell Health East
• Raymond Dalfsen
• James Dolan
• Martin Soukup
• Craig Stevens, Corewell Health East
• Rohan Deraniyagala, Corewell Health East
• Xuanfeng Ding, Corewell Health East

Document Type

Article

Publication Date

4-1-2026

Publication Title

Journal of applied clinical medical physics [electronic resource] / American College of Medical Physics

Abstract

BACKGROUND: Treatment 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.

METHODS: The 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

RESULTS: Distal 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.

CONCLUSIONS: Monaco'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.

Volume

27

Issue

4

First Page

e70587

Recommended Citation

Xu X, Cong X, Liang J, Qin A, Chen S, Li X, et al [Zheng W, Liu P, Stevens C, Deraniyagala R, Ding X] Commissioning and clinical implementation of Monaco treatment planning system on a compact pencil beam scanning proton therapy system. J Appl Clin Med Phys. 2026 Apr;27(4):e70587. doi: 10.1002/acm2.70587. PMID: 41987019

DOI

10.1002/acm2.70587

ISSN

1526-9914

PubMed ID

41987019