MCNP5 Monte Carlo based dosimetry for the Nucletron Iridium-192 high dose-rate brachytherapy source with tissue heterogeneity corrections

A Monte Carlo model has been developed using MCNP5 to simulate the Nucletron Ir-192 HDR source in order to investigate the influence of tissue heterogeneities on dose calculations compared to the dose in homogeneous water media, as it is typically calculated by brachytherapy Treatment Planning Systems (TPS). Validity of the simulation was verified in water medium in comparison with peer reviewed results using the dosimetric parameters recommended by AAPM, Task Group-43. The dose-rates in simulated prostate, bladder and rectum were compared to those obtained in the homogeneous water phantom. Based on the resulting dose differences, it is inferred that TPS algorithms for brachytherapy dose calculations overestimate the dose to tissues like prostate and bladder by up to 49%. A clinically relevant dose underestimation of 5.5% to the rectum was also found. We recommend that further investigation using actual patient CT data as input to the Monte Carlo simulation be performed.