Evaluation of MU2net as an online secondary dose check for MR guided radiation therapy with the Elekta unity MR linac.

During the adaptive workflow associated with MRgRT, a secondary dose calculation is required and MU2net (DOSIsoft, France) is one commercial option. The suitability of MU2net to be used in conjunction with the online Monaco treatment planning system of the Elekta Unity (Elekta AB, Stockholm, Sweden), is evaluated in this work. Monaco and MU2net point doses are compared for various fields on and off axis and at different SSDs. To investigate the comparative effects of attenuation due to the cryostat, couch and posterior coil, measured, MU2net and Monaco dose outputs at the isocentre, as a function of gantry angle, were compared. Point doses for the beams of nine step and shoot IMRT (SSIMRT) test plans (courtesy Elekta) were calculated with Monaco v5.4 and compared to corresponding doses computed with MU2net. In addition, Monaco v5.4 and MU2net point doses were compared for 1552 beams treated on the Unity at our facility. For the on-axis fields investigated the agreement between MU2net and measured data is acceptable. MU2net and Monaco point doses for the Elekta SSIMRT test plans were within ± 5.0% and ± 6.4% for beams delivered from gantry zero and at planned beam angles, respectively. For the 1552 beams delivered approximately 80.0% of MU2net and Monaco point doses agree within ± 5.0%, therefore it is recommended to correlate MU2net Dose Reference Points (DRPs) with pre and post treatment dosimetry verification. Computational accuracy of MU2net could be enhanced with improved modelling of attenuation due to the couch, cryostat and posterior MR imaging coil.