A second check software needs high accuracy to be more than only a plausibility check.
Modern treatment planning systems consider multiple interactions. A reliable second check software only makes sense if it considers more interactions than the TPS and not only a part of it. The second check software should calculate the dose with a higher accuracy than the treatment planning system to detect clinical relevant errors.
The algorithm of VERIQA RT MonteCarlo 3D delivers an accurate simulation of physical processes. The use of the SciMoCaTM Monte Carlo algorithm simplifies the complexity of a Monte Carlo algorithm and specifies it to its clinical use. This high accuracy allows the use of a strict gamma criterion to detect clinical relevant errors. Only a strict gamma criterion can guarantee that clinical relevant errors can be detected.
Other second check software that calculate with less accuracy will have a spread in the result. This spread will cause failed plans, even if they are calculated correctly by the TPS. Wrong warnings cause more work so that a second check software without a high enough accuracy will result in a higher workload rather than saving time.
Medical physicists from Aarhus University hospital performed a comparison between the VERIQA algorithm SciMoCaTM and Mobius (The clinical benefit of Monte Carlo with Custom beam models over an analytical algorithm with generic beam models for secondary dose calculation, L. Hoffmann, Aarhus University Hospital, ESTRO 2023). The result was that the gamma passing rate of Mobius is mainly random. For SciMoCaTM, the gamma passing rate can be traced to a reason. That means the high accuracy of the dose calculation of VERIQA RT MonteCarlo 3D enables the user to trace back to error sources. Hence, by using a strict gamma criterion Mobius will deliver false alerts and cause more work. The only way to avoid it, would be a less strict gamma criterion but then the second check calculation will be only a plausibility check. With SciMoCaTM and it’s high accuracy, it is possible to select a strict gamma criterion to reduce the workload, to detect only true errors and to trace it back to potential error sources. Higher accuracy allows for stricter criteria and guarantees the detection of clinical relevant errors instead of wasting time by analyzing wrong warnings.