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A percutaneous coronary intervention widens the arterial wall with the inflation of a balloon inside the lesion area and leaves behind a metal stent to prevent re\u2010narrowing of the artery (restenosis). However, in\u2010stent restenosis may occur due to damage to the arterial wall tissue, triggering neointimal hyperplasia, producing fibrotic and calcified plaques and narrowing the artery again. Drug\u2010eluting stents, which slowly release medication to inhibit neointimal hyperplasia, are used to prevent in\u2010stent restenosis but fail up to 20% of cases. Coronary intravascular brachytherapy (IVBT), which uses \u2010emitting radionuclides to prevent in\u2010stent restenosis, is used in these failed cases to prevent in\u2010stent restenosis. However, current clinical dosimetry for IVBT is water\u2010based, and heterogeneities such as the guidewire of the IVBT device, fibrotic and calcified plaques and stents are not considered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to develop a Monte Carlo\u2010based dose calculation software, accounting for patient\u2010specific geometry from Optical Coherence Tomography (OCT)\u00a0images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>RapidBrachyIVBT, a Monte Carlo dose calculation software based on the Geant4 toolkit v. 10.02.p02, was developed and integrated into RapidBrachyMCTPS, a treatment planning system for brachytherapy applications. The only commercially available IVBT delivery system, the Novoste Beta\u2010Cath 3.5F, with a  source train, was modeled with 30, 40, and 60\u00a0mm source train lengths. The software was validated with published TG\u2010149 parameters compared to Monte Carlo simulations in water. The dose calculation engine was tested with OCT images from a patient undergoing coronary IVBT for recurrent in\u2010stent restenosis at Brigham and Women's Hospital in Boston, Massachusetts. Considering the heterogeneities, the images were segmented and used to calculate the absorbed dose to water and the absorbed dose to medium. The prescribed dose was normalized to 23\u00a0Gy at 2.0\u00a0mm from the source center, which is the target volume in IVBT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The dose rate values in water obtained using RapidBrachyIVBT aligned with TG\u2010149 consensus values, showing agreement within a range of 0.03% to 1.7%. Considering the heterogeneities present in the patient's OCT images, the absorbed dose in the entire artery segment was up to 77.5% lower, while within the target volume, it was up to 56.6% lower, compared to the dose calculated in a homogeneous water\u00a0phantom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>RapidBrachyIVBT, a Monte Carlo dose calculation software for IVBT, was developed and successfully integrated into RapidBrachyMCTPS, a treatment planning system for brachytherapy applications, where accurate attenuation of the absorbed dose by heterogeneities is\u00a0considered.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17525","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T18:43:57Z","timestamp":1732041837000},"page":"1256-1267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["RapidBrachyIVBT: A dosimetry software for patient\u2010specific intravascular brachytherapy dose calculations on optical coherence tomography images"],"prefix":"10.1002","volume":"52","author":[{"given":"Maryam","family":"Rahbaran","sequence":"first","affiliation":[{"name":"Medical Physics Unit, Department of Oncology, Faculty of Medicine McGill University  Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Lady Davis Institute for Medical Research Jewish General Hospital  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Kalinowski","sequence":"additional","affiliation":[{"name":"Medical Physics Unit, Department of Oncology, Faculty of Medicine McGill University  Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Lady Davis Institute for Medical Research Jewish General Hospital  Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"DeCunha","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"},{"name":"Medical Physics Program University of Texas Health Science Center at Houston  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin J.","family":"Croce","sequence":"additional","affiliation":[{"name":"Department of Cardiology Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Bergmark","sequence":"additional","affiliation":[{"name":"Department of Cardiology Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M. 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