{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T08:02:32Z","timestamp":1784966552731,"version":"3.55.0"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Proton therapy offers precision in targeting tumors while minimizing damage to surrounding healthy tissues. Independent dose calculation is a secondary dose validation tool for patient-specific quality assurance (PSQA) using Monte Carlo simulations.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Purpose<\/jats:title>\n<jats:p>To implement independent dose calculation for PSQA in proton therapy and establish confidence limits, tolerance limits, and action limits.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods and Materials<\/jats:title>\n<jats:p>The point dose validation of independent dose calculation was performed by ionization chamber. The dose distributions between independent dose calculation and treatment planning calculation were compared in single and multiple energy plans. Fifty clinical plans covering five regions (head and neck, breast, chest, abdomen, and pelvis) were evaluated using the gamma analysis criteria of 3%, 3\u2009mm, and 5%, 3\u2009mm. Confidence limits, tolerance limits, and action limits were determined.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The dose differences between measurement and independent dose calculation for each energy level were within 1.0%. The results showing gamma passing rates of 99.4\u2009\u00b1\u20090.6% for single energy plans and over 98.0% for multiple energy plans. The average gamma passing rates for all treatment sites was 95.9\u2009\u00b1\u20092.7% with 3%\/3\u2009mm criteria, which increased to 97.9\u2009\u00b1\u20091.8% with 5%\/3\u2009mm criteria. The confidence limits, tolerance limits, and action limits showed 90.7%, 89.1%, and 85.4% with 3%\/3\u2009mm criteria and 94.3%, 93.2%, and 91.6% for 5%\/3\u2009mm criteria, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The independent dose calculation could potentially be implemented in PSQA. It is a secondary dose validation method for busy clinic. Particular attention should be paid to a confidence limit, tolerance limit, and action limit for reliable treatments.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0326525","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T17:25:57Z","timestamp":1750181157000},"page":"e0326525","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Towards implementation of independent calculation-based dose verification in proton therapy"],"prefix":"10.1371","volume":"20","author":[{"given":"Nichakan","family":"Chatchumnan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mananchaya","family":"Vimolnoch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakda","family":"Kingkaew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puntiwa","family":"Oonsiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8167-0764","authenticated-orcid":true,"given":"Sornjarod","family":"Oonsiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"issue":"3","key":"pone.0326525.ref001","doi-asserted-by":"crossref","first-page":"238","DOI":"10.4103\/jmp.jmp_71_23","article-title":"Dosimetric characteristics of radiophotoluminescent glass dosimeters for proton beams","volume":"48","author":"S Oonsiri","year":"2023","journal-title":"J Med Phys"},{"issue":"2","key":"pone.0326525.ref002","doi-asserted-by":"crossref","first-page":"105","DOI":"10.14338\/IJPT-23-00016.1","article-title":"Patient-specific quality assurance in pencil beam scanning by 2-dimensional array","volume":"10","author":"N Rawiwan","year":"2023","journal-title":"Int J Part Ther"},{"issue":"11","key":"pone.0326525.ref003","doi-asserted-by":"crossref","first-page":"5359","DOI":"10.1118\/1.3238104","article-title":"IMRT commissioning: multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119","volume":"36","author":"GA Ezzell","year":"2009","journal-title":"Med Phys"},{"key":"pone.0326525.ref004","first-page":"808","article-title":"Report of AAPM Task Group 219 on independent calculation\u2010based dose\/MU verification for IMRT","volume":"48","author":"TC Zhu","year":"2021","journal-title":"Med Phys"},{"key":"pone.0326525.ref005","volume-title":"myQA iON instructions for use. 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