# The Effects of Noise on Gamma¶

Here is an example of the effects noise can have on gamma. Simply by adding noise to the evaluation distribution the Gamma goes from a passing rate of about 50% to about 99%. For a Monte Carlo planning system this dose distribution includes statistical noise potentially pushing the Gamma pass rate artificially higher than should that noise be absent.

In [ ]:
import numpy as np
import matplotlib.pyplot as plt

In [ ]:
!pip install pymedphys

import pymedphys

In [ ]:
gamma_options = {
'dose_percent_threshold': 3,
'distance_mm_threshold': 3,
'lower_percent_dose_cutoff': 20,
'interp_fraction': 10,  # Should be 10 or more for more accurate results
'max_gamma': 2,
'random_subset': None,
'local_gamma': True,
'ram_available': 2**29,  # 1/2 GB
'quiet': True
}

In [ ]:
grid = 0.5
scale_factor = 1.035
noise = 0.01

In [ ]:
xmin = -28
xmax = 28
ymin = -25
ymax = 25

extent = [xmin-grid/2, xmax+grid/2, ymin-grid/2, ymax+grid/2]


## Defining an example dose reference¶

Here we are defining an idealised square field using an exponential function. We are also creating a coords variable which we will be passing to the pymedphys.gamma function.

In [ ]:
x = np.arange(xmin, xmax + grid, grid)
y = np.arange(ymin, ymax + grid, grid)

coords = (y, x)

xx, yy = np.meshgrid(x, y)
dose_ref = np.exp(-((xx/15)**20 + (yy/15)**20))

plt.figure()
plt.title('Reference dose')

plt.imshow(
dose_ref, clim=(0, 1.04), extent=extent)
plt.colorbar();


Of importance the length of the first coordinate set in coords matches the first dimension of dose_ref, and the length of the second coordinate set in coords matches the second dimension of dose_ref. This is required because pymedphys.gamma internally uses scipy.interpolate.RegularGridInterpolator and the gamma implimentation has been chosen to align with this scipy coordinate convention uses here.

In [ ]:
len(coords[0])

In [ ]:
len(coords[1])

In [ ]:
np.shape(dose_ref)

In [ ]:
dimensions_of_dose_ref = np.shape(dose_ref)
assert dimensions_of_dose_ref[0] == len(coords[0])
assert dimensions_of_dose_ref[1] == len(coords[1])


## Defining an example evaluation dose¶

Let's scale our reference dose by a scaling factor. We have chosen above to scale by 3.5% purposefully so that the dose will go larger than the dose percent evaluation criterion of 3% that was chosen above.

In [ ]:
dose_eval = dose_ref * scale_factor

plt.figure()
plt.title('Evaluation dose')

plt.imshow(
dose_eval, clim=(0, 1.04), extent=extent)
plt.colorbar();


## Seeing a dose difference¶

In [ ]:
dose_diff = dose_eval - dose_ref

plt.figure()
plt.title('Dose Difference')

plt.imshow(
dose_diff,
clim=(-0.1, 0.1), extent=extent,
cmap='seismic'
)
plt.colorbar();


## Evaluation Gamma¶

Now lets evaluate gamma for the distributions defined above. As expected, due to the dose being scaled larger than the dose threshold, quite a few points fail.

In [ ]:
gamma_no_noise = pymedphys.gamma(
coords, dose_ref,
coords, dose_eval,
**gamma_options)

plt.figure()
plt.title('Gamma Distribution')

plt.imshow(
gamma_no_noise, clim=(0, 2), extent=extent,
cmap='coolwarm')
plt.colorbar()

plt.show()
valid_gamma_no_noise = gamma_no_noise[~np.isnan(gamma_no_noise)]
no_noise_passing = 100 * np.round(np.sum(valid_gamma_no_noise <= 1) / len(valid_gamma_no_noise), 4)

plt.figure()
plt.title(f'Gamma Histogram | Passing rate = {round(no_noise_passing, 2)}%')
plt.xlabel('Gamma')
plt.ylabel('Number of pixels')

plt.hist(valid_gamma_no_noise, 20);


## Investigating the effect of noise¶

Let's now slightly adjust our evaluation distribution by adding some random normal noise.

In [ ]:
np.random.seed(0)
dose_eval_noise = (
dose_eval +
np.random.normal(loc=0, scale=noise, size=np.shape(dose_eval))
)

plt.figure()
plt.title('Evaluation dose with Noise')

plt.imshow(
dose_eval_noise, clim=(0, 1.04), extent=extent)
plt.colorbar();


Let's see what our dise difference looks like with this noise

In [ ]:
dose_diff_with_noise = dose_eval_noise - dose_ref

plt.figure()
plt.title('Dose Difference with Noise')

plt.imshow(
dose_diff_with_noise,
clim=(-0.1, 0.1), extent=extent,
cmap='seismic'
)
plt.colorbar();


But what about our gamma?

In [ ]:
gamma_with_noise = pymedphys.gamma(
coords, dose_ref,
coords, dose_eval_noise,
**gamma_options)

plt.figure()
plt.title('Gamma Distribution')

plt.imshow(
gamma_with_noise, clim=(0, 2), extent=extent,
cmap='coolwarm')
plt.colorbar()

plt.show()
valid_gamma_with_noise = gamma_with_noise[~np.isnan(gamma_with_noise)]
with_noise_passing = 100 * np.round(np.sum(valid_gamma_with_noise <= 1) / len(valid_gamma_with_noise), 4)

plt.figure()
plt.title(f'Gamma Histogram | Passing rate = {round(with_noise_passing, 2)}%')
plt.xlabel('Gamma')
plt.ylabel('Number of pixels')

plt.hist(valid_gamma_with_noise, 20);


## Conclusion¶

So, pymedphys does provide a gamma implementation, but should it be a defacto standard of validation? I highly recommend giving the following paper a read to highlight some other tools we can use to augment our usage of Gamma.

Evaluating IMRT and VMAT dose accuracy: Practical examples of failure to detect systematic errors when applying a commonly used metric and action levels

A key take home message from that paper relevant to this pymedphys.gamma utility is the following:

Using 3%G/3 mm gamma passing rates as a basis of gauging “sufficient accuracy” as per TG-119 has knock-on effects outside of commissioning. One such effect is that it is often used as the de facto standard to “validate” a new or modified product. For example, even very recently 3%G/3 mm passing rates have been quoted to prove the accuracy of TPS dose algorithms, delivery systems, or dosimetry devices.

In this work, we show a variety of clear examples of the metric’s insensitivity, supporting the argument that it is inappropriate as a sole basis for commissioning. The same conclusion can be made for the yet further upstream task of product validation by medical device manufacturers and their clinical partners.