  Monte Carlo (MC) simulation is commonly considered to be the most accurate
dose calculation method in radiotherapy. However, its efficiency still requires
improvement for many routine clinical applications. In this paper, we present
our recent progress towards the development a GPU-based MC dose calculation
package, gDPM v2.0. It utilizes the parallel computation ability of a GPU to
achieve high efficiency, while maintaining the same particle transport physics
as in the original DPM code and hence the same level of simulation accuracy. In
GPU computing, divergence of execution paths between threads can considerably
reduce the efficiency. Since photons and electrons undergo different physics
and hence attain different execution paths, we use a simulation scheme where
photon transport and electron transport are separated to partially relieve the
thread divergence issue. High performance random number generator and hardware
linear interpolation are also utilized. We have also developed various
components to handle fluence map and linac geometry, so that gDPM can be used
to compute dose distributions for realistic IMRT or VMAT treatment plans. Our
gDPM package is tested for its accuracy and efficiency in both phantoms and
realistic patient cases. In all cases, the average relative uncertainties are
less than 1%. A statistical t-test is performed and the dose difference between
the CPU and the GPU results is found not statistically significant in over 96%
of the high dose region and over 97% of the entire region. Speed up factors of
69.1 ~ 87.2 have been observed using an NVIDIA Tesla C2050 GPU card against a
2.27GHz Intel Xeon CPU processor. For realistic IMRT and VMAT plans, MC dose
calculation can be completed with less than 1% standard deviation in 36.1~39.6
sec using gDPM.
