Version 6 of Plaque Simulator (PS6) is designed for relatively recent (2020 or later models) Apple Macintosh computers, especially those with Apple silicon M-series SoCs. Some older models with Intel Xeon, Core i5, i7 or i9 x86 processors that can install OSX version 10.13 or greater are also supported.

As of May 2025, Eye Physics recommends running PS6 on the fastest M series SoC chip Apple desktop computer that you can afford with at least 10 processor cores, ≥32 GB of RAM and MacOS 15.4.1 (Sequoia). Support for MacOS 10.13 (High Sierra) requires PS6 version 6.6.1 or later and MacOS 10.14 (Mojave) requires PS6 version 6.6.7 or later. Support for MacOS 11 (Big Sur) on Intel cpus requires PS6 version 6.7.7.

Apple silicon M series system on chip (SoC) models are faster and far more energy efficient than models that use Intel processors and M series models are very highly recommended. However, because SoC computers are not memory, SSD, cpu or gpu upgradeable after purchase, be sure to order as powerful a version as you can possibly afford with an at least 32 GB RAM. You can anticipate a useful software compatability of at least 5 years for these computers and a hardware lifetime up to 7 years.

As of 2022, Intel Xeon and Core series processors should be considered as obsolete. They consume far more energy than Apple silicon processors, the chips run very hot which results in significant thermal throttling and they deliver poor battery life in laptops. Some Intel CPUs are hyper-threaded which means that for each processor core that is physically present, the operating system addresses two virtual or logical cores, and shares the workload between them when possible. The Intel Core i5 and later generation i7 processors found in older iMacs and Mac laptops have less cache and are usually not hyper-threaded. PS6 will run on the Core i5 processor but dosimetry performance will be sluggish compared to an i7 or i9. In general, outfit your computer with as many cores (e.g. ≥6) and threads as you can afford.

Plaque Simulator version 6.2 and later leverages multicore processors when performing all 2D, 3D and histogram dosimetry calculations. For instance, when running on a hyper-threaded 4 core Xeon processor, PS6 distributed its dosimetry calculations uniformly and concurrently amongst 8 logical cores, resulting in a 5X acceleration compared to running on a single logical core. The acceleration factor is about 7X on a 6 core processor and ≥12X on a 12 core processor. Performance per core is superior on Apple silicon SoCs where thermal throttling is a minor issue.

Eye Physics recommends running PS6 on the fastest multicore processor that your institution can afford in order to achieve the best overall user experience possible. For any given processor speed, increasing the number of cores will proportionally increase the speed of multidimensional calculations, resulting in more rapid image reconstruction, isodose line, isodose surface and dose histogram comparisons of alternative plan options. MacOS leverages the GPUs on the video card to accelerate some graphics and many features of the operating system, so choosing the most powerful video capability offered at the time of purchase is also desireable.

The Eye Physics software development systems as of May 2025 include a 2025 M4-Max 16-core Mac Studio desktop with 40 gpus, 64GB RAM and 2 TB SSD running MacOS 15.4.1 (Sequoia) and a 2023 24-core M2-Ultra Mac Pro desktop tower with 76 gpus, 192 GB RAM and 4 TB SSD running MacOS 15.4.1 (Sequoia). The two systems are roughly equivalent in computing power. We also have a 2019 Mac Pro as backup configured with a 4 GHz, 16 core Xeon W processor, AMD Radeon Pro Vega II 32 GB graphics card, 96 GB RAM and 4TB secure boot SSD. Our Mac Pro desktops all feature a pair of secure 2TB WD Black SN750 MVNe M2 SSDs on a dual PCIe adapter for fast image and patient file storage, 16 TB of SSDs configured in RAID0 on a PCIe adapter for fast scratch storage, a pair of internally mounted 18TB Seagate Exos X18 spinning hard drives configured as 36TB in RAID0 for archival storage, 25 TB of external Thunderbolt-3 connected RAID5 DAS storage, and 32 TB of privately managed Synology and WD MyCloud NAS servers. Peripherals include a USB3 connected optical DVD/CD drives for loading CT images from disc if needed, a trio of Dell 30" ultrasharp UP3017 display monitors, an Epson 4870 Photo flatbed scanner with VueScan software, an HP Color LaserJet Pro M254dw printer, a Logitech 4K Pro Webcam for online teaching and meetings, a Yeti Nano USB3 microphone and various USB and analog connected speaker systems. The Eye Physics office has a 2.5 Gbps symmetric (upload and download) fiber-optic internet connection and 10 Gbps local area network.

As a backup treatment planning systems, Eye Physics still maintains a 2010 Mac Pro desktop computer which was upgraded from its stock configuration to firmware MacPro5,1 and a pair of 3.46 GHz 6-Core Intel Xeon processors (total 12 physical cores, 24 logical cores), an 802.11ac+Bluetooth_4 mini PCIe card, a Sapphire Radeon Nitro+ RX 580 8GB GDDR5 Dual HDMI / DVI-D / Dual DP w/ Backplate Special Edition (UEFI) PCI-E Graphic Card 11265-21-20G. This card works fine for dual 30 inch monitors and MacOS 10.14 or greater, and can be flashed for MacOS booting. An inexpensive dual 6-pin to single 8-pin power adapter is required. These older Mac Pro systems also incorporate 4 port USB3 PCI cards, Samsung 970 EVO plus NVMe M2 SSDs on PCIe adapter cards as fast boot drives, Samsung 860 SSD drives mounted on a PCI SATA3 adapter cards for intermediate speed storage, 4 WD Black series 6TB spinning hard disks for archival storage, a DVD-RW optical drive, and 96 GB RAM running under MacOS 10.15.5 (Catalina). All of the Mac Pro 5,1 upgrade components are still available on ebay and/or from various other internet vendors. Eye Physics "officially" retired all of its Intel based MacOS systems from routine service in 2023.

• Computer:
  
  • Desktop:
    • Best: The 2025 Mac Studio with M4-Max or M3-Ultra SoC, ≥64GB RAM and ≥2TB SSD.
    • Very Good: The 2023 M2-Ultra Mac Pro with ≥96GB RAM and ≥2TB SSD. Mac Pros towers are ideal for development and high volume planning purposes because they provide loads of internal PCIe and SATA expansion capability for fast I/O and SSD and/or HDD RAID storage, but they are also expensive.
    • Good: The 2025 M4 or M4-Pro Mac Mini ≥32GB RAM and ≥1 TB SSD.
    • Okay: The 24" iMac with M4 cpu with ≥32GB RAM and ≥1 TB SSD.
    • Marginal: Recent generation 27 inch iMacs or iMac Pros with 6, 8, 10 or more core i7, i9 or Xeon W processors running at least 3 GHz feature reasonable computing power, large screens and cost effectiveness when purchased used.
    • Laptop: 16" MacBook Pro with M4-Max SoC, ≥64 GB RAM and ≥1 TB SSD.
    • Other models: Avoid models with processors slower than 2 GHz and dual-core processors such as older Mac minis, MacBooks, MacBook Air and any others that are only available with dual-core processors and of course avoid all older models that can't run OSX 10.13 or later.
  • Models with Apple silicon CPUs: these are VERY powerful and efficient system on chip (SoC) computers and hence can not be upgraded so order as fully configured as you can possibly afford. These are some example entry level configurations as of early 2025:
    
    • M4-Max: with ≥64 GB RAM, ≥2TB SSD.
    • M2-Ultra: with ≥64 GB RAM, ≥2TB SSD.
    • M3-Ultra: with ≥64 GB RAM, ≥2TB SSD.
  • Models with Intel CPUs: Intel CPUs are obsolete since 2022 because they are energy inefficient and thermally throttle but a few are still useful. In 2022, Eye Physics still used a couple of 2018-2019 era Macs that ran on Intel CPUs, but they have all since been retired and replaced with Apple Silicon systems.
    
    • Xeon: Configurations such as the Mac Pro 2019 with ≥16 cores are still pretty good.
    • Core i9: ≥6 core versions of the i9 cpu are okay.
    • Core i7: ≥4 core versions of the i7 cpu are okay.
    • Core i5: The i5 processor has less on-board cache than the i7 or i9 and its 4-core version is not hyper-threaded, but it is adequate.
    • Other models: Dual-core processor variants work but are not recommended.
    In 2023, Eye Physics retired all of its remaining Intel based MacOS computers.
    
  • Speed: Fastest affordable (e.g. ≥4.3 GHz), 2.6 GHz minimum.
  • Cores: Six or more processor cores are recommended, 4 cores minimum.
  • RAM: ≥32 GB is recommended, 64 GB is much better, 16 GB is absolute minimum.
  • OS: As of mid 2025, Eye Physics uses MacOS 15.4.1 (Sequoia) for development and routine treatment planning. MacOSX 10.13 is the minimum supported OS version.
  • Graphics: Any Apple supplied standard or upgraded graphics configuration that is compatible with your computer and MacOS version is fine. Eye Physics used a AMD Radeon Pro Vega II 32 GB graphics card in our now retired 2019 Mac Pro tower. Very capable 3D graphics that share memory with the cpu are built-in to all Apple Silicon M series (system on chip) computers. Get as many gpu cores as you can afford because the graphics are not upgradeable.
  • Displays: Apple computers work best with Apple provided "Retina" screens and/or 3rd party screens that have pixel densities of about 110 ppi. We do NOT recommend using 3rd party 4K screens for treatment planning. Screens in the 2K, 5K or 6K class work better. Screens in the 24" and larger class greatly enhance the user experience when working with text and CT reconstructions using PS and/or OsiriX, fundus photo collages and fusions using Photoshop, and for treatment planning in general. iMacs and laptops with 27 inch Retina displays are fine. Eye Physics uses a trio of Dell UP3017 30 inch 2K-class displays with our Mac Pro 2023 tower. The UP3017 screens feature 2560x1600 pixels, 0.251 mm pixel pitch and 101 pixels per inch (ppi). For our Apple silicon M4-max Mac Studio desktops we use Dell 34" curved displays. These are wide quad high definition (WQHD) models with 3440x1440 pixels, 0.2325 mm pixel pitch and 109 ppi.
    
    • Mac Pro: One or more "2K" class 24" to 34" monitors are recommended.
    • Mac Studio: One or more "2K" class 24" to 34" monitors are recommended.
    • Mac Studio: One 34" WQHD monitor is recommended.
    • iMac: Models with 24" screen 5K Retina display panels are recommended, smaller screen versions are okay.
    • MacBook Pro: 16" retina screen recommended.
    • Retina display: PS works best when the display resolution preference is set to "default". Image quality and performance degrade slightly if any of the other scaled resolutions are selected in order to display more (or fewer) logical pixels. Retina display iMacs and laptops are recommended.
    • Apple desktop displays: The 27" 5K Studio Display and 32" 6K Pro Display XDR are both Retina displays and are recommended but are expensive. Dell offers some similar screens with thunderbolt connections at lower cost but avoid all 4K-class models.
  • Flatbed Digitizer: A "high-quality" flatbed scanner with 8x10 inch transparency option and USB or firewire connection (e.g. Epson Perfection V700 Photo). Only the most recent Apple hardware supports USB3, and recent models no longer include firewire ports, so verify in advance that your computer is compatible with whichever scanner you select. These scanners usually cost less than $700.
  • Input devices: PS6 is designed to work best with a wired USB multi-button mouse with a scroll-wheel or scroll-ball such as Apple's "mighty" mouse. Eye Physics uses a 3rd party SteelSeries Rival 710 mouse with its desktop systems. Apple's wireless bluetooth "magic" mice and/or trackpads (version 2) with forceTouch are also higly recommended add-ons. These "magic" devices enable PS6 to respond to modern finger gestures such as pinches, swipes, and rotation gestures when running OSX 10.11 (El Capitan) or later. Current Apple laptops come equipped with forceTouch trackpads and touch bars. Eye Physics uses a Magic Mouse 2 with its 2018 MacBook Pro laptop.
  • Keyboards: Eye Physics recommends wired USB keyboards. We prefer mechanical Cherry MX switch keyboards from Das Keyboard such as the Model 4 Professional for Mac. Eye Physics also uses various USB wired and Bluetooth wireless keyboards manufactured by Apple.
  • Printer: Eye Physics uses an HP Color LaserJet Pro M254dw printer, but any MacOSX compatible printer, either networked or directly connected, will work. MacOS 10.13 and 10.14 compatible drivers for the HP M254dw are available online from HP.
  • Example: As of May 2025, the Mac Studio desktop illustrated below is an example of an entry level hardware configuration, similar in computing power to the systems Eye Physics uses for development, planning, testing and training. More powerful versions of the Mac Studio are recommended if you can afford them. All Eye Physics owned Mac Studio desktops are configured with M4-Max 16-core CPUs, 40-core GPU, 64GB RAM and 2 TB SSDs. Eye Physics recommends the largest screen you can afford. Eye Physics uses multiple Dell 30", 32" and 34" 2K-class screens. If you can afford a 5K or 6K class screen then both Apple and Dell offer interesting options. The advantage of 5K and 6K class screens is smoother text when using 4 sub-pixels to make a display point. In native 4K and greater modes 10 and 12 point text will be too small to be readable.
    
    

    Example of 2025 entry level Mac Studio computer and the optional 27" Apple Studio Display. Approximately 10% lower pricing is available with educational affiliation. Upgraded configurations of the computer cpu, gpu, memory, storage, I/O configuration and display stand capabilities are available at greater cost.

    

    Example of a 2025 Dell 34" WQXGA (21:9) 110 ppi display to use with Mac Studio or Mini desktop or as additional screen to use with a laptop.

    
    
    

    Example of a 2025 Dell 32" 224 ppi native display (rescales to 112 ppi in recommended subpixel mode) to use with Mac Studio or Mini desktop or as additional screen to use with a laptop.

    
    
    

To get the most from Plaque Simulator you will want to do image based planning. Eye Physics uses the following well known 3rd party software solutions to prepare CT, MR, ultrasound and fundus images for export to Plaque Simulator.

• DCMTK: The DICOM toolkit DCMTK is a collection of cross platform libraries and applications implementing large parts the DICOM standard for Unix operating systems including MacOS. To install DCMTK you must first install a package manager for MacOS such as Homebrew. Follow the instructions on the Homebrew web site. Once you have installed Homebrew, you can then install DCMTK from a MacOS terminal window using the command brew install dcmtk. Be sure to make note of the Unix file path at which DCMTK was installed, it may differ slightly depending upon your version of MacOS. The file path is typically something like usr/local/bin.
• OsiriX: The multiplanar reconstruction functionality of OsiriX is now available in PS version 6.8.6 and later once you have installed DCMTK. For versions of PS prior to 6.8.6 please download the latest version of OsiriX that is compatible with your OSX version. OsiriX, a well established open source DICOM viwer and listener, is used by Eye Physics to create anonymized image series for teaching purposes and to export multiplanar reconstructions (MPR) of the eye from 3D CT and MR sources to Plaque Simulator versions that do not support DCMTK. There are a couple of "free" alternatives to OsirX which are based on code forks from older OsiriX distributions; HOROS and Miele-LXIV.
• Photoshop: Adobe Photoshop for Mac, a component of Adobe Creative Suite for Mac is used by Eye Physics when creating fundus collages and fusions, editing CT, MR and ultrasound images, and cropping and otherwise preparing pictures of plaques and seed carriers for inclusion in plaque model files.
• Vuescan: from Hamrick Software is a superior application for Windows, Mac OS X, and Linux that replaces the software that came with your flatbed scanner.
• BBEdit: from Bare Bones Software is a great text file editor that can be used to view and edit the .xml files created by PS6 and DCMTK.
• Excel: Microsoft Excel:Mac, the spreadsheet component of Microsoft Office for Mac was used by Eye Physics to create and edit the tab delimited text physics files used by Plaque Simulator version 5 (PS5). PS6 can open and save PS5 (.iphys) physics files, but prefers the newer xml versions (.iphys6) of these files.