Abstract
Objective: Metallic implants have impacts on dose distribution of radiotherapy. Our purpose is evaluating impact of metallic implants with different dose calculation algorithms on dose distribution. Material and Methods: Two patients with metallic implants on vertebral body were included in this study. They were treated with stereotactic radiotherapy. The data of the patients were retrospectively re-calculated with different TPSs and calculation algorithms. Ray-Tracing (Ry-Tc), Monte-Carlo (MC), Acuros XB (AXB) and analytical anisotropic algorithms (AAA) were compared. Results: Ry-Tc, AAA and AXB underestimated minimum and maximum doses of target volumes and critical organs compared with MC. Conclusion: MC seems more reliable for dose calculations in patients with metallic implants but more studies with more number of patients should be done to identify the best dose calculation algorithm for patients with metallic implants.
Highlights
Various metallic spinal implants have been used for bone stability on patients with spinal metastases or primary spinal tumors
Ry-Tc, analytical anisotropic algorithms (AAA) and Acuros XB (AXB) underestimated minimum and maximum doses of target volumes and critical organs compared with MC
MC seems more reliable for dose calculations in patients with metallic implants but more studies with more number of patients should be done to identify the best dose calculation algorithm for patients with metallic implants
Summary
Various metallic spinal implants have been used for bone stability on patients with spinal metastases or primary spinal tumors. The radiation therapy has been widely used to treat metastatic or primary spinal tumours. Spine stereotactic radiotherapy (SRT) is frequently used in the management of spinal tumors. SRT offers a highly conformal and high dose per fraction. The tolerance dose of spinal cord is a limitation factor for prescription dose. To deliver ablative radiotherapy CyberKnife® (CK)based SRT is an effective method. Ray Tracing (RyTc) and Monte Carlo (MC) algorithms are dose calculation algorithms which are used by Multi Plan (MP), Cyberknife® Accuray treatment planning system
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