Abstract
Purpose: The intensive use of Cone-Beam Computed Tomography (CBCT) during radiotherapy treatments raise some questions about the dose to healthy tissues delivered during image acquisitions. We hence developed a Monte Carlo (MC)-based tool to predict doses to organs delivered by the Elekta XVI kV-CBCT. This work aims at assessing the dosimetric accuracy of the MC tool, in all tissue types. Methods: The kV-CBCT MC model was developed using the PENELOPE code. The beam properties were validated against measured lateral and depth dose profiles in water, and energy spectra measured with a CdTe detector. The CBCT simulator accuracy then required verification in clinical conditions. For this, we compared calculated and experimental dose values obtained with OSL nanoDots and XRQA2 films inserted in CIRS anthropomorphic phantoms (male, female, and 5-year old child). Measurements were performed at different locations, including bone and lung structures, and for several acquisition protocols: lung, head-and-neck, and pelvis. OSLs and film measurements were corrected when possible for energy dependence, by taking into account for spectral variations between calibration and measurement conditions. Results: Comparisons between measured and MC dose values are summarized in table 1. A mean difference of 8.6% was achieved for OSLs when the energy correction was applied, and 89.3% of the 84 dose points were within uncertainty intervals, including those in bones and lungs. Results with XRQA2 are not as good, because incomplete information about electronic equilibrium in film layers hampered the application of a simple energy correction procedure. Furthermore, measured and calculated doses (Fig.1) are in agreement with the literature. Conclusion: The MC-based tool developed was validated with an extensive set of measurements, and enables the organ dose calculation with accuracy. It can now be used to compute and report doses to organs for clinical cases, and also to drive strategies to optimize imaging protocols.
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