Validation of absolute point dosimetry by the analytical anisotropic algorithm and Acuros XB algorithm employing intensity-modulated radiotherapy technique on an in-house develop cost-effective heterogeneous thorax phantom.

Abstract

Dose validation inside the human body needs a medium which can simulate the actual heterogeneities of a specific body site. The aim of the present work is to study the properties of a cost-effective heterogeneous thorax phantom (HTP) developed in-house by the author and its application for the evaluation of patient-specific absolute point dosimetry by employing analytic anisotropic algorithm (AAA) and Acuros XB (AXB) algorithm. HTP was made from the dust of porous pinewood, rib cage, and honeybee's wax. Density and central axis isodose depth distribution was measured on computed tomography images of actual patient and on HTP. Absolute point dose verification of 35 patients was done using AAA and AXB algorithm. The difference in the calculated dose by AAA and AXB was compared using the Wilcoxon signed-rank test. Density distribution and central axis depth dose inside the HTP compare well with that of an actual patient. The mean percentage variation between the planned and the measured doses inside the HTP was found to be 4.85 (standard deviation [SD] = 3.38) and 1.3 (SD = 2.93), respectively, using AAA and AXB algorithm. The difference in the measured dose and the planned dose was found to be significant for AAA with the significance level of 0.01 (p-value < 0.00001), whereas it was found to be insignificant (p-value < 0.00001) for AXB. The results of this study showed that the HTP is resembled with the human thorax in terms of its heterogeneities and radiological properties and can be used for pretreatment plan verification.