Pencil Beam Convolution Research Articles

Investigation of Dose Calculation Accuracy of Eclipse Treatment Planning System in the Presence of Metal Hip Prosthesis with Thermoluminescence Dosimeters

Aim: This study investigated the dose calculation accuracy of different treatment planning algorithms used in radiotherapy patients with hip prostheses. Method: The current research produced a tissue-equivalent cylindrical phantom that imitates a leg using a 3D printer. Co-Cr-Mo alloy and Ti-6AI-4V alloy prostheses were placed in the centre of the phantom, respectively. Both prostheses' dose measurements were taken with thermoluminescent dosimeters (TLD) at 92 points. The dose calculation accuracy of the Analytical Anisotropic Algorithm (AAA) and Pencil Beam Convolution (PBC) algorithms, widely used in radiotherapy, were compared with the measurement results. Results: Since the Co-Cr-Mo hip prosthesis has a high density, the number of backscattered photons around it was higher than the Ti-6AI-4V hip prosthesis. The average surface dose of the Co-Cr-Mo alloy was 364.05 cGy, while the average surface dose of the Ti-6AI-4V alloy was 347.79 cGy. Conclusion: It was observed that the dose estimation abilities of the AAA and PBC algorithms decreased as the density of the hip replacement increased. In addition, the AAA algorithm predicted the surface dose in the phantom better than the PBC algorithm.

Investigation of Surface Dose Accuracy of Two Dose Calculation Algorithms Using Thermoluminescent Dosimeters

Accurate estimation of the surface dose in radiotherapy is very important in reducing skin reactions. This study aims to evaluate the accuracy of two different treatment planning algorithms in calculating the surface dose in a specially designed phantom using thermoluminescent dosimetry (TLD). In this study, a special phantom was designed for surface dose measurement. The phantom surface consisted of an adhesive bolus for the adhesion of TLDs. 121 TLDs were placed 1 cm apart on the bolus surface. In TPS, irradiation plans were created at different fields and source-surface distances (SSD). Dose calculations were made with Anisotropic Algorithm algorithms (AAA) and Pencil Beam Convolution (PBC) algorithms for all plans. The mean dose was measured for each point. For each of the 4x4, 6x6, 8x8, 10x10, and 12x12 cm2 domains, the TLDs within the domain were approximately 1 cm inward from the edge. To measure the effect of SSD on surface dose, the isocenter point was located at depths of 0 cm, 2.5 cm and 5.0 cm, respectively. The surface dose at each depth was measured with TLDs. The doses calculated by the AAA and PBC algorithms were compared with the doses measured by TLDs. The AAA algorithm overestimates the surface dose by 4% compared to the TLD measurement for the 4x4 field. The surface dose calculation of the PBC algorithm was found to be high when compared to TLD measurements for all SSDs and fields. There was a significant difference between the PBC algorithm dose calculation and TLD measurements in all fields and SSDs (p<0.001). It was observed that the AAA algorithm performed better in calculating the surface dose than the PBC algorithm. AAA and PBC algorithm users are advised to be more careful about surface dose calculation.

Accuracy of In-Field and Out-Field Doses Calculated by Analytical Anisotropic and Pencil Beam Convolution Algorithms: A Dosimetric Study

Out-of-field doses may affect the formation of secondary cancers, especially in radiosensitive organs, in patients treated with radiotherapy. The aim of this study is to investigate the in-field dose and out-of-field dose accuracy of Eclipse's analytic anisotropic algorithm (AAA) and pencil beam convolution (PBC) algorithms using TLDs. A tissue equivalent phantom containing a total of 21 measurement points at a depth of 5 cm from the anterior and posterior was created. Using Eclipse AAA and PBC algorithms in TPS, 100 MU for AP/PA fields and 95 cm source-skin distance (SSD) were planned. In-field measurement points including isocenter were 3, 5, 7 and 11 points for 3x3, 5x5, 7x7 and 10x10 cm2, respectively. Measuring points outside the field edge were 38, 36, 34 and 30 points for 3x3, 5x5, 7x7 and 10x10 cm2, respectively. In-field point dose values calculated by TPS for different fields were compared with TLD doses measured at the same location. The difference between in-field dose estimation and TLD measurements of both algorithms was generally below 1%. The difference between TPS and TLD was found to be 4.41% for the 10x10 cm2 irradiation field, due to the field edge at a distance of 5 cm from the isocenter. As the field size decreased, the out-of-field dose calculation performance of the AAA and PBC algorithms was adversely affected. For the 10x10 cm2 irradiation field, the TLD measurements and the out-of-field point dose difference of the PBC algorithm were found to be 39.40%. This difference was at most 12.06% for the AAA algorithm. The Eclipse TPS is good at calculating the in-field dose but underestimates the off-field dose. In out-of-field dose calculation, the AAA algorithm gives more accurate results than the PBC algorithm. Additionally, the smaller the field size, the worse the outfield dose accuracy. The use of in vivo dosimeters is recommended in order to estimate the out-of-field dose with great accuracy in radiotherapy.

Uncertainties in the dosimetric heterogeneity correction and its potential effect on local control in lung SBRT

Objective. Dose calculation in lung stereotactic body radiation therapy (SBRT) is challenging due to the low density of the lungs and small volumes. Here we assess uncertainties associated with tissue heterogeneities using different dose calculation algorithms and quantify potential associations with local failure for lung SBRT. Approach. 164 lung SBRT plans were used. The original plans were prepared using Pencil Beam Convolution (PBC, n = 8) or Anisotropic Analytical Algorithm (AAA, n = 156). Each plan was recalculated with AcurosXB (AXB) leaving all plan parameters unchanged. A subset (n = 89) was calculated with Monte Carlo to verify accuracy. Differences were calculated for the planning target volume (PTV) and internal target volume (ITV) Dmean[Gy], D99%[Gy], D95%[Gy], D1%[Gy], and V100%[%]. Dose metrics were converted to biologically effective doses (BED) using α/β = 10Gy. Regression analysis was performed for AAA plans investigating the effects of various parameters on the extent of the dosimetric differences. Associations between the magnitude of the differences for all plans and outcome were investigated using sub-distribution hazards analysis. Main results. For AAA cases, higher energies increased the magnitude of the difference (ΔDmean of −3.6%, −5.9%, and −9.1% for 6X, 10X, and 15X, respectively), as did lung volume (ΔD99% of −1.6% per 500cc). Regarding outcome, significant hazard ratios (HR) were observed for the change in the PTV and ITV D1% BEDs upon univariate analysis (p = 0.042, 0.023, respectively). When adjusting for PTV volume and prescription, the HRs for the change in the ITV D1% BED remained significant (p = 0.039, 0.037, respectively). Significance. Large differences in dosimetric indices for lung SBRT can occur when transitioning to advanced algorithms. The majority of the differences were not associated with local failure, although differences in PTV and ITV D1% BEDs were associated upon univariate analysis. This shows uncertainty in near maximal tumor dose to potentially be predictive of treatment outcome.

Mathematical Models Used for Brachytherapy Treatment Planning Dose Calculation Algorithms

Brachytherapy treatment is primarily used for the certain handling kinds of cancerous tumors. Using radionuclides for the study of tumors has been studied for a very long time, but the introduction of mathematical models or radiobiological models has made treatment planning easy. Using mathematical models helps to compute the survival probabilities of irradiated tissues and cancer cells. With the expansion of using HDR-High dose rate Brachytherapy and LDR-low dose rate Brachytherapy for the treatment of cancer, it requires fractionated does treatment plan to irradiate the tumor. In this paper, authors have discussed dose calculation algorithms that are used in Brachytherapy treatment planning. Precise and less time-consuming calculations using 3D dose distribution for the patient is one of the important necessities in modern radiation oncology. For this it is required to have accurate algorithms which help in TPS. There are certain limitations with the algorithm which are used for calculating the dose. This work is done to evaluate the correctness of five algorithms that are presently employed for treatment planning, including pencil beam convolution (PBC), superposition (SP), anisotropic analytical algorithm (AAA), Monte Carlo (MC), Clarkson Method, Fast Fourier Transform, Convolution method. The algorithms used in radiotherapy treatment planning are categorized as correction‐based and model‐based.

EP02.02-006 Differing Doses: The Effects of Radiation Dose Calculation Algorithms on Local Control in Early-Stage Lung Cancer

Stereotactic body radiation therapy (SBRT) is an established treatment option for stage I non-small cell lung cancer (NSCLC). Dose calculation for SBRT in lung tissue is highly complex due to significant density heterogeneity in both the target tissue and beam path. Dose calculation algorithms employed clinically, including Pencil Beam Convolution (PBC), convolution-superposition Anisotropic Analytical Algorithm (AAA), and Acuros XB (AXB), have varying levels of accuracy when compared with the gold standard, Monte Carlo.

Evaluating impact of medium variation on dose calculated through planning system in a low cost in-house phantom

Purpose: In radiotherapy, accuracy in dose estimation of dose calculation methods is critical. The influence of deformity on radiation dose calculations derived by planning system is evaluated in present study. The goal of study was to create a low-cost inhomogeneous phantom for measuring absorbed dose using an Ionisation chamber and Gafchromic film, which was validated using treatment planning system (TPS) dose outcome. Methods:and Materials: The central axis dose calculations were computed using Pencil Beam Convolution algorithm (PBC), Collapsed Cone Convolution (CCC) and Monte Carlo (MC) algorithm in the Monaco treatment planning system using an In-house phantom (20 × 20 × 20cm3) made up of acrylic sheet containing water and inhomogeneous material wooden powder equivalent to lung. Phantom was scanned in Computed Tomography (CT) scanner and image set was sent to the planning workstation. The depth dose evaluations were performed using ionization chamber and Gafchromic film with same beam settings and monitor units in every setup. Following that, the calculated doses obtained from TPS and measured depth doses were compared. Results: The results was reported for photon energies 6MV, 10MV, 15MV, 6FFF and 10FFF at varying field sizes of 4 × 4 cm2, 5 × 5 cm2, 10 × 10 cm2, and 15 × 15 cm2. MC maximum dose variation predicted was 2.06% in 15MV of measured chamber dose and −2.06% of measured gafchromic film dose in 6MVFFF. CCC maximum dose variation predicted was 2.68% of measured chamber dose in 6MV and 3.31% of measured gafchromic film dose in 6MV whereas PB maximum dose variation predicted was −5.94% in 15MV of measured chamber dose and −11.6% of measured gafchromic film dose in 6MVFFF. Conclusion: Low-cost in-house phantoms can be utilised to assess point and planar doses during patient-specific quality assurance in centres that don’t have accessibility to phantoms due to the high cost of commercially available tools.

Implementation and validation of anisotropic analytical algorithm in eclipse treatment planning system for indigenous telecobalt machine (Bhabhatron II)

Background:The photon dose calculation model anisotropic analytical algorithm (AAA) available with eclipse integrated treatment planning system (TPS) (Varian) supports telecobalt dose calculation from Version 13.6 onward. Formerly, pencil beam convolution (PBC) was used for modeling telecobalt machines. Eclipse TPS no longer supports PBC dose calculation algorithm in v13.6 and above. The AAA dose calculation model is a three-dimensional PBC/superposition algorithm. Its configuration is based on Monte-Carlo-determined basic physical parameters that are tailored to measured clinical beam data.Aim:The study investigated the feasibility of clinical implementation of AAA in Eclipse TPS for Bhabhatron II.Materials and Methods:The indigenous telecobalt machine, Bhabhatron II, was configured as a generic machine because an inbuilt machine model for the same was not available in Varian Eclipse TPS algorithm library. In such a scenario, it was necessary to evaluate and validate dosimetric parameters of the TPS because improper tailoring would cause errors in dose calculations. Beam data measurements of the machine were carried out which were used for configuration of the algorithm.Result:After successful configuration, a variety of plans created in TPS were executed on the machine and subsequently evaluated.Conclusion:From this study, we concluded that AAA-based dose calculation in TPS is very well suited for accurate dose calculations for telecobalt machine and can be implemented for clinical use.

Investigation of the effects on dose calculations of correction-based algorithms in different tissue medium

The aim of this study is to determine the effects of correction-based algorithms on dose distributions in the inhomogeneous medium and dosimetric parameters depending on the algorithms preferred in breast and lung treatment plans. In the treatment planning system (TPS) in which the Pencil Beam Convolution (PBC) dose calculation algorithm is used, dose calculations were performed in different correction-based algorithms Modified Batho and Equivalent Tissue-Air Ratio (ETAR) for soft tissue, bone and air medium. Rectilinear virtual phantoms were created in TPS for soft tissue, bone and air materials, and deep dose values and dose distribution profiles at lateral depth were obtained. Intensity modulated radiotherapy (IMRT) treatment planning technique was applied to 20 patients with breast and lung cancer diagnosis on computed tomography (CT) sections, and dose calculations were performed. Different dosimetric parameters obtained within the target volume were calculated. Although the effects of correction-based algorithms on dose values depending on the depth and dose distribution profiles in lateral depth were calculated below 1% in dose calculations performed on soft tissue virtual phantom, dose profiles were obtained as approximately 20% in bone and air medium. It was concluded that correction-based algorithms in the different inhomogeneous mediums have a significant effect on the dose values calculated in TPS.

Dose distrubution evaluation of different dental implants on a real human dry-skull model for head and neck cancer radiotherapy

ObjectivesIn this study, the effect of different dental implant materials on dose distribution in head and neck cancer radiotherapy planning was investigated in a real human dry-skull taken from cadaver. MethodsThe effect of Root-shaped Yttrium (Y) stabilized tetragonal Zr polycrystalline (Y-TZP), Titanium (Ti), Alumina (Al2O3) and polyether ether ketone (PEEK) dental implants on dose distribution was investigated by three different methods; Monte Carlo (MC) simulation, Eclipse Treatment Planning System's (TPS) Pencil Beam Convolution (PBC) algorithm and Thermoluminescence Dosimeter (TLD). The 6 MV photon beam simulation was performed for the Varian 2300 C/D linear accelerator using the EGSnrc based BEAMnrc MC Code. To perform MC simulation on skull phantom, phantom CT images with extended CT scale were imported to BEAMnrc/EGSnrc MC code via CTCREATE code. ResultsAccording to the dose distribution measurement in dry skull, the calculated dose differences between PBC and MC algorithms were in the range of 0.6–4.5% whereas the dose difference between MC and TLD were in the range of 1,1–14.6% range depending on implant material. The PBC calculated dose increase difference range confirmed with TLD measurements was between 1.7% and 19.8%. The PBC algorithm could not fully determine the dose due to backscattering caused by dental implants. This is probably due to the limitations and shortcomings of the PBC algorithm. ConclusionThe maximum dose increase was observed for the Y-TZP dental implant material, which has the highest physical density. No significant dose increase was observed for the PEEK implant probably due to the low physical density of implants close to the physical density of water.

Investigation of tube voltage dependence on CT number and its effect on dose calculation algorithms using thorax phantom in Monaco treatment planning system for external beam radiation therapy.

Introduction:The accuracy of dose calculation algorithms depends on the electron density and computed tomography (CT) number of medium scanned. Our study aimed to verify the impact of different CT scanning protocols on Hounsfield unit (HU) and effect on dose calculation algorithms.Materials and Methods:CIRS thorax phantom with different density material plugs was scanned at varying tube voltages from CT scanner and HU values were measured in treatment planning system (TPS). Calibration curves of electron density at different tube voltages were plotted and used for dose calculation with different calculation algorithms at varying high energy megavoltage photon energies.Results:Insignificant difference is obtained in electron density curves plotted at different tube voltages. The mean variation in HU values was found at different tube voltages for bone, lung, and water are 896.75 (standard deviation [SD] 122.88), −799.25 (SD 5.74), and −17.5 (SD 0.57), respectively. The estimated P values for change in HU values were 0.089, 0.258, and 0.121 for bone, lung, and water, respectively. Pencil beam (PB) convolution and collapsed cone algorithms show no significant dose difference, i.e., <1% variation and Monte Carlo (MC) shows maximum dose difference up to 1.4%.Conclusion:Third-generation algorithms such as MC shows dependence on varying tube voltages in dose calculation. Calibration curves plotted at different kVp in TPS advised to be chosen wisely to avoid any dosimetric errors in different medium.

Dosimetric comparison of three-field and four-field 3D conformal radiation therapy ballistics for rectal cancer treatment

The tremendous improvement made over the last ten years in radiotherapy has been achieved mainly by developing particle acceleration techniques. Three-dimensional conformal radiation therapy [3D-CRT] is crucially applied for decreasing the shape of advanced rectal tumors yet has several side consequences. Our investigation examined the dose distribution in planning target volumes (PTV), the protection of healthy organs at risk (OAR), and the quality of therapy for the two strategies based on the three fields and four fields ballistic used in treating rectal cancers. Using the Varian Linear Accelerator system (Varian Medical Systems, Inc., Palo Alto, CA, USA) integrated with an Eclipse MLC 2100 planning system including Pencil Beam Convolution PBC dose calculation algorithm. Two different treatments of rectal cancer based on the two approaches are performed. A dosimetric comparison of the parameters is made to evaluate the feasibility of each ballistic. These parameters, including the target volume coverage indicators, included average dose, conformity index (CI), and homogeneity index (HI) of planning tumor volume; OAR included the bladder and bilateral proximal femurs. The results achieved in this dosimetric comparative study advocate for the clinical application of three fields ballistic in all specialties already compared, except for the planning target volume PTV dose distribution. The study has shown that the three-field technique (an anterior and two opposing lateral fields with the portals orientation 0°, 90°, 270°) and applied energy photons of 18 MV and 6 MV provides the best bladder protection. According to the dose distribution in the target (PTV), all evaluated plans have not indicated any significant differences. The risk of morbidity in the femoral heads for all the applied methods, in a dose up to 56.396 Gy, was not a therapeutic problem. However, the three-field approach with beams orientation 0°, 120°, 240°gave the best sparing effect for femoral heads.

Head and Neck Immobilization Masks: Increase in Dose Surface Evaluated by EBT3, TLD‐100 and PBC Method

AbstractPositioning and immobilization tools are considered essential components of radiotherapy treatments to guarantee that the planned dose distribution can be efficiently reached. However, the benefits brought by their use are met by an apparent increase in the patient skin entrance dose. In the current study, we evaluated the dose surface effects provoked by the use of immobilization thermoplastic masks in head and neck radiotherapy treatments, carried out using a 6‐MV linear accelerator beam. The study was carried out using an anthropomorphic head–neck phantom and three dosimetric techniques: (i) thermoluminescent dosimetry (TL); (ii) radiochromic film dosimetry; and (iii) computational simulation using the pencil beam convolution (PBC) method. For calibration purposes, TLD chips and radiochromic (EBT3) small 2.0‐cm2 strip dosimeters were positioned between two virtual solid water plates, and exposed to absorbed doses ranging from 25 to 200 cGy. The use of an anthropomorphic head–neck phantom allows the dose variation in non‐flat surfaces to be taken into account. TLD chips, positioned on the surface of the supraclavicular fossa anatomical region, covered with a thermoplastic mask, detected an entrance skin dose that was approximately 38.4% higher than that measured without a mask. The EBT3 dosimeters, averaged among all strips used, also detected a medium increase of 58.6%. Both TLD and EBT3 detected increased doses for all measured points, and measured similar averaged surface doses without the use of immobilization masks; that is, 50.5% for EBT3 and 53.7% for TLD‐100. The pencil beam convolution simulation results suggested an increase for most of the measured points; however, no increased, and in some cases even decreased, doses were observed. The surface dose data of three other commercial thermoplastic masks irradiated in a solid water phantom are also provided.

Comparison of Gamma Index Passing Rate in Several Treatment Planning System Algorithms

The verification of dose calculation algorithm in a new Treatment Planning System (TPS) can be evaluated by comparing the passing rate of the gamma index analysis of the evaluated algorithm and the clinically implemented algorithms. In the present investigation, the gamma index passing rates was investigated as the reference data in the verification of the new three-dimensional TPS. The algorithms which are used in this study are Pencil Beam Convolution (PBC) version 11.0.31 and Anisotropic Analytical Algorithm (AAA) version 11.0.31 in Eclipse v.11 TPS, and Fast Convolution (FC), Adaptive Convolution (AC), and Collapsed-Cone Convolution (CCC) in Pinnacle 3 v.7.6c TPS. The 6 MV X-ray beam configurations were varied in the depth of measurement points, field sizes, source-to-surface distances, and wedge angles. The dose measurement was done using MatriXX Evolution and PTW 2D-array seven29. Then, OmniPro ImRT and Verisoft 3.1 software were chosen to analyze the gamma index from varied gamma criteria (3 %/3mm, 2 %/3mm, 3 %/2mm, and 2 %/2mm). Overall, the passing rate of AAA is the highest rate obtained of all algorithms. For gamma criterion of 2 %/2mm, the passing rate of AAA was 93.18 % ± 7.21 %, the passing rate of PBC was 89.76 % ± 7.21 %, and the passing rate of convolution algorithms was 76.84 % ± 11.10 %. 800x600 Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Times New Roman,serif;}

Dosimetric Comparison of Superflab and Specially Prepared Bolus Materials Used in Radiotherapy Practice.

This study compares standard commercial bolus material (Superflab) to custom prepared silicone dental impression material (CDIM) and play dough material (PDM) with respect to dosimetric properties and applicability by using ion chamber measurement and calculated dose values. The CDIM bolus was prepared by mixing dental impression silicone material with enough water to maintain a density of about 1.0 g/cm3. The prepared bolus material is applied on an RW3 solid phantom by covering 10x10 cm2 area with 0.5-1 cm thickness. Ion chamber measurements were performed separately with and without bolus material application. The setup was scanned in CT and the same procedure was repeated in the TPS using the scan data, in which the Pencil Beam Convolution dose calculation algorithm was used. To compare the effect of bolus material on tissue, the Superflab bolus and CDIM bolus were applied with 1 cm of thickness on postmastectomy scar and dose calculations on TPS were performed. After comparison of the dosimetric values for Superflab, CDIM and PDM, we obtained statistically meaningful results between superflab and CDIM. For PDM, the results obtained with TPS and ion chamber measurements indicated that, it is not suitable to use in radiotherapy application due to its material properties. For the simulated skin dose values obtained at five random points on the scar tissue, the comparison of Superflab and CDIM TPS calculation results were not statistically significant. The CDIM is easy to prepare and apply on irregular mastectomy scar tissue and it prevents formation of air gaps in the application surface. Especially for curved anatomical regions such as scar tissue, inclusion of the bolus material in treatment planning protocol will reduce dose uncertainty in application. It is safe to use CDIM as an alternative to Superflab in radiotherapy application, whereas PDM is not useful in clinical practice due to its material properties.

Boosting radiotherapy dose calculation accuracy with deep learning.

In radiotherapy, a trade‐off exists between computational workload/speed and dose calculation accuracy. Calculation methods like pencil‐beam convolution can be much faster than Monte‐Carlo methods, but less accurate. The dose difference, mostly caused by inhomogeneities and electronic disequilibrium, is highly correlated with the dose distribution and the underlying anatomical tissue density. We hypothesize that a conversion scheme can be established to boost low‐accuracy doses to high‐accuracy, using intensity information obtained from computed tomography (CT) images. A deep learning‐driven framework was developed to test the hypothesis by converting between two commercially available dose calculation methods: Anisotropic analytic algorithm (AAA) and Acuros XB (AXB). A hierarchically dense U‐Net model was developed to boost the accuracy of AAA dose toward the AXB level. The network contained multiple layers of varying feature sizes to learn their dose differences, in relationship to CT, both locally and globally. Anisotropic analytic algorithm and AXB doses were calculated in pairs for 120 lung radiotherapy plans covering various treatment techniques, beam energies, tumor locations, and dose levels. For each case, the CT and the AAA dose were used as the input and the AXB dose as the “ground‐truth” output, to train and test the model. The mean squared errors (MSEs) and gamma passing rates (2 mm/2% & 1 mm/1%) were calculated between the boosted AAA doses and the “ground‐truth” AXB doses. The boosted AAA doses demonstrated substantially improved match to the “ground‐truth” AXB doses, with average (± s.d.) gamma passing rate (1 mm/1%) 97.6% (±2.4%) compared to 87.8% (±9.0%) of the original AAA doses. The corresponding average MSE was 0.11(±0.05) vs 0.31(±0.21). Deep learning is able to capture the differences between dose calculation algorithms to boost the low‐accuracy algorithms. By combining a less accurate dose calculation algorithm with a trained deep learning model, dose calculation can potentially achieve both high accuracy and efficiency.

Dosimetric Accuracy Comparison between ACUROSE XB, AAA and PBC Dose Calculation Algorithms in EclipseTM TPS Using a Heterogeneous Phantom

Purpose: The aim of this study is to compare the accuracy of different algorithms in EclipseTM Treatment Planning System (TPS) using a heterogeneous phantom. Materials and Methods: The method is based on the International Atomic Energy Agency's TEC-DOC 1583 report. The chest phantom of CIRS, PTW30010 ionization chamber and an electrometer (PTW, Freiburg) were used for the measurements. Three ACUROSE XB (AXB), Analytical Anisotropic Algorithm (AAA) and Pencil Beam Convolution (PBC) dose calculation algorithms available in Eclipse TM TPS were considered in this study. Results: Based on the measurements, the maximum differences between calculated dose by TPS and measured dose in TEC-DOC 1583 tests were 2.5%, 8.6% and 16.1% for the AXB, AAA and PBC algorithms in heterogeneous media, respectively. Conclusion: The Acuros XB algorithm has superior accuracy to predict the dose distribution in the heterogeneous tissues such as lung compared to AAA and PBC algorithms

Ipsilateral lung normal tissue complication probability parameters for different dose calculation algorithms in radiotherapy of breast cancer.

Different dose calculation algorithms (DCAs) predict different dose distributions for the same treatment. Awareness of optimal model parameters is vital for estimating normal tissue complication probability (NTCP) for different algorithms. The aim is to determine the NTCP parameter values for different DCAs in left-sided breast radiotherapy, using the Lyman-Kutcher-Burman (LKB) model. First, the methodology recommended by International Atomic Energy Agency TEC-DOC 1583 was used to establish the accuracy of dose calculations of different DCAs including: Monte Carlo (MC) and collapsed cone algorithms implemented in Monaco, pencil beam convolution (PBC) and analytical anisotropic algorithm (AAA) implemented in Eclipse, and superposition and Clarkson algorithms implemented in PCRT3D treatment planning systems (TPSs). Then, treatment planning of 15 patients with left-sided breast cancer was performed by the mentioned DCAs and NTCP of the left-lung normal tissue were calculated for each patient individually, using the LKB model. For the PB algorithm, the NTCP parameters were taken from previously published values and new model parameters obtained for each DCA, using the iterative least squares methods. For all cases and DCAs, NTCP computation with the same model parameters resulted in >15% deviation in NTCP values. The new NTCP model parameters were classified according to the algorithm type. Thus, the discrepancy of NTCP computations was reduced up to 5% after utilizing adjusted model parameters. This paper confirms that the NTCP values for a given treatment type are different for the different DCAs. Thus, it is essential to introduce appropriate NTCP parameter values according to DCA adopted in TPS, to obtain a more precise estimation of lung NTCP. Hence, new parameter values, classified according to the DCAs, must be determined before introducing NTCP estimation in clinical practice.

Impact of choice of dose calculation algorithm on PTV and OAR doses in lung SBRT

Five dose calculation algorithms commonly used in lung SBRT planning are evaluated for their dosimetric impact on planning target volume (PTV) and organ-at-risk (OAR) doses. Treatment plans for thirty lung SBRT patients were included in this multi-institutional planning study. Lung SBRT plans were initially generated using BrainLab Pencil Beam (PB) convolution algorithm to deliver 50 Gy in 5 fractions to PTV (PB_OP plans). Plans were recalculated using BrainLab Monte Carlo (MC) algorithm with the same beam parameters, field settings, and MUs (MC_NO plans) to investigate accuracy limits of PB plans. Next, these plans were re-optimized via MU scaling in MC algorithm while keeping original beam parameters and settings (MC_OP). Further, with these new MUs, all patient plans were recalculated with Pinnacle collapsed cone convolution superposition (CCC), Eclipse anisotropic analytic algorithm (AAA), and Eclipse Acuros XB (AXB) algorithms, and are referred to as AP_NO, AAA_NO, and AXB_NO plans, respectively. DVH of PTV and OARs were used to calculate dosimetric parameters for comparison with MC_OP plans. Patient plans were compared based on PTV size as well as the location in the lung: island targets, adjacent to the ribs/chest wall, or mixed. Lung SBRT plans using PB dose algorithm overestimated target doses by 10–20% of prescribed dose and these differences were highlighted mainly in the target periphery/dose-buildup region as seen in Dmin and D90. Compared with MC, both Pinnacle and AAA plans overestimated PTV dose in the penumbra region, whereas Acuros plans were in good agreement with MC plans. PTV dose differences ranged 3–5% among Pinnacle, AAA, and Acuros. In general, Acuros AXB performed well for adjacent and mixed targets near the ribs and chest wall, whereas Pinnacle CCC was favored for island targets. OAR Dmax and lung V20 were better reproduced in Pinnacle, whereas Dmean were comparable among all TPS. Knowing the strengths and limitations of clinical treatment planning system allows more consistent and accurate dose comparison for patients enrolled in protocol studies.

Dosimetric comparison of different algorithms in stereotactic body radiation therapy (SBRT) plan for non-small cell lung cancer (NSCLC).

PurposesThe main aim of the study was to investigate the dosimetric difference between acuros XB algorithm (AXB), anisotropic analytic algorithm (AAA), and pencil beam convolution (PBC) algorithm in stereotactic body radiation therapy (SBRT) plan for non-small cell lung cancer (NSCLC).Patients and MethodsThirty-eight NSCLC patients were included. GTV, PTV, and organs at risk were delineated by the radiation oncologists. Three optimized SBRT plans for each patients were gained using three algorithms of AXB, AAA, and PBC with the identical plan parameters. Dosimetric endpoints were collected and compared among the three plans, including dosimetric criteria: V100%, V90%, PTV Dmin, Dmax, Dmean, homogeneity index (HI), and Paddick conformity index (CI).ResultsAXB plan resulted in decreased V100% with a mean difference 6.14% compared with PBC plan (For V100%, AXB vs AAA vs PBC=93.44% vs 95.54% vs 99.58%, P<0.05). Three plans showed no significant difference as to the parameter V90%. AXB plan leaded to reduced Dmin of PTV compared with other two algorithms (For Dmin of PTV, AXB vs AAA vs PBC=4048cGy vs 4365Gy vs 4873Gy, P<0.05). PBC induced the enhanced trend of Dmax of PTV compared with other two algorithms (Dmax among three algorithms, P>0.05); and increased the Dmean of PTV in three algorithms with significant difference (For Dmean of PTV, AXB vs AAA vs PBC=5332cGy vs 5330Gy vs 5785Gy, P<0.05). AXB algorithm achieved a similar plan conformity with other two algorithms (For CI, AXB vs AAA vs PBC=0.80 vs 0.85 vs 0.71, P>0.05).ConclusionFor SBRT plan of NSCLC, AAA and PBC algorithms overestimate target coverage, AXB algorithm is recommended for the SBRT plan of NSCLC.