Hogstrom, Kenneth R.

The purpose of this study was to evaluate the accuracy and calculation speed of electron dose distributions calculated by the Eclipse electron Monte Carlo (eMC) algorithm for use with bolus electron conformal therapy (ECT). The recent commercial availability of bolus ECT technology requires further validation of the eMC dose calculation algorithm. eMC‐calculated electron dose distributions for bolus ECT have been compared to previously measured TLD‐dose points throughout patient‐based cylindrical phantoms (retromolar trigone and nose), whose axial cross sections were based on the mid‐PTV (planning treatment volume) CT anatomy. The phantoms consisted of SR4 muscle substitute, SR4 bone substitute, and air. The treatment plans were imported into the Eclipse treatment planning system, and electron dose distributions calculated using 1% and statistical uncertainties. The accuracy of the dose calculations using moderate smoothing and no smoothing were evaluated. Dose differences (eMC‐calculated less measured dose) were evaluated in terms of absolute dose difference, where 100% equals the given dose, as well as distance to agreement (DTA). Dose calculations were also evaluated for calculation speed. Results from the eMC for the retromolar trigone phantom using 1% statistical uncertainty without smoothing showed calculated dose at of the measured TLD‐dose points was within 3% dose difference or 3 mm DTA of the measured value. The average dose difference was , and the net standard deviation was 2.32%. Differences as large as 3.7% occurred immediately distal to the mandible bone. Results for the nose phantom, using 1% statistical uncertainty without smoothing, showed calculated dose at of the measured TLD‐dose points within 3% dose difference or 3 mm DTA. The average dose difference was 1.08%, and the net standard deviation was 3.17%. Differences as large as 10% occurred lateral to the nasal air cavities. Including smoothing had insignificant effects on the accuracy of the retromolar trigone phantom calculations, but reduced the accuracy of the nose phantom calculations in the high‐gradient dose areas. Dose calculation times with 1% statistical uncertainty for the retromolar trigone and nose treatment plans were 30 s and 24 s, respectively, using 16 processors (Intel Xeon E5‐2690, 2.9 GHz) on a framework agent server (FAS). In comparison, the eMC was significantly more accurate than the pencil beam algorithm (PBA). The eMC has comparable accuracy to the pencil beam redefinition algorithm (PBRA) used for bolus ECT planning and has acceptably low dose calculation times. The eMC accuracy decreased when smoothing was used in high‐gradient dose regions. The eMC accuracy was consistent with that previously reported for accuracy of the eMC electron dose algorithm and shows that the algorithm is suitable for clinical implementation of bolus ECT.PACS number(s): 87.55.kd

In the present work, we investigated the accuracy of the electron pencil‐beam redefinition algorithm (PBRA) in calculating central‐axis percent depth dose in water for rectangular fields. The PBRA energy correction factor C(E) was determined so that PBRA‐calculated percent depth dose best matched the percent depth dose measured in water. The hypothesis tested was that a method can be implemented into the PBRA that will enable the algorithm to calculate central‐axis percent depth dose in water at a 100‐cm source‐to‐surface distance (SSD) with an accuracy of 2% or 1‐mm distance to agreement for rectangular field sizes cm. Preliminary investigations showed that C(E), determined using a single percent depth dose for a large field (that is, having side‐scatter equilibrium), was insufficient for the PBRA to accurately calculate percent depth dose for all square fields cm. Therefore, two alternative methods for determining C(E) were investigated. In Method 1, C(E), modeled as a polynomial in energy, was determined by fitting the PBRA calculations to individual rectangular‐field percent depth doses. In Method 2, C(E) for square fields, described by a polynomial in both energy and side of square W [that is, ], was determined by fitting the PBRA calculations to measured percent depth dose for a small number of square fields. Using the function C(E, W), C(E) for other square fields was determined, and C(E) for rectangular field sizes was determined using the geometric mean of C(E) for the two measured square fields of the dimension of the rectangle (square root method). Using both methods, PBRA calculations were evaluated by comparison with measured square‐field and derived rectangular‐field percent depth doses at 100‐cm SSD for the Siemens Primus radiotherapy accelerator equipped with a ‐cm applicator at 10 MeV and 15 MeV. To improve the fit of C(E) and C(E, W) to the electron component of percent depth dose, it was necessary to modify the PBRA's photon depth dose model to include dose buildup. Results showed that, using both methods, the PBRA was able to predict percent depth dose within criteria for all square and rectangular fields. Results showed that second‐ or third‐order polynomials in energy (Methods 1 and 2) and in field size (Method 2) were typically required. Although the time for dose calculation using Method 1 is approximately twice that using Method 2, we recommend that Method 1 be used for clinical implementation of the PBRA because it is more accurate (most measured depth doses predicted within approximately 1%) and simpler to implement.PACS number: 87.53.Fs