SU-E-T-496: A Study of Two Commercial Dose Calculation Algorithms in Low Density Phantom




Some lung cancer patients have very low lung density due to comorbidities. We investigate calculation accuracy of Eclipse AAA and Acuros(AXB) using a phantom that simulates this situation.


A 2.5 x 5.0 x 5 cm (long) solid water inhomogeneity positioned 10 cm deep in a Balsa lung phantom (density 0.099 gm/cc) was irradiated with an off-center field such that the central axis was parallel to one side of the inhomogeneity. Radiochromic films were placed at 2.5cm(S1) and 5cm(S2) depths. After CT scanning, Hounsfield Units(HU) were converted to electron(ρe) and mass(ρm) density using in-house(IH) and vendor-supplied(V) calibration curves. IH electron densities were generated using a commercial electron density phantom. The phantom was exposed to 6 MV 3×3 and 20×20 fields. Dose distributions were calculated using the AAA and AXB algorithms.


The HU of BW is -910±40 which translates to ρe of 0.088±0.050(IH) and 0.090±0.050(V), and ρm of 0.101±0.045(IH) and 0.103±0.039(V). Both ρe(V) and ρm(V) are higher than ρe(IH) and ρm(IH) respectively by 1.4-5.3% and 0.5-12.3%. The average calculated dose inside the solid water ‘tumor’ are within 3.7% and 2.4% of measurements for both calibrations and field sizes using AAA and AXB. Within 10mm outside the ‘tumor’, AAA on average underestimates by 18.3% and 17.0% respectively for 3×3 using IH and V. AXB underestimates by 5.9%(S1)-6.6%(S2) and 13.1%(S1)-16.0%(S2) respectively using IH and V. For 20×20, AAA and AXB underestimate by 2.8%(S1)-4.4%(S2) and 0.3%(S1)-1.4%(S2) respectively with either calibration.


The difference in the HU calibration between V and IH is not of clinical significance in normal field sizes. In the low density region of small fields, the calculations from both algorithms differ significantly from measurements. This may be attributed to the insufficient lateral electron transport modeled by two algorithms resulting in the over-estimation in penumbra expansion.