SU-G-BRC-17: Using Generalized Mean for Equivalent Square Estimation




Equivalent Square (ES) is a widely used concept in radiotherapy. It enables us to determine many important quantities for a rectangular treatment field, without measurement, based on the corresponding values from its ES field. In this study, we propose a Generalized Mean (GM) type ES formula and compare it with other established formulae using benchmark datasets.


Our GM approach is expressed as ES=(w•fx^α+(1-w)•fy^α)^(1/α), where fx, fy, α, and w represent field sizes, power index, and a weighting factor, respectively. When α=−1 it reduces to well-known Sterling type ES formulae. In our study, α and w are determined through least-square-fitting. Akaike Information Criterion (AIC) was used to benchmark the performance of each formula. BJR (Supplement 17) ES field table for X-ray PDDs and open field output factor tables in Varian TrueBeam representative dataset were used for validation.


Switching from α=−1 to α=−1.25, a 20% reduction in standard deviation of residual error in ES estimation was achieved for the BJR dataset. The maximum relative residual error was reduced from ∼3% (in Sterling formula) or ∼2% (in Vadash/Bjarngard formula) down to ∼1% in GM formula for open fields of all energies and at rectangular field sizes from 3cm to 40cm in the Varian dataset. The improvement of the GM over the Sterling type ES formulae is particularly noticeable for very elongated rectangular fields with short width. AIC analysis confirmed the superior performance of the GM formula after taking into account the expanded parameter space.


The GM significantly outperforms Sterling type formulae at slightly increased computational cost. The GM calculation may nullify the requirement of data measurement for many rectangular fields and hence shorten the Linac commissioning process. Improved dose calculation accuracy is also expected by adopting the GM formula into treatment planning and secondary MU check systems.