//Dose Calculation Algorithms

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Dose Calculation Algorithms

Dose calculation models for IMRT are not fundamentally different than those used for conventional FP. This is because the dose calculations and the actual optimization processes are often decoupled. Some treatment planning systems, however, may employ a simpler dose calculation algorithm during plan optimization to speed up the process and require that a final dose calculation be performed after optimization is completed. In this case, the resultant optimized plan may deviate from the final calculated plan because of the difference in dose-calculation methods. Having said that, we must note that there are still some complications associated with MLC IMRT dose calculations. First, when delivering an IMRT dose, only a portion of the entire field is exposed at any given time. As a result, the total beam-on time (or MUs) required can be two to four times longer than for conventional treatments. [58] In general, the more complex the intensity modulation, the more MUs required. This means that factors such as variable-beam transmission through rounded leaf-ends or through tongues and grooves, which are ignorable in conventional dose calculations, must be more accurately accounted for with IMRT. Overall leakage through MLC leaves can also amount to several percent of the total IMRT dose as opposed to less than 1% for conventional treatments. Extremely variable effective field sizes during IMRT beam delivery also complicates calculation of the output factor, as the relationship between collimator scatter factor and phantom scatter factor becomes more complicated than for conventional dose calculations. [86] One accurate method of dose calculation developed at Memorial Sloan-Kettering Cancer Center[87] entails a one-time Monte Carlo (MC) calculation of pencil beams or dose kernels to describe the transport of photons and electrons in homogeneous and inhomogeneous media. Patient treatment planning then incorporates a convolution of pencil beams. In this dose model, inhomogeneity effects are accounted for by the traditional method of equivalent path length (or similar algorithm) and pencil-beam convolution is used only as a correction factor to account for the variation of intensity relative to a flat, uniform field.[87] However, in a highly heterogeneous media such as the lung, the accuracy of this calculation method needs improvement, for which development is in progress. The MC method can provide the most accurate dose calculation, but, because of the lengthy computation time, its routine use awaits faster computer speed. Nevertheless, the MC method is relied on to derive an accurate pencil-beam kernel and the source function (which predicts the incident intensity pattern), with detailed accounting for the finite source size, extra-focal radiation (from the flattening filters, primary and secondary collimators), beam spectrum, and so on.

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10/02/2010 04:55 PM