An algorithm for kilovoltage x-ray dose calculations with applications in kV-CBCT scans and 2D planar projected...

A new model-based dose calculation algorithm is presented for kilovoltage x-rays and is tested for the cases of calculating the radiation dose from kilovoltage cone-beam CT (kV-CBCT) and 2D planar projected radiographs. This algorithm calculates the radiation dose to water-like media as the sum of primary and scattered dose components. The scatter dose is calculated by convolution of a newly introduced, empirically parameterized scatter dose kernel with the primary photon fluence. Several approximations are introduced to increase the scatter dose calculation efficiency: (1) the photon energy spectrum is approximated as monoenergetic; (2) density inhomogeneities are accounted for by implementing a global distance scaling factor in the scatter kernel; (3) kernel tilting is ignored. These approximations allow for efficient calculation of the scatter dose convolution with the fast Fourier transform. Monte Carlo simulations were used to obtain the model parameters. The accuracy of using this model-based algorithm was validated by comparing with the Monte Carlo method for calculating dose distributions for real patients resulting from radiotherapy image guidance procedures including volumetric kV-CBCT scans and 2D planar projected radiographs. For all patients studied, mean dose-to-water errors for kV-CBCT are within 0.3% with a maximum standard deviation error of 4.1%. Using a medium-dependent correction method to account for the effects of photoabsorption in bone on the dose distribution, mean dose-to-medium errors for kV-CBCT are within 3.6% for bone and 2.4% for soft tissues. This algorithm offers acceptable accuracy and has the potential to extend the applicability of model-based dose calculation algorithms from megavoltage to kilovoltage photon beams.