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Dosimetric Comparison between Acuros XB (AXB) and Anisotropic Analytical Algorithm (AAA) in Volumetric Modulated Arc

S Sriram Prasath1,2, Padmanabhan Ramesh Babu2

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The Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) dose calculation algorithms show minimal differences for most megavoltage (MV) photon beams. While AAA generally calculates higher doses, the variations are not statistically significant for flattening filter free (FFF) beams.

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Radiotherapy Physics

Background:

  • Accurate dose calculation is crucial for effective radiation therapy.
  • Comparing dose calculation algorithms like AAA and AXB is essential for treatment planning optimization.
  • Volumetric Modulated Arc Therapy (VMAT) requires precise dose calculations, especially in heterogeneous media.

Purpose of the Study:

  • To compare the dose calculation accuracy of Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) for various megavoltage (MV) photon beams (FF and FFF).
  • To validate these algorithms' accuracy using an inhomogeneous phantom in VMAT.
  • To assess dose differences in different phantom materials and target shapes.

Main Methods:

  • VMAT plans were created using AAA and AXB algorithms with single or double arcs.
  • A Cheese Phantom with density calibration plugs was used for dose measurements.
  • Point doses were measured using an ionization chamber in a linear accelerator for 6MV, 10MV, 6MV FFF, and 10MV FFF beams.

Main Results:

  • The minimum average mean dose difference for PTV structures between AAA and AXB was 1.2% (p=0.02).
  • Significant dose differences (>2%) were observed in specific density plugs like solid water, bone, and cortical bone.
  • AAA generally calculated higher maximum and mean doses than AXB, except for lung inserts; differences were minimal for FFF beams.

Conclusions:

  • AAA and AXB show minimal dose calculation differences for most MV photon beams, though AAA tends to overestimate dose.
  • The accuracy of both algorithms is comparable, with slight variations in specific tissue densities.
  • Further validation is recommended for clinical implementation, especially for FFF beams.