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Does extending the body contour into air enhance surface dose calculation accuracy?

Joshua N Wancura1, Olga M Dona Lemus2, Sean M Tanny3

  • 1Department of Radiation Oncology, University of Massachusetts Chan Medical School, Worcester, MA.

Medical Dosimetry : Official Journal of the American Association of Medical Dosimetrists
|January 10, 2025
PubMed
Summary

The default body contour (DBC) more accurately estimates superficial radiation dose than an extended body contour (EBC), especially for oblique beams. Using an extended contour overestimates surface dose, while the default contour underestimates it under oblique conditions.

Keywords:
Body contourEclipseRadiation therapyRadiotherapySkin doseSuperficial doseSurface dose

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Area of Science:

  • Medical Physics
  • Radiotherapy
  • Dosimetry

Background:

  • Accurate modeling of superficial dose in radiotherapy is crucial for treatment planning.
  • Current systems often use a default body contour (DBC) at the air-tissue interface.
  • The accuracy of dose calculations using DBC versus an extended body contour (EBC) needs investigation.

Purpose of the Study:

  • To compare the accuracy of superficial dose calculations using DBC and EBC against radiochromic film measurements.
  • To evaluate the impact of contour definition on surface dose accuracy in radiotherapy planning.

Main Methods:

  • Radiochromic films were used to measure surface doses on slab and anthropomorphic phantoms.
  • Irradiations were performed with static and dynamic beams at various incident angles.
  • Dose calculations were performed using Eclipse 15.6 Acuros XB with both DBC and EBC, where EBC extended 1 cm beyond DBC.

Main Results:

  • Differences between DBC and EBC calculations were most significant within the top 2 mm of tissue.
  • For oblique beams, DBC underestimated surface dose (e.g., 33% vs. 43% measured at 60°), while EBC overestimated it (66% vs. 43%).
  • On an anthropomorphic phantom, DBC calculated 65% and EBC calculated 99% of prescription dose, versus 76% measured.

Conclusions:

  • Extended body contour (EBC) calculations overestimate superficial dose, particularly under oblique incidence.
  • Default body contour (DBC) calculations underestimate superficial dose with oblique beams.
  • For bare skin, the default body contour at the air-tissue interface provides a more accurate estimation of surface dose.