Comparing dose calculation algorithms for an orthovoltage beam in a bone phantom

The aim of this work was to compare dose calculation algorithm results at orthovoltage energies for a phantom composed of a bone slab in water. The calculation methods investigated were: no correction, ETAR, Batho, convolution/superposition and Monte Carlo. All algorithms calculated depth dose curves in a water phantom within 4% of experiment. However in the bone phantom, differences of over 40% between the No Correction/ETAR/Batho/Convolution and Monte Carlo results in the 1 cm thick bone slab were observed. These differences are predominantly because the algorithms do not account for the differing atomic number of the bone compared to water. The increased dose to bone and the tissue adjacent to the bone interface should be considered when treating with orthovoltage photons.