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Implementation of Acuros XB in Treatment Planning of SBRT of Lung Cancer

Journal article
Authors Emma Hedin
Roumiana Chakarova
Anna Bäck
Published in Annals of Radiation Therapy and Oncology
Volume 1
Issue 2
ISSN 2577-8757
Publication year 2017
Published at Institute of Clinical Sciences, Department of Radiation Physics
Language en
Keywords SBRT lung cancer; AAA; Acuros XB; Monte Carlo
Subject categories Cancer and Oncology, Radiological physics


Goal: The overall goal of this study is to present data assisting the implementation of the principle based dose calculation algorithm Acuros XB for Stereotactic Body Radiation Treatments (SBRT) of lung tumors. In particular, the goal is to investigate differences in target dose distributions calculated by the clinical algorithms AAA and Acuros XB as well as by the Monte Carlo method. Materials and Methods: Twenty conventional 3D conformal plans for SBRT of lung cancer were investigated. The prescribed dose was 3 Gy × 22 Gy at the center and 3 Gy × 15 Gy at the periphery of PTV. The plans were originally designed with AAA based on the requirement PTV-V100% (percentage of PTV receiving a dose larger than 100%=45 Gy), to be 100%. Recalculations were performed by utilizing Acuros XB as well as by full Monte Carlo method. Dose variations were evaluated in terms of DVH parameters D5%, D50%, D98% for GTV and PTV as well as PTV-V100%. Five plans showing large algorithm sensitivity in terms of PTV-V100% were re-planned by Acuros XB using the same treatment planning criteria. Results: AAA systematically overestimated the PTV dose compared to Acuros XB and Monte Carlo. Differences between AAA and Acuros XB of up to 8%, 10% and 5% were observed for PTV-D50%, PTV-D98% and PTV-V100%, correspondingly. The values obtained by the Monte Carlo method were up to 7% lower than these for Acuros XB. The variations in the PTV dose estimation could not be related to patient/plan characteristics like target volume, lung tissue volume included in the target or tumor proximity to the lung wall. The variations in the GTV parameters were smaller and the agreement between AAA and AXB as well as between Acuros XB and Monte Carlo was within 3%. Planning with Acuros XB increased the volume of the lung tissue close to the tumor receiving full dose by more than 20%. Conclusion: PTV dose coverage was overestimated in plans calculated by AAA. Transition to Acuros XB without changing the treatment planning criteria increased the dose to the lung tissue close to the tumor. The GTV dose coverage was more robust with respect to the algorithm changes.

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