Journal of Radiation Oncology

, Volume 8, Issue 3, pp 337–347 | Cite as

Dosimetric evaluation of the dose calculation accuracy of different algorithms for two different treatment techniques during whole breast irradiation

  • Hilal AcarEmail author
  • Ayse Yildirim Altinok
  • Mehmet Sıddık Cebe
Original Research



In-field, partially in-field, and out-of-field organ doses calculated by the Acuros XB (AXB) and analytical anisotropic algorithm (AAA) were compared with experimentally measured data for two different techniques of whole breast radiotherapy (WBRT).


The field-in-field conformal radiotherapy (FIF) and intensity-modulated radiation therapy (IMRT) plans were calculated by AAA and dose-to-water (Dw) and dose-to-medium (Dm) options used by AXB. In field (planning target volume (PTV)), partially in-field (ipsilateral lung, heart, left ascending coronary artery (LAD)), and out-of-field (contralateral lung and contralateral breast) organ at risk (OAR) doses were measured using thermoluminescent dosimeters (TLDs) and EBT3 films in an anthropomorphic phantom. Furthermore, target dose differences between AAA and AXB were analyzed for the corresponding real patients.


For the verification of planar dose distribution in PTV, the percentages of pixels that passed the gamma analysis with the ± 3%/3mm criteria were 93.5%, 93.9%, and 99.0% for AAA, AXB_Dm, and AXB_Dw, respectively, averaged over all IMRT and FIF plans. For the verification of point doses within the target using TLD in the randophantom, the max percentage deviations between the calculated and measured data when averaged over all IMRT and FIF plans were 6.8%, 4.7%, and 3.9% for AAA, AXB_Dm, and AXB_Dw, respectively.


When using the Eclipse TPS for breast cancer, AXB should be used instead of the AAA algorithm, bearing in mind that the AXB may still overestimate all OARs doses.





There is no funding for this study.

Compliance wıth ethical standards

Conflict of interest

None of the authors has conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Tillikainen L, Helminen H, Torsti T, Siljamäki S, Alakuijala J, Pyyry J et al (2008) A 3D pencil-beam-based superposition algorithm for photon dose calculation in heterogeneous media. Phys Med Biol 53:3821–3839CrossRefGoogle Scholar
  2. 2.
    Vassiliev ON, Wareing T, McMhee J, Failla G, Salehpour M, Mourtada F (2010) Validation of a new grid based Boltzmann equation solver for dose calculation in radiotherapy with photon beams. Phys. Med. Biol. 55:581–598CrossRefGoogle Scholar
  3. 3.
    Fogliata A, Nicolini G, Clivio A, Vanetti E, Mancosu P, Cozzi L (2011) Dosimetric validation of the Acuros XB advanced dose calculation algorithm: fundamental characterization in water. Phys. Med. Biol. 56:1879–1904CrossRefGoogle Scholar
  4. 4.
    Siebers V, Keall PJ, Nahum AE, Mohan R (2000) Converting absorbed dose to medium to absorbed dose to water for Monte Carlo based photon beam dose calculations. Phys. Med. Biol. 45:983–995CrossRefGoogle Scholar
  5. 5.
    International Atomic Energy Agency (2004) Commissioning and quality assurance of computerized planning systems for radiation treatment of cancer. TRS Report Number 430. Vienna, AustriaGoogle Scholar
  6. 6.
    Sievinen J, Ulmer W, Kaissl W (2005) AAA photon dose calculation model in Eclipse. RAD #7170B:Varian Medical SystemsGoogle Scholar
  7. 7.
    Fraass B, Doppke K, Hunt M, Kutcher G, Starkschall G, Stern R et al (1998) AAPM TG 53: quality assurance for clinical radiotherapy treatment planning. Med. Phys. 25(10):1773–1829CrossRefGoogle Scholar
  8. 8.
    Varian Medical Systems I (2008) Eclipse algorithms reference guide, version 86; Varian Medical SystemsGoogle Scholar
  9. 9.
    Basran PS, Zavgorodni S, Berrang T, Olivotto IA, Beckham W (2010) The impact of dose calculation algorithms on partial and whole breast radiation treatment plans. Radiation Oncology. 5:120–132CrossRefGoogle Scholar
  10. 10.
    Kan MW, Leung LH, So RW, Yu PK (2013) Experimental verification of the Acuros XB and AAA dose calculation adjacent to heterogeneous media for IMRT and RapidArc of nasopharygeal carcinoma. Med Phys. 40:031714CrossRefGoogle Scholar
  11. 11.
    Guebert A, Conroy L, Weppler S et al (2018) Clinical implementation of AXB from AAA for breast: plan quality and subvolume analysis. J Appl Clin Med Phys 19(3):243–250CrossRefGoogle Scholar
  12. 12.
    Rana S, Pokharel S (2014) Dose-to-medium vs. dose-to-water: dosimetric evaluation of dose reporting modes in Acuros XB for prostate, lung and breast cancer. Int J Cancer Ther Oncol 2(4):020421CrossRefGoogle Scholar
  13. 13.
    Lonski P, Taylor ML, Hackworth W et al (2014) In vivo verification of radiation dose delivered to healthy tissue during radiotherapy for breast cancer. J Phys Conf Ser 489:012015CrossRefGoogle Scholar
  14. 14.
    Zifodya JM, Challens CH, Hsieh WL (2016) From AAA to Acuros XB-clinical implications of selecting either Acuros XB dose-to-water or dose-to-medium. Australas Phys Eng Sci Med. 39(2):431–439CrossRefGoogle Scholar
  15. 15.
    Papanikolaou N, Battista JJ, Pooger AL et al (2004) Tissue inhomogeneity corrections for megavoltage photon beams. AAPM report no. 85. Medical Physics Publishing, Madison, pp 1–135Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medicine Faculty, Department of Radiation OncologyIstanbul Medipol UniversityIstanbulTurkey

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