Dosimetric comparison of Acuros XB deterministic radiation transport method with Monte Carlo and model-based convolution methods in heterogeneous media

Purpose: The deterministic Acuros XB (AXB) algorithm was recently implemented in the Eclipse treatment planning system. The goal of this study was to compare AXB performance to Monte Carlo (MC) and two standard clinical convolution methods: the anisotropic analytical algorithm (AAA) and the collapsed-cone convolution (CCC) method. Methods: Homogeneous water and multilayer slab virtual phantoms were used for this study. The multilayer slab phantom had three different materials, representing soft tissue, bone, and lung. Depth dose and lateral dose profiles from AXB v10 in Eclipse were compared to AAA v10 in Eclipse, CCC in Pinnacle³, and EGSnrc MC simulations for 6 and 18 MV photon beams with open fields for both phantoms. In order to further reveal the dosimetric differences between AXB and AAA or CCC, three-dimensional (3D) gamma index analyses were conducted in slab regions and subregions defined by AAPM Task Group 53. Results: The AXB calculations were found to be closer to MC than both AAA and CCC for all the investigated plans, especially in bone and lung regions. The average differences of depth dose profiles between MC and AXB, AAA, or CCC was within 1.1, 4.4, and 2.2, respectively, for all fields and energies. More specifically, those differences in bone region were up to 1.1, 6.4, and 1.6; in lung region were up to 0.9, 11.6, and 4.5 for AXB, AAA, and CCC, respectively. AXB was also found to have better dose predictions than AAA and CCC at the tissue interfaces where backscatter occurs. 3D gamma index analyses (percent of dose voxels passing a 2/2 mm criterion) showed that the dose differences between AAA and AXB are significant (under 60 passed) in the bone region for all field sizes of 6 MV and in the lung region for most of field sizes of both energies. The difference between AXB and CCC was generally small (over 90 passed) except in the lung region for 18 MV 10 10 cm² fields (over 26 passed) and in the bone region for 5 5 and 10 10 cm² fields (over 64 passed). With the criterion relaxed to 5/2 mm, the pass rates were over 90 for both AAA and CCC relative to AXB for all energies and fields, with the exception of AAA 18 MV 2.5 2.5 cm² field, which still did not pass. Conclusions: In heterogeneous media, AXB dose prediction ability appears to be comparable to MC and superior to current clinical convolution methods. The dose differences between AXB and AAA or CCC are mainly in the bone, lung, and interface regions. The spatial distributions of these differences depend on the field sizes and energies.