In radiotherapy treatment planning, convolution/superposition algorithms currently represent the best practical approach for accurate photon dose calculation in heterogeneous tissues. In this work, the implementation, accuracy and performance of the FFT convolution (FFTC) and multigrid superposition (MGS) algorithms are presented. The FFTC and MGS models use the same 'TERMA' calculation and are commissioned using the same parameters. Both models use the same spectra, incorporate the same off-axis softening and base incident lateral fluence on the same measurements. In addition, corrections are explicitly applied to the polyenergetic and parallel kernel approximations, and electron contamination is modelled. Spectra generated by Monte Carlo (MC) modelling of treatment heads are used. Calculations using the MC spectra were in excellent agreement with measurements for many linear accelerator types. To speed up the calculations, a number of calculation techniques were implemented, including separate primary and scatter dose calculation, the FFT technique which assumes kernel invariance for the convolution calculation and a multigrid (MG) acceleration technique for the superposition calculation. Timing results show that the FFTC model is faster than MGS by a factor of 4 and 8 for small and large field sizes, respectively. Comparisons with measured data and BEAM MC results for a wide range of clinical beam setups show that (a) FFTC and MGS doses match measurements to better than 2% or 2 mm in homogeneous media; (b) MGS is more accurate than FFTC in lung phantoms where MGS doses are within 3% or 3 mm of BEAM results and (c) FFTC overestimates the dose in lung by a maximum of 9% compared to BEAM.

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Therapeutic treatment plan evaluation is often based on examining the radiotherapy treatment planning (RTP) system dose distributions in the target and surrounding normal structures. To study the effects of tissue inhomogeneities on photon dose distributions, we compared FOCUS RTP system dose distributions from the measurement‐based Clarkson and model‐based MultiGrid Superposition (MGS) algorithms with those from the beam Monte Carlo code system in a set of heterogeneous phantoms. The phantom inhomogeneities mimic relevant clinical treatment sites, which include lung slab, lung‐bone slab, bone‐lung slab, mediastinum, and tumor geometries. The benchmark comparisons were performed in lung densities of 0.20 and 0.31normalg/cm3, and a bone density of 2.40normalg/cm3 for 5×5cm2 and 10×10cm2,6− and 15‐MV photon beams. Benchmark comparison results show that the MGS model and beam doses match better than 3% or 3 mm, and the MGS model is more accurate than the Clarkson model in all phantoms. The MGS model, unlike the Clarkson model, predicts the build‐down and build‐up of dose near tissue interfaces and penumbra broadening in lung associated with high energy beams. The Clarkson model overestimates the dose in lung by a maximum of 10% compared to beam. Dose comparisons suggest turning‐off the effective path length inhomogeneity correction in the Clarkson model for lung treatments.PACS number(s): 87.53.–j, 87.53.Bn