Dosimetric comparison of Acuros XB, AAA, and XVMC in stereotactic body radiotherapy for lung cancer

Tsuruta, Yusuke; Nakata, Manabu; Nakamura, Mitsuhiro; Matsuo, Yukinori; Higashimura, Kyoji; Monzen, Hajime; Mizowaki, Takashi; Hiraoka, Masahiro

doi:10.1118/1.4890592

Cited by 71 publications

(69 citation statements)

References 19 publications

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“…In all cases, AXB exhibited closer agreement with MC calculations than AAA and the differences were generally less than 5%. The results of these studies support the hypothesis that AXB produces more accurate dose calculations in heterogeneous materials and has led to follow‐up clinical application studies into the implications of using AXB in lung treatment planning 13, 15, 16, 17, 18. The irradiation volume in whole breast radiotherapy is quite inhomogeneous with severe contour changes.…”

Section: Discussionsupporting

confidence: 61%

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis

Guebert

Conroy

Weppler

et al. 2018

J Applied Clin Med Phys

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PurposeTwo dose calculation algorithms are available in Varian Eclipse software: Anisotropic Analytical Algorithm (AAA) and Acuros External Beam (AXB). Many Varian Eclipse‐based centers have access to AXB; however, a thorough understanding of how it will affect plan characteristics and, subsequently, clinical practice is necessary prior to implementation. We characterized the difference in breast plan quality between AXB and AAA for dissemination to clinicians during implementation.MethodsLocoregional irradiation plans were created with AAA for 30 breast cancer patients with a prescription dose of 50 Gy to the breast and 45 Gy to the regional node, in 25 fractions. The internal mammary chain (IMCCTV) nodes were covered by 80% of the breast dose. AXB, both dose‐to‐water and dose‐to‐medium reporting, was used to recalculate plans while maintaining constant monitor units. Target coverage and organ‐at‐risk doses were compared between the two algorithms using dose–volume parameters. An analysis to assess location‐specific changes was performed by dividing the breast into nine subvolumes in the superior–inferior and left–right directions.ResultsThere were minimal differences found between the AXB and AAA calculated plans. The median difference between AXB and AAA for breastCTV V 95%, was <2.5%. For IMCCTV, the median differences V 95%, and V 80% were <5% and 0%, respectively; indicating IMCCTV coverage only decreased when marginally covered. Mean superficial dose increased by a median of 3.2 Gy. In the subvolume analysis, the medial subvolumes were “hotter” when recalculated with AXB and the lateral subvolumes “cooler” with AXB; however, all differences were within 2 Gy.ConclusionWe observed minimal difference in magnitude and spatial distribution of dose when comparing the two algorithms. The largest observable differences occurred in superficial dose regions. Therefore, clinical implementation of AXB from AAA for breast radiotherapy is not expected to result in changes in clinical practice for prescribing or planning breast radiotherapy.

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Section: Discussionsupporting

confidence: 61%

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis

Guebert

Conroy

Weppler

et al. 2018

J Applied Clin Med Phys

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“…The Acuros XB algorithm, a numerical method based on linear Boltzmann transport equation solver, is also available in the Eclipse TPS. The algorithm has been compared to the AAA in numerous studies, and demonstrated that it has better agreement with full MC simulation in slab phantoms containing various materials 49 , 50 . Rana et al (51) reported the dose calculation using the Acuros XB had better agreement with the measurement than using the AAA in the inhomogeneous phantoms.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of a novel treatment system for linear accelerator–based stereotactic radiosurgery

Song

Chin-Snyder

et al. 2015

J Applied Clin Med Phys

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The purpose of this study is to characterize the dosimetric properties and accuracy of a novel treatment platform (Edge radiosurgery system) for localizing and treating patients with frameless, image‐guided stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT). Initial measurements of various components of the system, such as a comprehensive assessment of the dosimetric properties of the flattening filter‐free (FFF) beams for both high definition (HD120) MLC and conical cone‐based treatment, positioning accuracy and beam attenuation of a six degree of freedom (6DoF) couch, treatment head leakage test, and integrated end‐to‐end accuracy tests, have been performed. The end‐to‐end test of the system was performed by CT imaging a phantom and registering hidden targets on the treatment couch to determine the localization accuracy of the optical surface monitoring system (OSMS), cone‐beam CT (CBCT), and MV imaging systems, as well as the radiation isocenter targeting accuracy. The deviations between the percent depth‐dose curves acquired on the new linac‐based system (Edge), and the previously published machine with FFF beams (TrueBeam) beyond Dmax were within 1.0% for both energies. The maximum deviation of output factors between the Edge and TrueBeam was 1.6%. The optimized dosimetric leaf gap values, which were fitted using Eclipse dose calculations and measurements based on representative spine radiosurgery plans, were 0.700 mm and 1.000 mm, respectively. For the conical cones, 6X FFF has sharper penumbra ranging from 1.2−1.8 mm (80%‐20%) and 1.9−3.8 mm (90%‐10%) relative to 10X FFF, which has 1.2−2.2 mm and 2.3−5.1 mm, respectively. The relative attenuation measurements of the couch for PA, PA (rails‐in), oblique, oblique (rails‐out), oblique (rails‐in) were: −2.0%, −2.5%, −15.6%, −2.5%, −5.0% for 6X FFF and −1.4%, −1.5%, −12.2%, −2.5%, −5.0% for 10X FFF, respectively, with a slight decrease in attenuation versus field size. The systematic deviation between the OSMS and CBCT was −0.4±0.2 mm, 0.1±0.3 mm, and 0.0±0.1 mm in the vertical, longitudinal, and lateral directions. The mean values and standard deviations of the average deviation and maximum deviation of the daily Winston‐Lutz tests over three months are 0.20±0.03 mm and 0.66±0.18 mm, respectively. Initial testing of this novel system demonstrates the technology to be highly accurate and suitable for frameless, linac‐based SRS and SBRT treatment.PACS number: 87.56.J‐

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“…Fogliata et al reported that up to 2% of dose deviation from AAA with high energy beams. 57 Tsuruta et al 58 found that AXB yielded more accurate dose calculations that were closer to those with Monte Carlo than did AAA in lung SBRT cases. Our previous research also indicated that dose difference between AXB and AAA in lung and tumour regions was different.…”

Section: Discussionmentioning

confidence: 99%

Optimizing the flattening filter free beam selection in RapidArc®-based stereotactic body radiotherapy for Stage I lung cancer

Jy¹,

Lin²,

Px³

et al. 2015

BJR

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Jia-Yang Lu and Zhu Lin contributed equally to this work.Objective: To optimize the flattening filter-free (FFF) beam selection in stereotactic body radiotherapy (SBRT) treatment for Stage I lung cancer in different fraction schemes. Methods: Treatment plans from 12 patients suffering from Stage I lung cancer were designed using the 6XFFF and 10XFFF beams in different fraction schemes of 4 3 12, 3 3 18 and 1 3 34 Gy. Plans were evaluated mainly in terms of organs at risk (OARs) sparing, normal tissue complication probability (NTCP) estimation and treatment efficiency.Results: Compared with the 10XFFF beam, 6XFFF beam showed statistically significant lower dose to all the OARs investigated. The percentage of NTCP reduction for both lung and chest wall was about 10% in the fraction schemes of 4 3 12 and 3 3 18 Gy, whereas only 7.4% and 2.6% was obtained in the 1 3 34 Gy scheme. For oesophagus, heart and spinal cord, the reduction was greater with the 6XFFF beam, but their absolute estimates were ,10 26 %. The mean beam-on time for 6XFFF and 10XFFF beams at 4 3 12, 3 3 18 and 1 3 34 Gy schemes were 2.2 6 0.2 vs 1.5 6 0.1, 3.3 6 0.9 vs 2.0 6 0.5 and 6.3 6 0.9 vs 3.5 6 0.4 min, respectively. Conclusion: The 6XFFF beam obtains better OARs sparing and lower incidence of NTCP in SBRT treatment of Stage I lung cancer, whereas the 10XFFF beam improves the treatment efficiency. To balance the OARs sparing and intrafractional variation owing to the prolonged treatment time, the authors recommend using the 6XFFF beam in the 4 3 12 and 3 3 18 Gy schemes but the 10XFFF beam in the 1 3 34 Gy scheme. Advances in knowledge: This study optimizes the FFF beam selection in different fraction schemes in SBRT treatment of Stage I lung cancer. INTRODUCTIONLung cancer is the first and second leading cause of cancer death both in males and females, respectively, accounting for 13% of the total cases and 18% of deaths in 2008.

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Dosimetric comparison of Acuros XB, AAA, and XVMC in stereotactic body radiotherapy for lung cancer

Cited by 71 publications

References 19 publications

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis

Clinical implementation of AXB from AAA for breast: Plan quality and subvolume analysis

Characteristics of a novel treatment system for linear accelerator–based stereotactic radiosurgery

Optimizing the flattening filter free beam selection in RapidArc®-based stereotactic body radiotherapy for Stage I lung cancer

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