Assessment of Imprecise Small Photon Beam Modeling by Two Treatment Planning System Algorithms

BACKGROUND: Dosimetric accuracy in intensity-modulated radiation therapy (IMRT) is the main part of quality assurance program. Improper beam modeling of small fields by treatment planning system (TPS) can lead to inaccuracy in treatment delivery. This study aimed to evaluate of the dose delivery accuracy at small segments of IMRT technique using two-dimensional (2D) array as well as evaluate the capability of two TPSs algorithm in modeling of small fields. METHODS: Irradiation were performed using 6 MV photon beam of Siemens Artiste linear accelerator. Dosimetric behaviors of two dose calculation algorithms, namely, collapsed cone convolution/superposition (CCCS) and full scatter convolution (FSC) in small segments of IMRT plans were analyzed using a 2D diode array and gamma evaluation. RESULTS: Comparisons of measurements against TPSs calculations showed that percentage difference of output factors of small fields were 2% and 15% for CCCS and FSC algorithm, respectively. Gamma analysis of calculated dose distributions by TPSs against those measured by 2D array showed that in passing criteria of 3 mm/3%, the mean pass rate for all segment sizes is higher than 95% except for segment sizes below 3 cm × 3 cm optimized by TiGRT TPS. CONCLUSIONS: High pass rate of gamma index (95%) achieved in planned small segments by Prowess relative to results obtained with TiGRT. This study showed that the accuracy of small field modeling differs between two dose calculation algorithms.