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Dosimetric comparison and validation of Eclipse anisotropic analytical algorithm (AAA) and AcurosXB (AXB) algorithms in RapidArc-based radiosurgery plans of patients with solitary brain metastasis

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MEDICAL DOSIMETRY 2022年第1期47卷 E7-E12页

作者： Menon, Sharika Venugopal Raghukumar, P. Bhasi, Saju Gopalakrishnan, Zhenia Sarin, B. Shilpa, K. Nair, Raghuram K. Reg Canc Ctr Div Radiat Phys Thiruvananthapuram 695011 Kerala India Bharathiar Univ Ctr Res & Evaluat Coimbatore Tamil Nadu India SUT Royal Hosp Thiruvananthapuram Kerala India

Stereotactic radiosurgery (SRS) is increasingly being used to manage solitary or multiple brain metastasis. This study aims to compare and validate anisotropic analytical algorithm (AAA) and AcurosXB (AXB) algorithms of Eclipse Treatment Planning System (TPS) in RapidArc-based SRS plans of patients with solitary brain metastasis. Twenty patients with solitary brain metastasis who have been already treated with RapidArc SRS plans calculated using AAA plans were selected for this study. These plans were recalculated using AXB algorithm keeping the same arc orientations, multi-leaf collimator apertures, and monitor units. The two algorithms were compared for target coverage parameters, isodose volumes, plan quality metrics, dose to organs at risk and integral dose. The dose calculated by the TPS using AAA and AXB algorithms was validated against measured dose for all patient plans using an in-house developed cylindrical phantom. An Exradin AI4SL ionization chamber was positioned at the center of this phantom to measure the in-field dose. NanoDot Optically Stimulated Luminescent Dosimeters (OSLDs) (Landauer Inc.) were placed at distances 3.0 cm, 4.0 cm, 5.0 cm, and 6.0 cm respectively from the center of the phantom to measure the non-target dose. In addition, the planar dose distribution was measured using amorphous silicon a51000 Electronic Portal Imaging Device. The measured 2D dose distribution was compared against AAA and AXB estimated 2D distribution using gamma analysis. All results were tested for significance using the paired t-test at 5% level of significance. Significant differences between the AAA and AXB plans were found only for a few parameters analyzed in this study. In the experimental verification using cylindrical phantom, the difference between the AAA calculated dose and the measured dose was found to be highly significant (p < 0.001). However, the difference between the AXB calculated dose and the measured dose was not significant (p = 0.197). The d

关键词： anisotropic analytical algorithm AcurosXB RapidArc Radiosurgery Brain metastasis

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Dosimetric effects of the acuros XB and anisotropic analytical algorithm on volumetric modulated arc therapy planning for prostate cancer using an endorectal balloon

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RADIATION ONCOLOGY 2015年第1期10卷 48-48页

作者： Koo, Taeryool Chung, Jin-Beom Eom, Keun-Yong Seok, Jin-Yong Kim, In-Ah Kim, Jae-Sung Seoul Natl Univ Coll Med Dept Radiat Oncol Seoul 110799 South Korea Seoul Natl Univ Bundang Hosp Dept Radiat Oncol Songnam 463707 South Korea

Background: To compare the dosimetric effects of Acuros XB (AXB) and anisotropic analytical algorithm (AAA) on volumetric modulated arc therapy (VMAT) planning for postoperative prostate cancer patients irradiated using an endorectal balloon (ERB). Methods: We measured central axis doses with film in a phantom containing an air cavity, and compared measurements with calculations of the AAA and AXB. For clinical study, 10 patients who had undergone whole pelvic radiotherapy (WPRT) followed by prostatic bed-only radiotherapy (PBRT) using VMAT were enrolled. An ERB was used for PBRT but not for WPRT. To compare dosimetric parameters, the cumulative dose-volume histograms, mean, maximum, and minimum doses were measured for the planning target volume. Homogeneity of plans were confirmed using V-95%, V-107% (V-X%, percentage volumes receiving at least X% of prescribed doses) and conformity indices (homogeneity index [HI], conformity index [CI], and conformation number [CN]). We compared volumes of the organ-at-risk receiving 10% to 100% (10-tier at 10% interval) of prescribed doses (V-10% - V-100%). Results: In the phantom study, the AAA showed larger disagreement with the measurements, and overestimated the dose in the air cavity, comparing with the AXB. For WPRT planning, the AAA predicted a lower maximum dose and V-107% than the AXB. For PBRT planning, the AAA estimated a higher minimum dose, lower maximum dose, and smaller V-107%, and larger V-95% than the AXB. Regarding the conformity indices, the AAA was estimated to be more homogenous than the AXB for PBRT planning (HI, 0.088 vs. 0.120, p = 0.005;CI, 1.052 vs. 1.038, p = 0.022;and CN, 0.920 vs. 0.900, p = 0.007) but not for WPRT planning. Among V-10% to V-100% of the rectum, the PBRT exhibited significant discrepancies in V-30%, V-40%, V-70%, V-80%, and V-90%;while the WPRT did in V-20% and V-30%. Conclusions: The phantom study demonstrated that the AXB calculates more accurately in the air cavity than the AAA. In

关键词： Acuros XB anisotropic analytical algorithm Endorectal balloon Prostate cancer Volumetric modulated arc therapy

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Dose calculation of Acuros XB and anisotropic analytical algorithm in lung stereotactic body radiotherapy treatment with flattening filter free beams and the potential role of calculation grid size

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RADIATION ONCOLOGY 2015年第1期10卷 53-53页

作者： Huang, Baotian Wu, Lili Lin, Peixian Chen, Chuangzhen Shantou Univ Coll Med Canc Hosp Dept Radiat Oncol Shantou 515031 Peoples R China Shantou Univ Coll Med Affiliated Hosp 2 Dept Nosocomial Infect Management Shantou 515041 Peoples R China

Background: The study aimed to appraise the dose differences between Acuros XB (AXB) and anisotropic analytical algorithm (AAA) in stereotactic body radiotherapy (SBRT) treatment for lung cancer with flattening filter free (FFF) beams. Additionally, the potential role of the calculation grid size (CGS) on the dose differences between the two algorithms was also investigated. Methods: SBRT plans with 6X and 10X FFF beams produced from the CT scan data of 10 patients suffering from stage I lung cancer were enrolled in this study. Clinically acceptable treatment plans with AAA were recalculated using AXB with the same monitor units (MU) and identical multileaf collimator (MLC) settings. Furthermore, different CGS (2.5 mm and 1 mm) in the two algorithms was also employed to investigate their dosimetric impact. Dose to planning target volumes (PTV) and organs at risk (OARs) between the two algorithms were compared. PTV was separated into PTV_soft (density in soft-tissue range) and PTV_lung (density in lung range) for comparison. Results: The dose to PTV_lung predicted by AXB was found to be 1.33 +/- 1.12% (6XFFF beam with 2.5 mm CGS), 2.33 +/- 1.37% (6XFFF beam with 1 mm CGS), 2.81 +/- 2.33% (10XFFF beam with 2.5 mm CGS) and 3.34 +/- 1.76% (10XFFF beam with 1 mm CGS) lower compared with that by AAA, respectively. However, the dose directed to PTV_soft was comparable. For OARs, AXB predicted a slightly lower dose to the aorta, chest wall, spinal cord and esophagus, regardless of whether the 6XFFF or 10XFFF beam was utilized. Exceptionally, dose to the ipsilateral lung was significantly higher with AXB. Conclusions: AXB principally predicts lower dose to PTV_lung compared to AAA and the CGS contributes to the relative dose difference between the two algorithms.

关键词： Dose difference Acuros XB anisotropic analytical algorithm Stereotactic body radiotherapy Calculation grid size

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Critical appraisal of the accuracy of Acuros-XB and anisotropic analytical algorithm compared to measurement and calculations with the compass system in the delivery of RapidArc clinical plans

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RADIATION ONCOLOGY 2013年第2013期8卷 1-9页

作者： Kathirvel, Murugesan Subramanian, Shanmuga Clivio, Alessandro Arun, Gandhi Fogliata, Antonella Nicolini, Giorgia Subramani, Vellaiyan Swamy, Shanmugam Thirumalai Vanetti, Eugenio Cozzi, Luca Yashoda Super Special Hosp Hyderabad Andhra Pradesh India Oncol Inst Southern Switzerland Dept Med Phys Bellinzona Switzerland All India Inst Med Sci New Delhi India Bharathiar Univ Res & Dev Ctr Coimbatore Tamil Nadu India Oncol Inst Southern CH-6504 Bellinzona Switzerland

Background: The accuracy of the two dose calculation engines available for RapidArc planning (both released for clinical use) is investigated in comparison to the COMPASS data. Methods: Two dose calculation algorithms (Acuros-XB and anisotropic Analytic algorithm (AAA)) were used to calculate RA plans and compared to calculations with the Collapsed Cone Convolution algorithm (CC) from the COMPASS system (IBA Dosimetry). CC calculations, performed on patient data, are based on experimental fluence measurements with a 2D array of ion chambers mounted on the linac head. The study was conducted on clinical cases treated with RA. Five cases for each of the following groups were included: Brain, Head and Neck, Thorax, Pelvis and stereotactic body radiation therapy for hypo-fractionated treatments with small fields. COMPASS measurements were performed with the iMatrixx-2D array. RapidArc plans were optimized for delivery using 6MV photons from a Clinac-iX (Varian, Palo Alto, USA). Accuracy of the RA calculation was appraised by means of: 1) comparison of Dose Volume histograms (DVH) metrics;2) analysis of differential dose distributions and determination of mean dose differences per organ;3) 3D gamma analysis with distance-to-agreement and dose difference thresholds set to 3%/3 mm or 2%/2 mm for targets, organs at risks and for the volumes encompassed by the 50 and 10% isodoses. Results: For almost all parameters, the better agreement was between Acuros-XB and COMPASS independently from the anatomical site and fractionation. The same result was obtained from the mean dose difference per organ with Acuros-CC average differences below 0.5% while for AAA-CC data, average deviations exceeded 0.5% and in the case of the pelvis 1%. Relevance of observed differences determined with the 3D gamma analysis resulted in a pass rate exceeding 99.5% for Acuros-CC and exceeding 97.5% for AAA-CC. Conclusions: This study demonstrated that i) a good agreement exists between COMPASS-CC calcu

关键词： Acuros-XB anisotropic analytical algorithm RapidArc Compass

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Radiation as an Immune Modulator: Where We Are With Modern Total Body Irradiation

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SEMINARS IN RADIATION ONCOLOGY 2025年第1期35卷 67-86页

作者： Simiele, Eric Dandapani, Savita Han, Chunhui Wong, Jeffrey Hiniker, Susan M. Kovalchuk, Nataliya Stanford Univ Dept Radiat Oncol Stanford CA 94305 USA Univ Alabama Birmingham Dept Radiat Oncol Birmingham AL USA City Hope Natl Med Ctr Dept Radiat Oncol Duarte CA USA

Total body irradiation (TBI) has been an important component of myeloablative and nonmyeloablative conditioning regimens for allogeneic hematopoietic stem cell transplantation (HSCT) for decades. Playing a dual role, both cytotoxic and immuno-suppressive, TBI eliminates residual disease while also impairing the immune system from rejecting the foreign donor cells being transplanted. Unlike chemotherapy, radiotherapy is not hampered by perfusion, diffusion, or the blood-barrier effect and can effectively treat sanctuary sites. However, radiotherapy is subject to radiobiological trade-offs between destroying cancer cells, preserving immune and hematopoietic stem cells, and causing various adverse effects in normal tissue. Optimizing the immuno- suppressive effect of fractionated TBI while sparing normal organs requires careful consideration of total dose, dose per fraction, dose rate, target dose coverage, and dose to organs. Prospective multi-institutional trials are required to elucidate this matter further. However, as various recent surveys across the world indicate, the heterogeneity of 2D TBI practices, inaccurate dose calculation and dosimetry, and differences in reporting across institutions makes conducting these multi-institutional studies of TBI challenging. Technological advancements in radiotherapy planning and delivery are prompting a transition to (VMAT) TBI and helical TomoTherapyTM TBI, which can better spare normal organs and potentially reduce radiotherapy-related toxicities without compromising TBI effectiveness. This review discusses the present developments and outcomes and toxicity for modern TBI techniques as well as total marrow irradiation (TMI), and total marrow and Semin Radiat Oncol 35:67-86 (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： AAA anisotropic analytical algorithm ALL acute lymphoblastic leukemia AML acute myeloblastic leukemia AP/PA anteroposterior-posteroanterior BID twice per day BU busulfan CBCT cone beam computed tomography CML chronic myeloid leukemia CNS central nervous system COG Children's Oncology Group CR1, first complete remission CR2 second complete remission CR3 third complete remission Cy cyclophosphamide DFS disease free survival DVH dose-volume histogram EFS event free survival EPID electronic portal imaging detector Flu fludarabine FFS feet first supine cGVHD chronic graft versus host disease GVHD graft versus host disease HFS head first supine HSCT hematopoietic stem cell transplantation IC ion chamber IF induction failure IMRT intensity-modulated radiation therapy MDS myelodysplastic syndrome Mel melphalan MF modulation factor MM multiple myeloma MOSFET metal oxide semiconductor field-effect transistor NCT numbers Clinicaltrials.gov identifiers NRM nonrelapse mortality OAR organ at risk OS overall survival OSLD optically stimulated luminescence dosimeter P pitch PFS progression-free survival PR partial response PTCy post-transplant cyclophosphamide PTV planning target volume RT radiotherapy TBI total body irradiation TLD thermo-luminescent dosimeters VMAT volumetric modulated arc therapy TMI total marrow irradiation TMLI total marrow lymphoid irradiation TPS treatment planning system

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Efficacy of flattening filter-free beams with the acuros XB algorithm in thoracic spine stereotactic body radiation therapy

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MEDICAL DOSIMETRY 2024年第3期49卷 232-238页

作者： Tarek, Islam Hafez, Abdelrahman Fathy, Mohamed M. Fahmy, Heba M. Abdelaziz, Dina M. Cairo Univ Fac Sci Dept Biophys Cairo 12613 Egypt Baheya Ctr Early Detect & Treatment Breast Canc Dept Radiotherapy Giza Egypt Cairo Univ NCI Dept Radiotherapy Cairo Egypt

This study aimed to determine the dosimetric value of flattening filter-free (FFF) beams compared to flattening filter (FF) beams using different algorithms in the treatment planning of thoracic spine stereotactic body radiation therapy (SBRT). A total of 120 plans were created for 15 patients using the anisotropic analytical algorithm (AAA) and the Acuros External Beam (AXB) algorithm with FF and FFF beams at 6 MV and 10 MV energies. Various dosimetric parameters were evaluated, including target coverage, dose spillage, and organs-at-risk sparing of the spinal cord and esophagus. Treatment delivery parameters, such as the monitor units (MUs), modulation factors (MFs), beam-on time (BUT), and dose calculation time (DCT), were also collected. Significant differences were observed in the dosimetric parameters when AXB was used for all energies ( P < 0.05). 6 XFFF energy was the best option for target coverage, dose spillage, and organs-at-risk sparing. In contrast, dosimetric parameters had no significant difference when using the AAA. The AAA and AXB calculations showed that the 6 XFFF beam had the shortest DCT. The treatment delivery parameters indicated that 10 XFF beam required the fewest MUs and MFs. In addition, the 10 XFFF beam demonstrated the shortest BUT. For effective treatment of the thoracic spine using SBRT, it is recommended to use the 10 XFFF beam because of the short BUT. Moreover, the AXB algorithm should be used because of its accurate dose calculation in regions with tissue heterogeneity. (c) 2024 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

关键词： Flattening filter free beams Acuros external beam anisotropic analytical algorithm Thoracic spine tumors Stereotactic body radiotherapy

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Dosimetric and Radiobiological Impact of Flattening Filter-Free Beam and Dose Calculation algorithm Using RapidArc Plans for Cervical Cancer Treatment

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PRECISION RADIATION ONCOLOGY 2023年第3期7卷 197-206页

作者： Manna, Sumanta Singh, Sharad Gupta, Pramod Kumar Ragul, T. Kalyan Singh Super Specialty Canc Inst Med Phys Lucknow 226002 Uttar Pradesh India Kalyan Singh Super Specialty Canc Inst Radiat Oncol Lucknow Uttar Pradesh India

PurposeThe aim of this study is to quantify the potential benefits of a flattening filter-free (FFF) beam and implement a dose-computation algorithm for cervical radiotherapy through dosimetric and radiobiological analyses using ***-three patients were enrolled, and four RapidArc plans were created for each patient using a dual-arc flattening filter and 6-MV FFF photon beams for the two calculation algorithms. Homogeneity index (HI), conformity index (CI), target coverage, monitor units (MUs), and organ-at-risk (OAR) dosimetric characteristics were compared between the plans. Radiobiological characteristics and normal tissue complication probability (NTCP) scores were computed for the OAR using different biological *** significant differences were observed in the Dmax, D98%, and CI in the planning target volume (PTV). Both computations estimated a significant difference in V95%, D2%, and HI for the PTV. Furthermore, the FFF beam showed a significant increase in the MUs and a significant reduction in V30% for the femoral heads. The NTCP score showed a significant increase in the late effects on the bladder, rectum, and bowel with FFF *** current study recommends FFF beams for better conformity, comparable dose coverage for the target, and OAR sparing invariable to the dose computation algorithm. The difference in the NTCP score for OAR was minimal with the FFF beam. The impact of a flattening filter-free beam in RadpidArc treatment planning of cervical cancer for two different dose calculation algorithms. We evaluated the treatment plans in terms of different dosimetric parameters of the target and organ at risk and different radiological models used to evaluate endpoint toxicity of the organ at risk. The figures show the isodose colour wash and dose-volume histogram of target and organs at risk planned with FF and FFF beam with different computation algorithms. image

关键词： flattening filter-free flattening filter anisotropic analytical algorithm Acuros XB dosimetric evaluation cervical cancer

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Dose prediction accuracy of anisotropic analytical algorithm and pencil beam convolution algorithm beyond high density heterogeneity interface

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SOUTH ASIAN JOURNAL OF CANCER 2013年第1期2卷 26-30页

作者： Rana, Suresh B. Arizona Ctr Canc Care Dept Radiat Oncol Peoria AZ 85381 USA

Purpose: It is well known that photon beam radiation therapy requires dose calculation algorithms. The objective of this study was to measure and assess the ability of pencil beam convolution (PBC) and anisotropic analytical algorithm (AAA) to predict doses beyond high density heterogeneity. Materials and Methods: An inhomogeneous phantom of five layers was created in Eclipse planning system (version 8.6.15). Each layer of phantom was assigned in terms of water (first or top), air (second), water ( third), bone (fourth), and water (fifth or bottom) medium. Depth doses in water ( bottom medium) were calculated for 100 monitor units (MUs) with 6 Megavoltage (MV) photon beam for different field sizes using AAA and PBC with heterogeneity correction. Combinations of solid water, Poly Vinyl Chloride (PVC), and Styrofoam were then manufactured to mimic phantoms and doses for 100 MUs were acquired with cylindrical ionization chamber at selected depths beyond high density heterogeneity interface. The measured and calculated depth doses were then compared. Results: AAA's values had better agreement with measurements at all measured depths. Dose overestimation by AAA (up to 5.3%) and by PBC (up to 6.7%) was found to be higher in proximity to the high-density heterogeneity interface, and the dose discrepancies were more pronounced for larger field sizes. The errors in dose estimation by AAA and PBC may be due to improper beam modeling of primary beam attenuation or lateral scatter contributions or combination of both in heterogeneous media that include low and high density materials. Conclusions: AAA is more accurate than PBC for dose calculations in treating deep-seated tumor beyond high-density heterogeneity interface.

关键词： anisotropic analytical algorithm dose prediction high density heterogeneity inhomogeneity corrections pencil beam convolution

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Clinical implication in the use of the AAA algorithm versus the AXB in nasopharyngeal carcinomas by comparison of TCP and NTCP values

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RADIATION ONCOLOGY 2020年第1期15卷 150-150页

作者： Bufacchi, Antonella Caspiani, Orietta Rambaldi, Giulia Marmiroli, Luca Giovinazzo, Giuseppe Polsoni, Mattia Amethyst Radioterapia Italia S Giovanni Calibita Fatebenefratelli Hosp Med Phys Dept Rome Italy PIOXI Clin Rome Italy Amethyst Radioterapia Italia S Giovanni Calibita Fatebenefratelli Hosp UOC Radiotherapy Rome Italy Amethyst Radioterapia Italia Rome Italy

Purpose Retrospective analysis of volumetric modulated arc therapy treatment plans to investigate qualitative, possible, clinical consequences of the use of AAA versus AXB in nasopharyngeal cancer (NPC) cases. Methods The dose distribution of 26 treatment plans, produced using RapidArc technique and AAA algorithm, were recalculated using AXB and the same number of monitor units provided by AAA and clinically delivered to each patient. The potential clinical effect of dosimetric differences in the planning target volume (PTV) and in organs at risk (OAR) were evaluated by comparing TCP and NTCP values. The Wilcoxon Signed Rank test was used for statistical comparison of all results obtained from the use of the two algorithms. Results The poorer coverage of the PTV, with higher prescribed dose, was reflected in the TCP, which was significantly lower when AXB was used, the median value was 81.55% (range: 74.90, 88.60%) and 84.10% (range: 77.70, 89.90%) for AAA (p < 0.001). OAR mean dose was lower in the AXB recalculated plan than the AAA plan and the difference was statistically significant for all the structures. The NTCP for developing mandible necrosis showed the largest median percentage difference between AAA and AXB (56.6%), the NTCP of risk for larynx edema of Grade >= 2 followed with 12.2%. Conclusions Differences in dose distribution of NPC treatment plans recalculated with AXB are of clinical significance in those situations where the PTV and OAR involve air or bone, media in which AXB has been shown to more accurately represent the true dose distribution. The availability of AXB algorithm could improve patient dose estimation, increasing the data consistency of clinical trials.

关键词： Dose volume histogram Tumor control probability Normal tissue complication probability anisotropic analytical algorithm Acuros XB algorithm

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Dosimetric impact of switching from AAA to Acuros dose-to-water and dose-to-medium for RapidArc plans of nasopharyngeal carcinomas

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CANCER RADIOTHERAPIE 2020年第8期24卷 842-850页

作者： Sayah, R. Felefly, T. Zouein, L. El Barouky, J. Khater, N. Farah, N. Roukoz, C. El Khoury, C. Azoury, F. Nasr, D. Nehme Nasr, E. St Joseph Univ Dept Radiat Oncol Hotel Dieu de France Univ Hosp Beirut Lebanon St Joseph Univ Dept Radiat Oncol Sch Med Beirut Lebanon St Joseph Univ Phys Dept Fac Sci Beirut Lebanon St Louis Univ Dept Radiat Oncol St Louis MO 63103 USA

Purpose. - This work aims to evaluate the dosimetric consequences of replacing the anisotropic analytical algorithm (AAA) by Acuros XB (AXB), dose-to-water (Dw) or dose-to-medium (Dm), for RapidArc plans of nasopharyngeal carcinomas (NPC). Materials and Methods. - Seventeen NPC plans created with AAA (v15.6) were recalculated with AXB (v15.6) Dw and Dm. The dose-volume parameters to the planning target volumes (PTV) and relevant organs at risk (OAR) were compared. The high dose PTV was divided into bone, air and tissue components and the comparison was performed for each of them. Results. - AXB Dw revealed no significant differences in the PTVs compared to AAA. Lower values were observed to spinal cord, brainstem, oral cavity and parotids (0.5% to 2.3%), and higher values to cochleas (up to 5.4%) and mandible (up to 6.7%). AXB Dm predicted lower values than AAA for all PTVs and OARs (2.0% to 6.1%). For the bone PTV subvolume, AXB Dw and Dm predicted respectively higher (2.4%) and lower (2.2% to 3.4%) values. No significant differences were noted in air. AXB predicted lower values than AAA in soft tissues (0.4% to 1.6%). The largest difference was found to the mandible V-60Gy parameter, with median differences of 6.7% for AXB Dw and -6.0% for AXB Dm. Conclusion. - Significant dose differences are expected when switching from AAA to AXB in NPC cases. The dose prescriptions and the tolerance limits for some OARs, especially those of high density, may need to be adjusted depending on the selected dose calculation algorithm and reporting mode. (C) 2020 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.

关键词： Nasopharyngeal carcinoma anisotropic analytical algorithm Acuros XB

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