Dosimetric evaluation of Acuros XB Advanced Dose Calculation algorithm in heterogeneous media

Background: A study was realised to evaluate and determine relative figures of merit of a new algorithm for photon dose calculation when applied to inhomogeneous media. Methods: The new Acuros XB algorithm implemented in the Varian Eclipse treatment planning system was compared against a Monte Carlo method (VMC++), and the Analytical Anisotropic Algorithm (AAA). The study was carried out in virtual phantoms characterized by simple geometrical structures. An insert of different material and density was included in a phantom built of skeletal-muscle and HU = 0 (setting A): Normal Lung (lung, 0.198 g/cm(3)); Light Lung (lung, 0.035 g/cm(3)); Bone (bone, 1.798 g/cm(3)); another phantom (setting B) was built of adipose material and including thin layers of bone (1.85 g/cm(3)), adipose (0.92 g/cm(3)), cartilage (1.4745 g/cm(3)), air (0.0012 g/cm(3)). Investigations were performed for 6 and 15 MV photon beams, and for a large (13 x 13 cm(2)) and a small (2.8 x 13 cm(2)) field. Results: Results are provided in terms of depth dose curves, transverse profiles and Gamma analysis (3 mm/3% and 2 mm/2% distance to agreement/dose difference criteria) in planes parallel to the beam central axis; Monte Carlo simulations were assumed as reference. Acuros XB gave an average gamma agreement, with a 3 mm/3% criteria, of 100%, 86% and 100% for Normal Lung, Light Lung and Bone settings, respectively, and dose to medium calculations. The same figures were 86%, 11% and 100% for AAA, where only dose rescaled to water calculations are possible. Conclusions: In conclusion, Acuros XB algorithm provides a valid and accurate alternative to Monte Carlo calculations for heterogeneity management.