Tolerances for the accuracy of photon beam dose calculations of treatment planning systems

Background and purpose: To design a consistent set of criteria for acceptability of photon beam dose calculations of treatment planning systems. The set should be applicable in combination with a test package used for evaluation of a treatment planning system, such as the ones proposed by the AAPM Task Group 23 or by the Netherlands Commission on Radiation Dosimetry. Results: Tolerances have been defined for the accuracy with which a treatment planning system should be able to calculate the dose in different parts of a photon beam: the central beam axis and regions with large and small dose gradients. For increasing complexity of the geometry, wider tolerances are allowed, varying between 2 and 5%. For the evaluation of a large number of data points an additional quantity, the confidence limit, has been introduced, which combines the influence of systematic and random deviations. The proposed tolerances have been compared with other recommendations for a number of clinically relevant examples, showing considerable differences, which are partly due to the way the complexity of the geometry is taken into account. Furthermore differences occur if criteria for acceptability of dose calculations are related either to the local dose value or to a normalized dose value. Conclusions: Although it is acknowledged that the general aim must be to have good agreement between dose calculation and the actual dose value, e.g. within 2% or 2 mm, current day algorithms and their implementation into commercial treatment planning systems result often in larger deviations. A high accuracy can at present only be achieved in relatively simple cases. The new set of tolerances and the quantity confidence limit have proven to be useful tools for the acceptance of photon beam dose calculation algorithms of treatment planning systems. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.