Abstract
BACKGROUND: Inverse planning typically utilizes fast, less accurate dose calculation algorithms during the iterative optimization process, thus leading to dose calculation errors (DCEs) and suboptimal plans that often require dose normalization and/or plan re-optimization. PURPOSE: A graphic processing unit (GPU) accelerated Fourier transform dose calculation (FTDC) was recently commissioned at our institution during the Eclipse treatment planning system (Varian Medical Systems) v18.0 upgrade. We hypothesize that FTDC could reduce DCEs and planning failure rates (PFRs) compared to its predecessor, multi-resolution dose calculation (MRDC), while improving efficiency through utilization of GPUs. METHODS: Fifty lung SBRT plans were optimized with MRDC and FTDC dose calculation algorithms. Acuros XB (AXB) was then used for final dose calculations. DCEs for target and organ-at-risk (OAR) were calculated as the percent difference between AXB and dose calculated at the final optimization step. Plan quality was assessed using an in-house planning scorecard where PFRs were calculated as the percentage of plans that had a plan score less than 90% with optimal plans scored at 100%. RESULTS: FTDC showed excellent agreement with AXB in terms of planning target volume (PTV) coverage, as PTV D95% DCE(FTDC) averaged 0.8% ± 0.9%, compared to DCE(MRDC)'s -2.5% ± 3.2%. DCEs for thoracic OARs were reduced with less variation when optimizing with FTDC as compared to MRDC. FTDC had a PFR of 10% (5 out of 50) versus MRDC's 32% (16 out of 50). The subsequent re-optimization rate resulted from a plan normalization of 3% or greater was 4% for FTDC compared to MRDC's 38%. FTDC with GPU acceleration reduced optimization time by 75% on average compared to MRDC without GPU acceleration. CONCLUSIONS: FTDC shows more accurate dose calculation accuracy compared to MRDC. Its use during the optimization process improved planning quality and efficiency assisted with GPUs.