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Dose calculation issues ‚in practice‘:

Dose calculation in presence of CT artifacts

typical cases in RT: dental

metal implants, hip implants

significant dose calculation

errors possible in soft tissue

artifact regions due to wrong

Hounsfield (CT-) values

Hounsfield values of metal

structures itself wrong as well

AND usually dose calculation

ESTRO IMRT course 2016

Dose Calculation in Static and Rotational IMRT

London April 7th, 2016

-62-

algorithms do not model

radiation transport through

metal correctly

do not trust your dose ‘behind’

metal structures!

if possible (hip implants), try

to avoid beam directions passing

metal structures

further reading e.g. Kim et al. 2006 (Radiother. Oncol. 79(2))

pragmatic approach in

our department:

dummy contours,

density override with

water density