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      Dosimetric evaluation of a pencil-beam algorithm for electrons employing a two-dimensional heterogeneity correction.

      International Journal of Radiation Oncology, Biology, Physics
      Carcinoma, Squamous Cell, radiography, Computers, Electrons, Humans, Mathematics, Models, Structural, Mouth Neoplasms, Nose Neoplasms, Radiation Monitoring, methods, Thermoluminescent Dosimetry, Tissue Distribution, Tomography, X-Ray Computed, Water

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          Abstract

          The accuracy of a pencil-beam algorithm for electrons employing a two-dimensional heterogeneity correction is demonstrated by comparing calculation with measurement. Ionization measurements have been made in a water phantom for a variety of non-standard geometries. Geometries to demonstrate the effect of an extended treatment distance, a sloping skin surface, and an irregular skin surface have been selected. Additionally, thermoluminescent dosimeters have been used to measure distributions in tissue-substitute phantoms, which were designed from individual patient computerized tomographic scans. Three patient scans have been selected: (1) diffuse hystiocytic lymphoma of the left buccal mucosa and retromolar trigone; (2) squamous cell carcinoma of the nose at the columnella ; and (3) carcinoma of the maxillary antrum. Results demonstrate the algorithm's ability to simultaneously account for the isodose shifting as a result of internal heterogeneities and for sidescatter non-equilibrium caused by lateral discontinuities of the skin surface and internal anatomy. The algorithm is shown to generally be accurate to within +/- 4% in the treatment volume or +/- 4 mm in regions of sharp dose gradients as found in the penumbra and distal edge of the beam. Examples of greater disagreement are shown and their physical interpretation discussed.

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