At our facility we have Eclipse treatment planning software.

After speaking to our physicists,

they explained that we use an Analytical Anisotropic Algorithm (AAA) at our clinic for photon
beams. This is a model-based algorithm. When our machine was commissioned our physicists
took measurements of beam output at various depths and fields sizes, to obtain beam profile and
symmetry information as well as necessary information such as the percent depth dose (PDD) for
all field sizes and energies. This information is used in each calculation to determine monitor
units. One drawback to this algorithm is that it looks at heterogeneity as “partial water” for
example 4 cm of .25 density lung would be viewed as 1 cm of water. This causes a dose
variation of around 3-5% at air tissue interfaces within the body compared to Monte Carlo
algorithms; however, the AAA is very comparable in all other aspects and is much faster at
performing calculations, which makes it more practical for use in the clinic.
For electron beams, we use Monte Carlo. This algorithm simulates how all particles interact
from the time of origination to reaching the patient. This results in a more accurate dose
calculation because it takes into account dose as a result of interactions with the jaws, detectors,
the mirror, mylar, multi leaf collimators (MLC’s), etc. The probability of these interactions
happening as a result of the beam energy and field size chosen is also figured into this
calculation. With the Monte Carlo algorithm, all density is seen as it truly is, not as “partial
water” as in the AAA. This true depiction of density provides for a more accurate dose
calculation at air tissue interfaces, making this algorithm superior in this aspect. However, one
drawback to the Monte Carlo algorithm is the amount of time it takes to calculate beam data due
to the many different factors it takes into account.
One question I have when discussing this topic is how, with the advances in technology and
computing speed that have been made, does it still take so long to calculate beam data for the
Monte Carlo algorithm?