The effect of algorithms on dose distribution in inhomogeneous phantom: Monaco treatment planning system versus monte carlo simulation

Background: The aim of this study is to evaluate the dose calculation algorithms commonly used in TPS by using MC simulation in the highly different inhomogeneous region and in the small fields and to provide the following uniquely new information in the study of correction algorithm. Materials and Methods: We compared the dose distribution obtained by Monaco TPS for small fields. Results: When we examine lung medium, for four different fields, we can see that the algorithms begin to differ. In both the lung and bone environment, the percentage differences decrease as the field size increases. In areas less than or equal to 3x3 cm2, there are serious differences between the algorithms. The CC algorithm calculates a low dose value as the photon passes from the lung environment to water environment. We can also see that this algorithm measures a low dose value in voxel as the photon passes from the water medium to the bone medium. In the transition from the water environment to the bone environment or from the bone environment to the water environment, the results of the CC algorithm are not close to MC simulation. Conclusion: The effect of the algorithms used in TPS on dose distribution is very strong, especially in environment with high electron density variation and in applications such as Stereotactic Body Radiotherapy and Intensity Modulated Radiotherapy where small fields are used.