Comparative Analysis of Commercial Independent Dose Calculation Systems for Gamma Knife Stereotactic Radiosurgery
Abstract
Purpose: Independent dose calculation is recommended for stereotactic radiosurgery (SRS) quality assurance. This study evaluates the accuracy of three commercial secondary dose calculation software programs-MUCheck, RadCalc, and ClearCalc-against the Elekta Leksell Gamma Plan (LGP) treatment planning system (TPS) for Gamma Knife SRS. Materials and Methods: Dose calculations for 133 patients (239 intracranial targets) planned with the LGP TPS using the TMR10 algorithm were retrospectively analyzed with MUCheck, RadCalc, and ClearCalc. Point dose calculations were compared between each software and LGP. Statistical analysis included analysis of variance (ANOVA) and paired t-tests, with clinical tolerance assessed against the American Association of Physicists in Medicine (AAPM) Task Group (TG)-178 recommendations. Results: Mean differences were 0.34% ± 1.10% (MUCheck), 0.53% ±0.53% (RadCalc), and 0.63% ± 0.16% (ClearCalc). All showed statistically significant differences from LGP but remained within clinical tolerance. Clinical tolerance analysis showed 97.9%, 100%, and 100% of calculations within ±3% for MUCheck, RadCalc, and ClearCalc, respectively. ANOVA revealed significant differences among platforms (F = 10.46, P < 0.001), although all deviations remained clinically acceptable. Conclusion: All three software platforms provide clinically acceptable independent dose verification for Gamma Knife SRS, with deviations well below AAPM TG-178 recommended tolerance levels. Selection of the appropriate secondary dose calculation platform should be based on institutional workflow integration and specific clinical requirements rather than statistical differences alone.
Related
- Stereotactic radiosurgery plan optimization with a human-in-the-loop reasoning large language model agent
- Benchmarking intermediate dose spillage in single target stereotactic radiosurgery for brain metastases.
- Assessment of Calculation Grid Size Impact on Plan Quality and Gamma Evaluation Metrics in Intracranial Stereotactic Radiotherapy
- Independent Three-dimensional Dose Calculation from Log Files for Breast VMAT: A Measurement-free Quality Assurance Approach
- Advances in Stereotactic Body Radiation Therapy: Expanding Clinical Applications and Improving Treatment Precision
BibTeX
@article{lowe2026comparative,
title = {{Comparative Analysis of Commercial Independent Dose Calculation Systems for Gamma Knife Stereotactic Radiosurgery}},
author = {Michael D. Lowe and Jack C. Nelson and Joe Caron and Joel J. St-Aubin and Steven M. Herchko and Deepak K. Shrestha and Sridhar Yaddanapudi},
journal = {Journal of Medical Physics},
year = {2026},
month = jul,
doi = {10.4103/jmp.jmp_3_26},
url = {https://doi.org/10.4103/jmp.jmp_3_26},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Comparative Analysis of Commercial Independent Dose Calculation Systems for Gamma Knife Stereotactic Radiosurgery
AU - Michael D. Lowe
AU - Jack C. Nelson
AU - Joe Caron
AU - Joel J. St-Aubin
AU - Steven M. Herchko
AU - Deepak K. Shrestha
AU - Sridhar Yaddanapudi
PY - 2026
DA - 2026/07/01
JO - Journal of Medical Physics
DO - 10.4103/jmp.jmp_3_26
UR - https://doi.org/10.4103/jmp.jmp_3_26
AB - Purpose: Independent dose calculation is recommended for stereotactic radiosurgery (SRS) quality assurance. This study evaluates the accuracy of three commercial secondary dose calculation software programs-MUCheck, RadCalc, and ClearCalc-against the Elekta Leksell Gamma Plan (LGP) treatment planning system (TPS) for Gamma Knife SRS. Materials and Methods: Dose calculations for 133 patients (239 intracranial targets) planned with the LGP TPS using the TMR10 algorithm were retrospectively analyzed with MUCheck, RadCalc, and ClearCalc. Point dose calculations were compared between each software and LGP. Statistical analysis included analysis of variance (ANOVA) and paired t-tests, with clinical tolerance assessed against the American Association of Physicists in Medicine (AAPM) Task Group (TG)-178 recommendations. Results: Mean differences were 0.34% ± 1.10% (MUCheck), 0.53% ±0.53% (RadCalc), and 0.63% ± 0.16% (ClearCalc). All showed statistically significant differences from LGP but remained within clinical tolerance. Clinical tolerance analysis showed 97.9%, 100%, and 100% of calculations within ±3% for MUCheck, RadCalc, and ClearCalc, respectively. ANOVA revealed significant differences among platforms (F = 10.46, P < 0.001), although all deviations remained clinically acceptable. Conclusion: All three software platforms provide clinically acceptable independent dose verification for Gamma Knife SRS, with deviations well below AAPM TG-178 recommended tolerance levels. Selection of the appropriate secondary dose calculation platform should be based on institutional workflow integration and specific clinical requirements rather than statistical differences alone.
SN - 0971-6203
SN - 1998-3913
ER -