Algorithms Since the use of computers has become more common in treatment planning for radiation therapy, algorithms

have been developed that make the dose calculations much easier, faster and more accurate. There are many different types of algorithms, designed to model the behavior of a beam of electron or photon radiation or to model the way tissue heterogeneities cause the radiation dose to be distributed. According to the website www.wisegeek.org/what-is-analgorithm.htm1, an algorithm is simply any set of detailed instructions which results in a predictable end-state from a known beginning. A set of detailed instructions that a computer would follow is basically a computer program. Since computers are capable of performing many functions quickly, they are ideal for calculating dose distributions for radiation therapy. At Geisinger Wyoming Valley Hospital Cancer Center, the treatment planning system that is used for external beam radiation therapy planning is Pinnacle. This system uses the Collapsed Cone Convolution Superposition algorithm, which is considered the most accurate 3D dose calculation algorithm in the industry.2 This type of algorithm is model-based and contains an anatomical library of 3D structures of various organs to use when contouring. It also accounts for tissue heterogeneities by using collapsed cones. A collapsed cone is a model of a cone in space where the central axis of the cone uses a single ray of radiation.2 The Clarkson method is also used by Pinnacle, to calculate dose in any irregular shaped field (any shape other than a rectangle, circle or square).3 This method calculates the dose from the primary beam (takes into account penumbra, block or collimator transmission and flattening filter effects)4 and the dose from scatter separately and adds then together. The field is broken up into segments or sectors (of less than 10 degrees)4 and all sectors are added together. Since this is a time consuming process, computers are best suited to perform these types of calculations quickly and accurately. 1. What is an algorithm? WiseGEEK website. www.wisegeek.org/what-is-analgorithm.htm. Originally Published 2003. Updated March 14, 2014. Accessed March 18, 2014. 2. Khan FM. The Physics of Radiation Therapy. 4th edition. Philadelphia, PA: Lippencott Williams and Wilkins; 2010: 154. 3. Abing C. Three-dimensional Integration [SoftChalk]. LaCrosse, WI: University of Wisconsin LaCrosse Medical Dosimetry Program; 2014.

4. Abing C. Dose calculation algorithms [SoftChalk]. LaCrosse, WI: University of Wisconsin LaCrosse Medical Dosimetry Program; 2014.