Optimum delineation of skin structure for dose calculation with the linear Boltzmann transport equation algorithm in radiotherapy treatment planning

This study investigated the effectiveness of placing skin-ring structures to enhance the precision of skin dose calculations in patients who had undergone head and neck volumetric modulated arc therapy using the Acuros XB algorithm. The skin-ring structures in question were positioned 2 mm below the skin surface (skin A) and 1 mm above and below the skin surface (skin B) within the treatment-planning system. These structures were then tested on both acrylic cylindrical and anthropomorphic phantoms and compared with the Gafchromic EBT3 film (EBT3). The results revealed that the maximum dose differences between skins A and B for the cylindrical and anthropomorphic phantoms were approximately 12% and 2%, respectively. In patients 1 and 2, the dose differences between skins A and B were 9.2% and 8.2%, respectively. Ultimately, demonstrated that the skin-dose calculation accuracy of skin B was within 2% and did not impact the deep organs.