Advanced dose calculation strategies for clinical linear accelerators: a systematic review
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By
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May 1, 2026
Objective:
To assess the clinical significance of sophisticated Monte Carlo (MC)-based dose-calculation methods for linear accelerators (LINACs) and their advancements reported from 2010 to 2025.
Key Findings:
- MC-based dosage evaluations consistently outperformed traditional algorithms in small fields, heterogeneous media, and magnetic fields.
- GPU implementations achieved speed enhancements of 50 to 2500 times with dose discrepancies under 1%.
- AI technologies were employed to reduce noise and computational duration.
- Elekta's Monaco system features a clinically validated rapid MC engine, while Varian systems utilize MC for independent quality verification.
- Only one study addressed a Siemens LINAC system.
Interpretation:
Enhanced MC methodologies enable precise dose computation, potentially facilitating standard clinical procedures; however, direct evidence linking these dosimetric advancements to improved clinical outcomes remains limited.
Limitations:
- Scarcity of direct proof connecting dosimetric advancements to better clinical results, which may hinder the adoption of these techniques.
- Limited studies on Siemens LINAC systems, indicating a gap in the literature.
Conclusion:
Advancements in MC techniques enhance dose calculation precision in radiotherapy, but further research is essential to establish their impact on clinical outcomes.
