Commissioning of Aktina SRS cones and dosimetric validation of the RayStation photon Monte Carlo dose calculation algorithm.

Clinical implementation of SRS cones demands particular experimental care and dosimetric considerations in order to deliver precise and safe radiotherapy to patients. The purpose of this work was to present the commissioning data of recent Aktina cones combined with a 6MV flattened beam produced by an Elekta VersaHD linear accelerator. Additionally, the modelling process, and an assessment of dosimetric accuracy of the RayStation Monte Carlo dose calculation algorithm for cone based SRS was performed. There are currently no studies presenting beam data for this equipment and none that outlines the modelling parameters and validation of dose calculation using RayStation's photon Monte Carlo dose engine with cones. Beam data was measured using an SFD and a microDiamond and benchmarked against EBT3 film for cones of diameter 5-39 mm. Modelling was completed and validated within homogeneous and heterogeneous phantoms. End-to-end image-guided validation was performed using a StereoPHAN™ housing, an SRS MapCHECK and EBT3 film, and calculation time was investigated as a function of statistical uncertainty and field diameter. The TPS calculations agreed with measured data within their estimated uncertainties and clinical treatment plans could be calculated in under a minute. The data presented serves as a reference for others commissioning Aktina stereotactic cones and the modelling parameters serve similarly, while providing a starting point for those commissioning the same TPS algorithm for use with cones. It has been shown in this work that RayStation's Monte Carlo photon dose algorithm performs satisfactorily in the presence of SRS cones.