On the impact of improved dose calculation accuracy in clinical treatment planning for superficial high-dose-rate brachytherapy of extensive scalp lesions.

TG-43-based dose calculations disregard tissue heterogeneities and finite scatter conditions, prompting the introduction of model-based dose calculation algorithms (MBDCAs) to improve accuracy in high-dose-rate (HDR) brachytherapy. This study evaluated the effectiveness of MBDCAs over TG-43 in HDR Ir brachytherapy of extended scalp lesions. Treatment planning dose calculations were compared with Monte Carlo (MC) data. TG-43 exhibited a dose overestimation ranging from 10% to 23% as the distance from the implant increased, while a better agreement from 2% to 6% was observed between the MBDCA and MC, supporting the adoption of MBDCAs for dose calculations in broad scalp lesions.