Answer Choices –	Responses –
– Always	40.00% 28
– Sometimes	38.57% 27
– Never	21.43% 15
TOTAL	70

If Sometimes, please explain when you would use AXB rather than AAA.

Answered: 27
Skipped: 43

1. In the presence of high density material as well as inhomogeneities, i.e., air, lung and bone. 2. When the treatment technique is VMAT.

3/24/2021 03:55 AM

We use AXB for all plans in the thorax

3/23/2021 03:38 PM

Lung SABR with 10XFFF.

3/22/2021 04:51 PM

Intensity modulated plans and DCAs

3/22/2021 02:29 PM

Use AXB when there is a lot of air (lungs, nasopharyngeal)

3/20/2021 10:03 PM

AXB used in lung treatments

3/19/2021 06:07 PM

For SBRT lung

3/19/2021 06:01 PM

AXB used for lung at this point. Credentialed for RXB for VMAT with RTOG.

3/19/2021 03:34 PM

every case except post prostate seed implants

3/19/2021 02:17 PM

AXB used for SRS SBRT SRS faster calc, more accurate.

3/19/2021 01:27 PM

Q3 w

If Sometimes, please explain when you would use AAA rather than AXB.

Answered: 26
Skipped: 44

1. For 3D CRT treatment plans. 2. Less inhomogeneous volume.

3/24/2021 03:55 AM

We use AAA for all plans outside of the thorax

3/23/2021 03:38 PM

All non-lung sites (e.g., with bony involvement) to avoid current uncertainty / non-standardization issues with D2W vs D2M conversion.

3/22/2021 04:51 PM

AAA for 2D and 3D conformal plans.

3/22/2021 02:29 PM

Use AAA for everything that does not have a lot of air.

3/20/2021 10:03 PM

AAA used for brain and relatively homogeneous volumes

3/19/2021 06:07 PM

Policy is to use AXB for SBRT cases, AAA for all others. Just haven't moved dosimetry into full AXB, but we're trying!

3/19/2021 06:01 PM

Credentialing and testing for AXB not finalized. Secondary MU check system limitations when using AXB for VMAT.

3/19/2021 03:34 PM

post ldr implants leave 70-130 I-125 seeds within the prostate. the seeds lie within the ptv and covering them with the Rx isodose line is neither appropriate nor feasible without uneccesarily heating up the plan

3/19/2021 02:17 PM

AAA faster calc for 3D, acceptably accurately.

3/19/2021 01:27 PM

Q4 w

Please add any comments regarding the topic.

Answered: 25
Skipped: 45

AAA algorithm's been the default algorithm for many years in our center before AXB algorithm was available. Looking into making AXB our default algorithm

3/24/2021 03:55 AM

We had a large pelvis case that was planned with AXB who had a relatively small air bubble that happened to be in part of the PTV. The dose distribution on the plan looked great, and it was approved by the physician. For other reasons, the patient had to be reCT'd. The fields were copied over, and recalculated. Obviously, the original air bubble wasn't in the same location anymore. This was a problem though, since AXB accurately had taken that air bubble into account and optimized to it, so the spot where that air had been now had a ~120% hotspot in it. We elected to return to AAA for plans outside of the Thorax because of this.

3/23/2021 03:38 PM

Why use an inaccurate algorithm? AAA shouldn't be allowed to exist.

3/22/2021 09:16 PM

The superior capabilities of AcurosXB in heterogenous tissues, particularly the lung interfaces makes it a no-brainer as the go to calc engine.

3/22/2021 06:27 PM

The only advantage of AAA is its speed. When creating segments in a 3D plan, when the dosimetrist hits the calc button multiple times during the process, AXB takes a while but AAA saves time and hence less frustrating.

3/22/2021 02:29 PM

We've set AXB as the default algorithm, dose to medium, it's used for all sites.

3/22/2021 02:46 AM

We get good results from AAA. If they were giving it away, I would consider using it. Latest version of AAA made considerable changes to heterogeneity correction. Why pay more for another algorithm and make more work on top of it.

3/20/2021 06:32 PM

We have AXB available but haven't used it yet. Not sure if we want to.

3/20/2021 03:33 PM

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