Sensitivity and specificity of Monte Carlo based independent secondary dose computation for detecting modulation-related dose errors in intensity modulated radiotherapy.

There is a clear trend with respect to voxel size in regard of the choice of reference dose: while in two out of twelve cases, GPR of ISDC as reference dose is higher than GPR of TPS as reference for the 3 × 3 × 3 mm 3 grid, we find that in eleven out of twelve cases GPR of ISDC as reference is lower for the 1 × 1 × 1 mm 3 grid.

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The influence of voxel size and uncertainty on GPR is somewhat inconclusive with a slight trend towards higher GPR for smaller voxels when the plans present with high dose gradients.

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Overall, our sensitivity analysis shows a rather inconclusive picture regarding uncertainty and a weak trend towards higher GPR(1%, 1 mm) for smaller voxels.

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