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Proton dose calculation based on in-air fluence measurements

Proton dose calculation algorithms—as well as photon and electron algorithms—are usually based on configuration measurements taken in a water phantom. The exceptions to this are proton dose calculation algorithms for modulated scanning beams. There, it is usual to measure the spot profiles in air. We use the concept of in-air configuration measurements also for scattering and uniform scanning (wobbling) proton delivery techniques. The dose calculation includes a separate step for the calculation of the in-air fluence distribution per energy layer. The in-air fluence calculation is specific to the technique and—to a lesser extent—design of the treatment machine. The actual dose calculation uses the in-air fluence as input and is generic for all proton machine designs and techniques.