Inaccurate dose calculation in radiotherapy can lead to errors in treatment delivery and evaluation of treatment efficacy. Respiration can cause of intra-fractional motions, leading to uncertainties in tumor targeting. These motions should therefore be included in dose calculation. The finite element method-based deformable registration platform MORFEUS is able to accurately quantify organ deformations. The dose accumulation algorithm included in MORFEUS takes organ deformation and tumor movement into account. This study has experimentally validated this dose accumulation algorithm by combining 3D gel dosimetry, respiratory motion-mimicking actuation mechanism, and finite element analysis. Results have shown that within the intrinsic measurement uncertainties of gel dosimetry, under normal conformal dose distribution conditions, more than 90% of the voxels in MORFEUS generated dose grids have met the criterion analogous to the gamma test. The average (SD) distance between selected pairs of isodose surfaces on the gel and MORFEUS dose distributions is 0.12 (0.08) cm.MAS
