Surface and build‐up region dosimetry for obliquely incident intensity modulated radiotherapy 6 MV x rays

The more complex delivery techniques required for implementation of intensity‐modulated radiotherapy (IMRT) based on inverse planning optimization have changed the relationship between dose at depth and dose at buildup regions near the surface. Surface buildup dose is dependent on electron contamination primarily from the unblocked view of the flattening filter and secondarily from air and collimation systems. To evaluate the impact of beam segmentation on buildup dose, measurements were performed with 10×10 cm2 fields, which were delivered with 3 static 3.5×10 cm2 or 3×10 cm2 strips, 5 static 2×10 cm2 strips, 10 static 1×10 cm2 strips, and 1.1×10 cm2 dynamic delivery, compared with a 10×10 cm2 open field. Measurements were performed in water and Solid Water using parallel plate chambers, a stereotactic diode, and thermoluminescent dosimeters (TLDs) for a 6 MV X‐ray beam. Depth doses at 2 mm depth (relative to dose at 10 cm depth) were lower by 6%, 7%, 11%, and 10% for the above field delivery techniques, respectively, compared to the open field. These differences are most influenced by differences in multileaf collimator (MLC) transmission contributing to the useful beam. An example IMRT field was also studied to assess variations due to delivery technique (static vs. dynamic) and intensity level. Buildup dose is weakly dependent on the multileaf delivery technique for efficient IMRT fields.PACS numbers: 87.53.‐j, 87.53.Dq

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Surface buildup dose dependence on photon field delivery technique for IMRT

Yokoyama

Roberson

Litzenberg

et al. 2004

“…Butson et al. 9 showed that peripheral doses can be as large as 20% of maximum dose for normally incident beams and that these values can increase with oblique angle of incidence 10…”

Section: Introductionmentioning

confidence: 99%

Characterization of a novel scale maille contralateral breast shield: SMART Armor

Butson¹,

Carroll

Butson

et al. 2017

During breast radiotherapy treatment, the contralateral breast receives radiation doses to the skin and subcutaneous tissue caused mainly from incident electron contamination and low energy photon scatter radiation. Measurements have shown that for a typical hybrid tangential treatment, these dose levels can be up to 17% of maximum applied prescription dose if no shielding is used during the treatment process. This work examined the use of different shielding metals, aluminum, copper, and lead to reduce peripheral radiation dose to evaluate the optimal metal to form the basis of a contralateral breast radiation shield. This work also shows a simple but novel method to substantially reduce this unwanted radiation dose with the use of a copper scale maille sheet which can be easily and accurately draped over a patient's contralateral breast during treatment. The copper scale maille is flexible and can thus conform around typical breast shapes. It can also form irregular shaped edges to match those outlined by typical tangential treatment fields. As the shield is made from copper, it is nontoxic and can potentially be used directly on patients for treatment. The designed copper scale maille has shown to reduce contralateral breast skin and subcutaneous dose by up to 80% for typical radiation fields used in breast radiotherapy.

“…However, disadvantages include the energy dependence of film response and processor variation induced errors. Many recent studies have been performed to investigate the use of film for IMRT dose evaluation at depths of maximum dose or greater ( 7 – 10 ) and in the surface buildup regions (11) . The present study examines the validity of using film to measure dose in the near‐surface buildup region in clinical IMRT fields.…”

Section: Introductionmentioning

confidence: 99%

Radiographic film dosimetry for IMRT fields in the near‐surface buildup region

Roberson

Moran

Kulasekere

2008

Radiographic film dosimetry provides fast, convenient 2‐D dose distributions, but is challenged by the dependence of film response on scatter conditions (i.e., energy dependence). Verification of delivered dose in the surface buildup region is important for intensity modulated radiation therapy (IMRT) when volumes of interest encroach on these regions (e.g., head/neck, breast). The current work demonstrates that film dosimetry can accurately predict the dose in the buildup region for IMRT, since 1) film dosimetry can be performed with sufficient accuracy for small fields and 2) IMRT is delivered by a series of “small” segments (step and shoot IMRT). This work evaluates the accuracy of X‐OMAT V (XV) and Extended Dose Range (EDR) film for measurements from 2 mm to 15 mm depths for small fields and clinical IMRT beams. Film measurements have been compared to single point measurements made with a stereotactic diode and parallel plate ionization chamber (P11) and thermoluminescent dosimeters (TLD) at various depths for square (diode, P11) and IMRT (diode, TLD) fields. Film calibration was performed using an 8‐field step exposure on a single film at 5 cm depth, which has been corrected to represent either small field or large field depth dependent film calibration techniques. Up to 10% correction for film response variation as a function of depth was required for measurements in the buildup region. A depth‐dependent calibration can sufficiently improve the accuracy for IMRT calculation verification (i.e., ≤5% uncertainty). A small field film calibration technique was most appropriate for IMRT field measurements. Improved buildup region dose measurements for clinical IMRT fields promotes improved dose estimation performance for (inverse) treatment planning and allows more quantitative treatment delivery validation.PACS numbers: 87.53.‐j, 87.53.Dq