PubMed · 11444512
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C B Saw, K M Ayyangar, C A Enke. 2001. MLC-based IMRT-Part II.. https://doi.org/10.1016/s0958-3947(01)00065-6
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The beam characteristics of a dual physical wedge system, upper and lower, for Varian accelerators are studied over the energy range 6-18 MV. Wedge factors for both systems are measured in a water phantom as a function of field size, depth and source-to-wedge (SWD) distance. Our results indicate that apart from their physical differences, dosimetrically, the two wedge systems have <2% difference in central axis percentage depth dose beyond the build-up region. The lower wedge central axis percentage depth dose is consistently lower than that of the corresponding upper wedge, with the effect more pronounced for large field sizes. The wedge profiles are identical within 2% for all field sizes, depths and energies. The wedge factors for both wedge systems are also within 2% for all field sizes and depths for both 6 and 15 MV photons and slightly higher for the 18 MV beam and 45 degrees-60 degrees wedge angle. The wedge factor variation with SWD reveals an interesting fact that thinner wedges (15 degrees and 30 degrees) result in a higher surface dose in the central axis region than thicker wedges. As the SWD increases beyond 80 cm, the reverse is true, i.e. thicker wedges produce higher surface dose than thinner wedges. It is also verified that the wedge factor at any depth and for any field size can be calculated from the wedged and open field central axis percentage depth dose, and the wedge factor at dmax, resulting in nearly 44% reduction in water phantom scanning and 80% reduction in point measurements during commissioning.
The dose linearity and uniformity of a linear accelerator designed for multileaf collimation system-(MLC) based IMRT was studied as a part of commissioning and also in response to recently published data. The linear accelerator is equipped with a PRIMEVIEW, a graphical interface and a SIMTEC IM-MAXX, which is an enhanced autofield sequencer. The SIMTEC IM-MAXX sequencer permits the radiation beam to be " ON" continuously while delivering intensity modulated radiation therapy subfields at a defined gantry angle. The dose delivery is inhibited when the electron beam in the linear accelerator is forced out of phase with the microwave power while the MLC configures the field shape of a subfield. This beam switching mechanism reduces the overhead time and hence shortens the patient treatment time. The dose linearity, reproducibility, and uniformity were assessed for this type of dose delivery mechanism. The subfields with monitor units ranged from 1 MU to 100 MU were delivered using 6 MV and 23 MV photon beams. The doses were computed and converted to dose per monitor unit. The dose linearity was found to vary within 2% for both 6 MV and 23 MV photon beam using high dose rate setting (300 MU/min) except below 2 MU. The dose uniformity was assessed by delivering 4 subfields to a Kodak X-OMAT TL film using identical low monitor units. The optical density was converted to dose and found to show small variation within 3%. Our results indicate that this linear accelerator with SIMTEC IM-MAXX sequencer has better dose linearity, reproducibility, and uniformity than had been reported.
The dosimetric characteristics for modern computer-controlled linear accelerators with the same make, model, and nominal energy are known to be very similar, as long as the machines are unaltered from the manufacturer's original specifications. In this preliminary study, a quantitative investigation of the similarity in the basic photon dosimetry data from the Siemens Primus linear accelerators at eight different institutions is reported. The output factor, percentage depth dose (PDD), and in-air off-axis factor (OAF) for the 6 and 18 MV photon beams measured or verified by the Radiological Physics Center (RPC) were analyzed. The RPC-measured output factors varied by less than about 2% for each field size. The difference between the maximum and minimum RPC-verified PDD values at each depth was less than about 3%. The difference between the maximum and minimum RPC-measured in-air OAF was no more than 4% at all off-axis distances considered in this study. These results strongly suggest that it is feasible to establish a reference photon dosimetry data set for each make, model, and nominal energy, universally applicable to those machines unaltered from the manufacturers' original specifications, within a clinically acceptable tolerance (e.g., approximately +/-2%).