Dosimetric verification of a Monte Carlo electron beam model for an add-on eMLC

Dosimetric verification of a new Monte Carlo beam model for multi-leaf collimated electrons was performed using experimental data from an add-on electron multi-leaf collimator (eMLC) prototype. The measurements were compared against calculations using an electron phase space sampled from a parameterized electron beam model and the voxel Monte Carlo++ (VMC++) code for in-phantom energy deposition. Verification of the calculations was performed in a water phantom with the developed eMLC attached to a Varian 2100 C/D radiotherapy accelerator with nominal energies 6 MeV, 9 MeV, 12 MeV, 16 MeV and 20 MeV. The eMLC prototype consisting of 2 cm thick and 5 mm wide steel leaves is fixed under the 20 x 20 cm(2) electron applicator with a source-to-leaf distance 97.2 cm. The eMLC prototype has non-motorized leaves with straight leaf edges and a maximum field size of 20 x 20 cm(2) at SSD 100 cm. The beam model is a coupled multi-source model with parameters derived from detailed beam characterization measurements and a kernel model for the indirect leaf-scattered electrons. Typical calculation times with a 2% mean statistical uncertainty was under 5 min. In extensive set of in-water measurements 88% of the voxels were within 2% /2 mm acceptance criterion. Although at SSD 100 cm the dose near the phantom surface is slightly pronounced due to the short collimator-to-surface distance, the new beam model was suitable for dose calculation of the add-on type eMLC.     

Effects on electron beam penumbra using the photon MLC to reduce bremsstrahlung leakage for an add-on electron MLC

Electron IMRT treatments have the potential to reduce the integral dose due to the limited range of the electrons. However, bremsstrahlung produced in the scattering foils could penetrate an added electron MLC (eMLC), thus producing an unmodulated dose contribution that could become unacceptable in electron IMRT treatments. To limit this bremsstrahlung contribution, the photon MLC (xMLC) was used to track the eMLC, but with a margin to avoid penumbra widening through partial screening of the effective electron source. The purpose of this work was to study the effect of the photon-electron MLC tracking on the electron beam penumbra for different treatment head designs. Both isocentric designs and designs where the eMLC is used close to the patient (proximity geometry) have been analysed using Monte Carlo simulations. At 22.5 MeV energy, a tracking margin of 1 cm was enough to avoid penumbra degradation for a helium-filled isocentric geometry, while air-filled geometries (including proximity geometries) require a 2-3 cm margin. Illustrated by an example of a chest wall treatment by electron IMRT, the use of 1 cm tracking margin will reduce the collimator leakage contribution by a factor of 36 as compared to using a static setting of the photon collimator.     

Dosimetry of a prototype retractable eMLC for fixed-beam electron therapy

An electron multileaf collimator (eMLC) has been designed that is unique in that it retracts to 37 cm from the isocenter [63-cm source-to-collimator distance (SCD)] and can be deployed to distances of 20 and 10 cm from the isocenter (80 and 90 cm SCD, respectively). It is expected to be capable of arc therapy at 63 cm SCD; isocentric, fixed-beam therapy at 80 cm SCD; and source-to-surface distance (SSD), fixed-beam therapy at 90 cm SCD. In all positions, its leaves could be used for unmodulated or intensity-modulated therapy. Our goal in the present work is to describe the general characteristics of the eMLC and to demonstrate that its leakage characteristics and dosimetry are adequate for SSD, fixed-beam therapy as an alternative to Cerrobend cutouts with applicators once the prototype's leaves are motorized. Our eMLC data showed interleaf electron leakage at 15 MeV to be less than 0.1% based on a 0.0025 cm manufacturing tolerance, and lateral electron leakage at 5 and 15 MeV to be less than 2%. X-ray leakage through the leaves was 1.6% at 15 MeV. Our data showed that beam penumbra was independent of direction and leaf position. The dosimetric properties of square fields formed by the eMLC were very consistent with those formed by Cerrobend inserts in the 20 x 20 cm2 applicator. Output factors exhibited similar field-size dependence. Airgap factors exhibited almost identical field-size dependence at two SSDs (105 and 110 cm), consistent with the common assumption that airgap factors are applicator independent. Percent depth-dose curves were similar, but showed variations up to 3% in the buildup region. The pencil-beam algorithm (PBA) fit measured data from the eMLC and applicator-cutout systems equally well, and the resulting two-dimensional (2-D) dose distributions, as predicted by the PBA, agreed well at common airgap distance. Simulating patient setups for breast and head and neck treatments showed that almost all fields could be treated using similar SSDs as when using applicators, although head and neck treatments require placing the patient's head on a head-holder treatment table extension. The results of this work confirmed our design goals and support the potential use of the eMLC design in the clinical setting. The eMLC should allow the same treatments as are typically delivered with the electron applicator-cutout system currently used for fixed-beam therapy.     

Characterization of an add-on multileaf collimator for electron beam therapy

An add-on multileaf collimator for electrons (eMLC) has been developed that provides computer-controlled beam collimation and isocentric dose delivery. The design parameters result from the design study by Gauer et al (2006 Phys. Med. Biol. 51 5987-6003) and were configured such that a compact and light-weight eMLC with motorized leaves can be industrially manufactured and stably mounted on a conventional linear accelerator. In the present study, the efficiency of an initial computer-controlled prototype was examined according to the design goals and the performance of energy- and intensity-modulated treatment techniques. This study concentrates on the attachment and gantry stability as well as the dosimetric characteristics of central-axis and off-axis dose, field size dependence, collimator scatter, field abutment, radiation leakage and the setting of the accelerator jaws. To provide isocentric irradiation, the eMLC can be placed either 16 or 28 cm above the isocentre through interchangeable holders. The mechanical implementation of this feature results in a maximum field displacement of less than 0.6 mm at 90 degrees and 270 degrees gantry angles. Compared to a 10 x 10 cm applicator at 6-14 MeV, the beam penumbra of the eMLC at a 16 cm collimator-to-isocentre distance is 0.8-0.4 cm greater and the depth-dose curves show a larger build-up effect. Due to the loss in energy dependence of the therapeutic range and the much lower dose output at small beam sizes, a minimum beam size of 3 x 3 cm is necessary to avoid suboptimal dose delivery. Dose output and beam symmetry are not affected by collimator scatter when the central axis is blocked. As a consequence of the broader beam penumbra, uniform dose distributions were measured in the junction region of adjacent beams at perpendicular and oblique beam incidence. However, adjacent beams with a high difference in a beam energy of 6 to 14 MeV generate cold and hot spots of approximately 15% in the abutting region. In order to improve uniformity, the energy of adjacent beams must be limited to 6 to 10 MeV and 10 to 14 MeV respectively. At the maximum available beam energy of 14 MeV, radiation leakage results mainly from the intraleaf leakage of approximately 2.5% relative dose which could be effectively eliminated at off-axis distances remote from the field edge by adjusting the jaw field size to the respective opening of the eMLC. Additionally, the interleaf and leaf-end leakage could be reduced by using a tongue-and-groove leaf shape and adjoining the leaf-ends off-axis respectively.     

Manual multi-leaf collimator for electron beam shaping--a feasibility study

In electron beam therapy, lead or low melting point alloy (LMA) sheet cutouts of sufficient thickness are commonly used to shape the beam. In order to avoid making cutouts for each patient, an attempt has been made to develop a manual multi-leaf collimator for electron beams (eMLC). The eMLC has been developed using LMA for a 15 x 15 cm2 applicator. Electron beam characteristics such as depth dose, beam profiles, surface dose, output factors and virtual source position with the eMLC have been studied and compared with those of an applicator electron beam. The interleaf leakage radiation has also been measured with film dosimetry. Depth dose values obtained using the eMLC were found to be identical to those with the applicator for depths larger than Dmax. However, a decrease in the size of the beam penumbra with the eMLC and increase in the values of surface dose, output factors and virtual source position with eMLC were observed. The leakage between the leaves was less than 5% and the leakage between the opposing leaves was 15%, which could be minimized further by careful positioning of the leaves. It is observed that it is feasible to use such a manual eMLC for patients and eliminate the fabrication of cutouts for each patient.     

Sensitivity of large-field electron beams to variations in a Monte Carlo accelerator model

Adjustments made to Monte Carlo models during the commissioning of the simulation should be physically realistic and correspond to actual machine characteristics. Large electron fields, with the jaws fully open and the applicator removed, are sensitive to important source and geometry parameters and may provide the most accurate beam models, including those collimated by an applicator. We report on the results of a comprehensive Monte Carlo sensitivity study documenting the response of these large fields to changes in the configuration of a Siemens Primus linear accelerator. The study was performed for 6, 9 12, 15, 18 and 21 MeV configurations, and included variations of thickness, position and lateral alignment of all treatment head components. Variations of electron beam characteristics were also included in the study. Results were classified by their impact on central-axis depth dose distributions, including the bremsstrahlung tail, and on beam profiles near D(max) and in the bremsstrahlung region. Low-energy results show an increased sensitivity to electron beam properties. High-energy bremsstrahlung profiles are shown to be useful in determining misalignments between the beam axis and mechanical isocentre. For all energies, the alignment of the secondary scattering foil and monitor chamber are shown to be critical for correctly modelling beam asymmetries. The results suggest a methodology for commissioning of electron beams using Monte Carlo treatment head simulation.     

Monte Carlo and experimental investigations of multileaf collimated electron beams for modulated electron radiation therapy

Modulated electron radiation therapy (MERT) has been proposed as a means of delivering conformal dose to shallow tumors while sparing distal structures and surrounding tissues. Conventional systems for electron beam collimation are labor and time intensive in their construction and are therefore inadequate for use in the sequential delivery of multiple complex fields required by MERT. This study investigates two proposed methods of electron beam collimation: the use of existing photon multileaf collimators (MLC) in a helium atmosphere to reduce in-air electron scatter, and a MLC specifically designed for electron beam collimation. Monte Carlo simulations of a Varian Clinac 2100C were performed using the EGS4/BEAM system and dose calculations performed with the MCDOSE code. Dose penumbras from fields collimated by photon MLCs both with air and with helium at 6, 12, and 20 MeV at a range of SSDs from 70 to 90 cm were examined. Significant improvements were observed for the helium based system. Simulations were also performed on an electron specific MLC located at the level of the last scraper of a 25x25 cm2 applicator. A number of leaf materials, thicknesses, end shapes, and widths were simulated to determine optimal construction parameters. The results demonstrated that tungsten leaves 15 mm thick and 5 mm wide with unfocused ends would provide sufficient collimation for MERT fields. A prototype electron MLC was constructed and comparisons between film measurements and simulation demonstrate the validity of the Monte Carlo model. Further simulations of dose penumbras demonstrate that such an electron MLC would provide improvements over the helium filled photon MLC at all energies, and improvements in the 90-10 penumbra of 12% to 45% at 20 MeV and 6 MeV, respectively. These improvements were also seen in isodose curves when a complex field shape was simulated. It is thus concluded that an MLC specific for electron beam collimation is required for MERT.     

Monte Carlo investigation of electron beam output factors versus size of square cutout.

A major task in commissioning an electron accelerator is to measure relative output factors versus cutout size (i.e., cutout factors) for various electron beam energies and applicator sizes. We use the BEAM Monte Carlo code [Med Phys. 22, 503-524 (1995)] to stimulate clinical electron beams and to calculate the relative output factors for square cutouts. Calculations are performed for a Siemens MD2 linear accelerator with beam energies, 6, 9, 11, and 13 MeV. The calculated cutout factors for square cutouts in 10 X 10 cm2, 15 X 15 cm2, and 20 X 20 cm2 applicators at SSDs of 100 and 115 cm agree with the measurements made using a silicon diode within about 1% except for the smallest cutouts at SSD= 115 cm where they agree within 0.015. The details of each component of the dose, such as the dose from particles scattered off the jaws and the applicator, the dose from contaminant photons, the dose from direct electrons, etc., are also analyzed. The calculations show that inphantom side-scatter equilibrium is a major factor for the contribution from the direct component which usually dominates the output of a beam. It takes about 6 h of CPU time on a Pentium Pro 200 MHz computer to simulate an accelerator and additional 2 h to calculate the relative output factor for each cutout with a statistical uncertainty of 1%.     

A Monte Carlo investigation of fluence profiles collimated by an electron specific MLC during beam delivery for modulated electron radiation therapy

Modulated electron radiation therapy (MERT) is able to deliver conformal dose to shallow tumors while significantly reducing dose to distal structures and surrounding tissues. An electron specific multileaf collimator (eMLC) has been proposed and constructed as an effective means of delivering electron beams for MERT. The aim of this work is to apply the Monte Carlo method to investigate the fluence profiles collimated by the eMLC in order to achieve accurate beam delivery for MERT. In this work, the EGS4/BEAM code was used to simulate the eMLC collimated electron beams of 6-20 MeV generated from a Varian Clinac 2100C linear accelerator. An attempt was made to describe the fluence profiles with an analytic Sigmoid function. The function parameters were determined by the fittings of the Monte Carlo simulated fluence profiles. How the function parameters depend on the eMLC aperture size, the off-axis location, and the electron beam energy has been investigated. It has been found that the eMLC collimated fluence profiles are dependent on beam energy, while almost independent of leaf location or dimension of MLC aperture. There is little difference in the fluence profiles collimated by the leaf side and the leaf end for the straight-edged leaves. It is possible that these energy-dependent Sigmoid functions can serve as operators to account for the energy dependence of the eMLC collimated fluence profiles. These operators can be incorporated into the inverse planning algorithm to derive desired dose distributions using a set of electron beams of variable energy and field size suitable for delivery by the eMLC.     

Monte Carlo simulation of large electron fields

Two Monte Carlo systems, EGSnrc and Geant4, the latter with two different 'physics lists,' were used to calculate dose distributions in large electron fields used in radiotherapy. Source and geometry parameters were adjusted to match calculated results to measurement. Both codes were capable of accurately reproducing the measured dose distributions of the six electron beams available on the accelerator. Depth penetration matched the average measured with a diode and parallel-plate chamber to 0.04 cm or better. Calculated depth dose curves agreed to 2% with diode measurements in the build-up region, although for the lower beam energies there was a discrepancy of up to 5% in this region when calculated results are compared to parallel-plate measurements. Dose profiles at the depth of maximum dose matched to 2-3% in the central 25 cm of the field, corresponding to the field size of the largest applicator. A 4% match was obtained outside the central region. The discrepancy observed in the bremsstrahlung tail in published results that used EGS4 is no longer evident. Simulations with the different codes and physics lists used different source energies, incident beam angles, thicknesses of the primary foils, and distance between the primary and secondary foil. The true source and geometry parameters were not known with sufficient accuracy to determine which parameter set, including the energy of the source, was closest to the truth. These results underscore the requirement for experimental benchmarks of depth penetration and electron scatter for beam energies and foils relevant to radiotherapy.     

Multileaf collimation of electrons--clinical effects on electron energy modulation and mixed beam therapy depending on treatment head design

The aim of this study was to explore the possibilities of using multileaf-collimated electron beams for advanced radiation therapy with conventional scattering foil flattened beams. Monte Carlo simulations were performed with the aim to improve electron beam characteristics and enable isocentric multileaf collimation. The scattering foil positions, monitor chamber thickness, the MLC location and the amount of He in the treatment head were optimized for three common commercial accelerators. The performance of the three optimized treatment head designs was compared for different SSDs in air, at treatment depth in water and for some clinical cases. The effects of electron/photon beam matching including generalized random and static errors using Gaussian one-dimensional (1 D) error distributions, and also electron energy modulation, were studied at treatment depth in water. The modification of the treatment heads improved the electron beam characteristics and enabled the use of multileaf collimation in isocentric delivery of both electron and photon beams in a mixed beam IMRT procedure.     

Correcting for electron contamination at dose maximum in photon beams

Data are presented to allow the photon beam quality specifier being used in the new AAPM TG-51 protocol, %dd(10)x, to be extracted from depth-dose data measured with a 1 mm lead foil either 50 cm or 30 cm from the phantom surface. %dd(10)x is the photon component of the percentage depth dose at 10 cm depth for a 10x10 cm2 field on the surface of a phantom at an SSD of 100 cm. The purpose of the foil is to remove the unknown electron contamination from the accelerator head. Monte Carlo calculations are done: (a) to show these electrons are reduced to a negligible level; (b) to calculate the amount of electron contamination from the lead foil at the depth of dose maximum; and (c) to calculate the effect of beam hardening on %dd(10). The analysis extends the earlier work of Li and Rogers [Med. Phys. 21, 791-798 (1994)] which only provided data for the foil at 50 cm. An error in the earlier Monte Carlo simulations is reported and a more convenient method of analyzing and using the data is presented. It is shown that 20% variations in the foil thickness have a negligible effect on the calculated corrections.     

Monte Carlo techniques for scattering foil design and dosimetry in total skin electron irradiations

Total skin electron irradiation (TSEI) with single fields requires large electron beams having good dose uniformity, dmax at the skin surface, and low bremsstrahlung contamination. To satisfy these requirements, energy degraders and scattering foils have to be specially designed for the given accelerator and treatment room. We used Monte Carlo (MC) techniques based on EGS4 user codes (BEAM, DOSXYZ, and DOSRZ) as a guide in the beam modifier design of our TSEI system. The dosimetric characteristics at the treatment distance of 382 cm source-to-surface distance (SSD) were verified experimentally using a linear array of 47 ion chambers, a parallel plate chamber, and radiochromic film. By matching MC simulations to standard beam measurements at 100 cm SSD, the parameters of the electron beam incident on the vacuum window were determined. Best match was achieved assuming that electrons were monoenergetic at 6.72 MeV, parallel, and distributed in a circular pattern having a Gaussian radial distribution with full width at half maximum = 0.13 cm. These parameters were then used to simulate our TSEI unit with various scattering foils. Two of the foils were fabricated and experimentally evaluated by measuring off-axis dose uniformity and depth doses. A scattering foil, consisting of a 12 x 12 cm2 aluminum plate of 0.6 cm thickness and placed at isocenter perpendicular to the beam direction, was considered optimal. It produced a beam that was flat within +/-3% up to 60 cm off-axis distance, dropped by not more than 8% at a distance of 90 cm, and had an x-ray contamination of <3%. For stationary beams, MC-computed dmax, Rp, and R50 agreed with measurements within 0.5 mm. The MC-predicted surface dose of the rotating phantom was 41% of the dose rate at dmax of the stationary phantom, whereas our calculations based on a semiempirical formula in the literature yielded a drop to 42%. The MC simulations provided the guideline of beam modifier design for TSEI and estimated the dosimetric performance for stationary and rotational irradiations.     

The use of an extra-focal electron source to model collimator-scattered electrons using the pencil-beam redefinition algorithm

Currently, the pencil-beam redefinition algorithm (PBRA) utilizes a single electron source to model clinical electron beams. In the single-source model, the electrons appear to originate from a virtual source located near the scattering foils. Although this approach may be acceptable for most treatment machines, previous studies have shown dose differences as high as 8% relative to the given dose for small fields for some machines such as the Varian Clinac 1800. In such machines collimation-scattered electrons originating from the photon jaws and the applicator give rise to extra-focal electron sources. In this study, we examined the impact of modeling an additional electron source to better account for the collimator-scattered electrons. The desired dose calculation accuracy in water throughout the dose distribution is 3% or better relative to the given dose. We present here a methodology for determining the electron-source parameters for the dual-source model using a minimal set of data, that is, two central-axis depth-dose curves and two off-axis profiles. A Varian Clinac 1800 accelerator was modeled for beam energies of 20 and 9 MeV and applicator sizes of 15 x 15 and 6 x 6 cm2. The improvement in the accuracy of PBRA-calculated dose, evaluated using measured two-dimensional dose distributions in water, was characterized using the figure of merit, FA3%, which represents the fractional area containing dose differences greater than 3%. For the 15 x 15 cm2 field the evaluation was restricted to the penumbral region, and for the 6 x 6 cm2 field the central region of the beam was included as it was impacted by the penumbra. The greatest improvement in dose accuracy was for the 6 x 6 cm2 applicator. At 9 MeV, FA3% decreased from 15% to 0% at 100 cm SSD and from 34% to 4% at 110 cm SSD. At 20 MeV, FA3% decreased from 17% to 2% at 100 cm SSD and from 41% to 10% at 110 cm SSD. In the penumbra of the 15 x 15 cm2 applicator, the improvement was less, but still significant. At 9 MeV, FA3% changed from 11% to 1% at 100 cm SSD and from 10% to 12% at 110 cm SSD. At 20 MeV, FA3% decreased from 12% to 8% at 100 cm SSD and from 14% to 5% at 110 cm SSD. Results demonstrate that use of a dual-source beam model can provide significantly improved accuracy in the PBRA-calculated dose distribution that was not achievable with a single-source beam model when modeling the Varian Clinac 1800 electron beams. Time of PBRA dose calculation was approximately doubled; however, dual-source beam modeling of newer accelerators (e.g., the Varian Clinac 2100) may not be necessary because of less impact of collimator-scattered electrons on dosimetry.     

Spectral reconstruction by scatter analysis for a linear accelerator photon beam

Pre-existing methods for photon beam spectral reconstruction are briefly reviewed. An alternative reconstruction method by scatter analysis for linear accelerators is introduced. The method consists in irradiating a small plastic phantom at standard 100 cm SSD and inferring primary beam energy spectral information based on the measurement with a standard Farmer chamber of scatter around the phantom at several specific scatter angles: a scatter curve is measured which is indicative of the primary spectrum at hand. A Monte Carlo code is used to simulate the scatter measurement set-up and predict the relative magnitude of scatter measurements for mono-energetic primary beams. Based on mono-energetic primary scatter data, measured scatter curves are analysed and the spectrum unfolded as the sum of mono-energetic individual energy bins using the Schiff bremsstrahlung model. The method is applied to an Elekta/SL18 6 MV photon beam. The reconstructed spectrum matches the Monte Carlo calculated spectrum for the same beam within 6.2% (average error when spectra are compared bin by bin). Depth dose values calculated for the reconstructed spectrum agree with physically measured depth dose data to within 1%. Scatter analysis is preliminarily shown to have potential as a practical spectral reconstruction method requiring few measurements under standard 100 cm SSD and feasible in any radiotherapy department using a phantom and a Farmer chamber.     

基于GAMOS的蒙特卡罗方法模拟放疗电子线照射的剂量学研究

目的:探讨基于GAMOS的蒙特卡罗（MC）方法模拟电子线放疗的剂量精确性。方法:运用GAMOS MC程序,建立Varian Rapidarc加速器3档能量（6、9和12 MeV）及3种限光筒［（6×6）、（10×10）和（15×15） cm2］的束流模型,模拟束流在水模体中的剂量分布,并与测量得到的百分深度剂量和等平面剂量分布比较,评估GAMOS软件模拟电子线照射的精确性和运算效率。结果:模拟的粒子数越多,模拟与测量结果的误差越小;当模拟粒子的数量达到5×108时,各个能量的电子线射程（Rp）和50%剂量深度（R50）的模拟结果与测量结果一致;除建成区外,百分深度剂量模拟和测量的结果误差在2%以内;等平面剂量分布模拟和测量的结果误差也在2%以内,模拟的照射野大小与测量结果一致。运算效率中,能量越大,限光筒尺寸越大,并行同步模拟所用的时间越多,模拟时间的变化越大。结论:基于GAMOS的MC方法可准确地模拟放疗电子线照射剂量的分布,粒子数的增加可提高模拟的精确性,并行同步计算可提高模拟的效率。     

Depth dose enhancement of electron beams subject to external uniform longitudinal magnetic fields: a Monte Carlo study

We studied the dose distributions from electron beams subjected to a longitudinal magnetic field applied to them before they reach the phantom. We found that specific combinations of the length and intensity of the magnetic field produced enhancement of the peaks of the central-axis depth-dose distributions. The EGS4 Monte Carlo system was used in this study. In the simulations, a uniform axial magnetic field parallel to the electron beam direction was applied to the air gap between the collimation and the phantom. We extensively studied the simplified case of an 18 MeV electron beam point source. Dose deposition was calculated for various magnetic field strengths, distances through which the magnetic field was applied, collimation sizes, and source to collimation distances. The magnetic field strengths varied from 0 to 3 T, the source-to-collimation distances studied were 50 and 95 cm, the collimation sizes studied were 10 x 10 and 20 x 20 cm2, and the distance through which the field was applied ranged from 10 to 20 cm. Specific combinations of these variables resulted in as much as a 70% enhancement of the peak dose relative to the surface dose. Finally, to determine how the geometry of a real accelerator affects the resulting dose distribution, we performed a full simulation of an Elekta SL20 linear accelerator and compared the results with the ideal case.     

Calculation of absorbed dose and biological effectiveness from photonuclear reactions in a bremsstrahlung beam of end point 50 MeV.

The absorbed dose due to photonuclear reactions in soft tissue, lung, breast, adipose tissue and cortical bone has been evaluated for a scanned bremsstrahlung beam of end point 50 MeV from a racetrack accelerator. The Monte Carlo code MCNP4B was used to determine the photon source spectrum from the bremsstrahlung target and to simulate the transport of photons through the treatment head and the patient. Photonuclear particle production in tissue was calculated numerically using the energy distributions of photons derived from the Monte Carlo simulations. The transport of photoneutrons in the patient and the photoneutron absorbed dose to tissue were determined using MCNP4B; the absorbed dose due to charged photonuclear particles was calculated numerically assuming total energy absorption in tissue voxels of 1 cm3. The photonuclear absorbed dose to soft tissue, lung, breast and adipose tissue is about (0.11-0.12)+/-0.05% of the maximum photon dose at a depth of 5.5 cm. The absorbed dose to cortical bone is about 45% larger than that to soft tissue. If the contributions from all photoparticles (n, p, 3He and 4He particles and recoils of the residual nuclei) produced in the soft tissue and the accelerator, and from positron radiation and gammas due to induced radioactivity and excited states of the nuclei, are taken into account the total photonuclear absorbed dose delivered to soft tissue is about 0.15+/-0.08% of the maximum photon dose. It has been estimated that the RBE of the photon beam of 50 MV acceleration potential is approximately 2% higher than that of conventional 60Co radiation.     

Correlated histogram representation of Monte Carlo derived medical accelerator photon-output phase space.

We present a method for condensing the photon energy and angular distributions obtained from Monte Carlo simulations of medical accelerators. This method represents the output as a series of correlated histograms and as such is well-suited for inclusion as the photon-source package for Monte Carlo codes used to determine the dose distributions in photon teletherapy. The method accounts for the isocenter-plane variations of the photon energy spectral distributions with increasing distance from the beam central axis for radiation produced in the bremsstrahlung target as well as for radiation scattered by the various treatment machine components within the accelerator head. Comparison of the isocenter energy fluence computed by this algorithm with that of the underlying full-physics Monte Carlo photon phase space indicates that energy fluence errors are less than 1% of the maximum energy fluence for a range of open-field sizes. Comparison of jaw-edge penumbrae shows that the angular distributions of the photons are accurately reproduced. The Monte Carlo sampling efficiency (the fraction of generated photons which clear the collimator jaws) of the algorithm is approximately 83% for an open 10x10 field, rising to approximately 96% for an open 40x40 field. Data file sizes for a typical medical accelerator, at a given energy, are approximately 150 kB, compared to the 1 GB size of the underlying full-physics phase space file.     

Electron beam modeling and commissioning for Monte Carlo treatment planning

A hybrid approach for commissioning electron beam Monte Carlo treatment planning systems has been studied. The approach is based on the assumption that accelerators of the same type have very similar electron beam characteristics and the major difference comes from the on-site tuning of the electron incident energy at the exit window. For one type of accelerator, a reference machine can be selected and simulated with the Monte Carlo method. A multiple source model can be built on the full Monte Carlo simulation of the reference beam. When commissioning electron beams from other accelerators of the same type, the energy spectra in the source model are tuned to match the measured dose distributions. A Varian Clinac 2100C accelerator was chosen as the reference machine and a four-source beam model was established based on the Monte Carlo simulations. This simplified beam model can be used to generate Monte Carlo dose distributions accurately (within 2%/2 mm compared to those calculated with full phase space data) for electron beams from the reference machine with various nominal energies, applicator sizes, and SSDs. Three electron beams were commissioned by adjusting the energy spectra in the source model. The dose distributions calculated with the adjusted source model were compared with the dose distributions calculated using the phase space data for these beams. The agreement is within 1% in most of cases and 2% in all situations. This preliminary study has shown the capability of the commissioning approach for handling large variation in the electron incident energy. The possibility of making the approach more versatile is also discussed.