60Co重过滤低剂量率照射剂量学

目的:探讨低剂量60Coγ射线照射由于照射物理条件不同剂量学参数的变化.材料和方法:在常规照射和低熔点铅(LML)重过滤初始γ束条件下,用三维水箱自动测量装置和剂量仪分别测量PDD、OAR和绝对剂量定标后的K修正系数.结果:60Co γ射线初始束经重过滤后PDD在人体脾脏靶区深度5 cm～11cm区域平均降低1.2个百分点,OAR较常规60Co OAR圆弧化,绝对剂量较常规实际减弱80倍,并给出了治疗时间公式.讨论:对60Co γ射线的重过滤,是采用常规60Co γ射线治疗机实现低剂量辐射照射脾脏的最佳方法.     

应用辐射直接显色剂量胶片测量高能光子线的表面和建成区剂量

目的：准确测量高能光子射线剂量建成区的剂量分布，评估三维水箱扫描深度剂量曲线在表浅部位的误差。方法：使用辐射直接显色胶片（EBT胶片）测量加速器6MV光子线由体模表面到最大剂量深度区间的建成剂量分布，并与传统的电离室和半导体探头三维水箱扫描百分深度剂量曲线在该区间的剂量分布进行比较。结果：在接近最大剂量深度的区间（0．6cm-Dmax），EBT胶片与三维水箱扫描测量结果非常接近，差别小于2％；在电离室和半导体探头的有效测量深度至0．6cm深度区间，对不同射野大小，EBT胶片测量值大于两种三维水箱测量值5％～10％；在小于电离室和半导体探头的有效测量深度的区间，EBT胶片的测量值与水箱扫描结果比较差别最大分别达到22.7％（半导体探头）和49.3％（电离室）。结论：EBT胶片可以用于准确测量表面和建成区剂量分布，三维水箱扫描得到的PDD曲线应该进行建成区修正。     

半导体和电离室探头在直线加速器数据测量中的比较与分析

目的：比较分析半导体探头和电离室探头在三维水箱测量中的差异，为能够提高数据测量精度从而实现治疗计划系统建立准确的计算模型提供依据：方法：在加速器8MV光子线下，使用0．13cm^3的指形电离室和半导体探头在三维水箱中分别测量照射野1cm×lcm，2cm×2cm，3cm×3cm，4cm×4cm，5cm×5cm，6cm×6cm，8cm×8cm，10cm×l0cm的总散射因子、百分深度剂量曲线、离轴比曲线，对测量结果进行比较和分析；结果：对于总散射因子，在较大照射野测量时结果一致，在小野测量时存在差异，1cm×lcm照射野的两者测量结果偏差15．32％；对于百分深度曲线，在建成区差异最大，各照射野的在水面处的测量结果均偏差10％以上：对于离轴比曲线，在半影区存在显著差异．半导体探头在最大剂量点深度测量的射野大小均小明显小于电离室测量的结果。结论：总散射因子，小照射野测量时建议使用半导体探头或者较小体积的电离室；百分深度剂量曲线，建议使用电离室探头；离轴比曲线，使用半导体探头可测量到较好的射野半影区。     

国产NT-AD200型三维水箱射束扫描性能验证

目的:全面了解中国测试技术研究院NT-AD200型三维水箱的射束扫描精度与性能。 方法:以德国IBA公司Blue Phantom 2三维水箱为参照,分别使用NT-AD200型三维水箱与Blue Phantom 2三维水箱对美国瓦里安公司TrueBeam医用直线加速器进行6 MV光子线剂量学数据采集。测量源皮距为100 cm和不同射野大小条件下的百分深度剂量（PDD）曲线,比较分析各相同射野条件下不同深度的离轴比（OAR）曲线。 结果:与进口设备相比,在机械控制及易用性方面,NT-AD200还存在着一定的差距。在射束扫描性能方面,以Blue Phantom 2数据为基准,PDD建成区以外剂量偏差均值均小于1%,标准差小于0.3%,建成区最大剂量偏差出现在（3×3） cm2射野大小,为-5.23%±7.41%。OAR曲线80%射野大小范围内偏差均值均小于1%,标准差小于0.3%;80%~120%射野大小范围内（半影区）剂量偏差均值均小于1%,但标准差为0.51%~1.31%;120%射野大小范围以外NT-AD200型水箱的OAR比Blue Phantom 2水箱均偏大1%左右。 结论:NT-AD200型三维水箱与Blue Phantom 2三维水箱采集的剂量学数据有很好的一致性,射束扫描性能与进口设备相当。     

电子束环形限光筒剂量学特性的测量

目的:研究一种新型不锈钢壁环形限光筒的剂量学特性.方法:用PTW mp3三维水箱在标称源皮距下测量环形限光筒的百分深度剂量和照射野离轴比,用PTWUNIODS剂量仪和0.6 CC电离室测量射野输出因子、有效源皮距和X线污染,并将测量结果与6 cm×6 cm限光筒中制作的相同孔径的圆形铅块做比较.结果:环形限光筒电子线照射野的百分深度剂量、离轴比和有效源皮距与电子束能量、限光筒型号密切相关.有效射程和治疗深度随限光筒孔径增大而增大.限光简直径越小,电子线能量越大,表面剂量越高.环形限光筒的输出因子和相同孔径的圆形铅块不同,随能量变化较大.x线污染比较小.结论:环形限光筒的剂量学特性能满足临床要求,对于小肿瘤具有很好的适形效果,适合表浅的淋巴结预防照射、口腔粘膜肿瘤和某些管腔肿瘤治疗,也可以用于术中照射.     

清华同源双束医用加速器蒙特卡罗模拟

目的:使用蒙特卡罗方法模拟清华大学自主研制的同源双束医用加速器,为今后研究该设备KV级能量在放射治疗中成像剂量分布奠定基础。方法:(1)借助蒙卡BEAMnrc程序模拟加速器机头得到相空间文件。(2)以该相空间文件为源,使用蒙卡DOSXYZnrc程序计算水模体中百分深度剂量(percent depth dose,PDD)和离轴比(off axis ratio,OAR),采用MATLAB编程提取剂量数据显示于EXCEL。(3)分析蒙卡模拟参数对结果的影响。(4)对比实测调整模拟参数。结果:蒙卡模拟所得水模体中PDD和OAR曲线与实测有很好的吻合,得到加速器机头模型。结论:医用加速器KV级能量蒙卡模拟与高能有明显不同;要得到合适的该加速器蒙卡模型,需要选择合适的电子束能量和电子空间密度分布;该模拟所得加速器模型可用于成像剂量分布等后续研究。     

清华同源双束医用加速器成像剂量分布蒙卡模拟

目的：使用蒙特卡罗方法模拟计算清华同源双束医用加速器KV级能量成像束在肺部模型中剂量分布。方法：使用清华同源双束医用加速器KV级能量成像束机头蒙卡模型得到相空间文件;以此相空间为源,使用蒙卡DOSXYZnrc程序建立肺部模型,计算肺部模体中成像剂量;使用MATLAB编程处理剂量数据,得到百分深度剂量（percent depthdose,PDD）、离轴比（off axis ratio,OAR）和等剂量曲线（isodose curve）。结果：得到了清华同源双束医用加速器KV级能量成像束在肺部模型中剂量分布曲线。结论：先计算不同模拟参数下的加速器机头相空间文件并保存再进行剂量计算,能极大节约整个计算流程耗费的时间;该模拟得到的成像剂量分布曲线可指导评价成像剂量对肺部器官损伤;加速器机头模型可用于其它器官成像剂量分布计算等后续研究。     

Monte Carlo方法计算补偿材料在放射治疗中的影响

本文用Monte Carlo方法计算在添加不同厚度补偿材料(Paraffin和PMMA)情况下不同能量电子线照射水模体的剂量分布,对所得照射野离轴比和百分深度剂量曲线进行分析讨论.结果表明,补偿材料(Paraffin和PMMA)在放射治疗中可以起到补偿人体不规则的外轮廓,提高皮肤及皮下剂量和调整电子线的剂量分布等作用.     

DPM蒙特卡罗剂量计算算法在均匀组织和非均匀组织剂量精确性的验证

验证DPM蒙特卡罗剂量计算算法预测均匀组织和非均匀组织剂量的精确性。DPM分别计算:①6 MeV单能光子3cm×3cm照射野和Varian 60℃加速器源水模体百分深度剂量曲线和10cm深度处离轴比;②6 MeV单能光子3cm×3cm、10cm×10cm照射野分别在水(6cm)/肺(6cm)/水(8cm)、水(6cm)/骨骼(2cm)/水(12cm)非均匀组织的百分深度剂量曲线;③6MeV单能光子6cm×6cm照射野人体头部和腹部组织在射野内和射野外的百分深度剂量曲线。比较DPM计算值与DOSXYZnrc/EGSnrc系统在相同条件下的计算值。结果显示二者计算值在水模中的误差在±3%以内,在非均匀组织中,除了个别点,误差都在±3%以内。DPM能够精确计算均匀组织和非均匀组织剂量。     

调强放射治疗“end to end”质量控制核查中应用针尖电离室测量小野剂量的初步研究

目的:在调强放射治疗“end to end”质量核查中,探讨应用针尖电离室对调强放射治疗小野照射进行绝对剂量测量的研究。方法:选择3省20家医院,将放有热释光剂量计TLD（距模体表面距离约7.5 cm）和胶片的国际原子能机构（IAEA）模体进行CT扫描,图像导入放射治疗计划系统（TPS）中,设计治疗计划,进行7野等中心调强照射,MLC照射野大小>2 cm×2 cm且<4 cm×4 cm。同时针尖电离室（0.015 cc）放在固体水模体距模体表面7.5 cm下进行点剂量绝对剂量验证:（1）将治疗计划中射野角度归零平移到固体水模体中进行剂量验证;（2）治疗计划射野角度不归零时为实际治疗照射方向,平移到固体水模体中进行绝对剂量验证。结果:在调强放射治疗多叶光栅小野照射的固体水模体中,用针尖电离室测量的绝对剂量与TPS计算得到的绝对剂量比较,7野照射方向归为零度时,比较偏差<5%;实际照射方向时,比较偏差<5%。验证后的计划,在IAEA模体上进行实际7野调强治疗,模体中的高剂量靶区胶片（Gafchromic EBT3 film）绝对剂量通过率均≥90%（Gamma分析:3%, 3 mm）,TLD偏差<7%。均符合IAEA提出的标准。结论:在调强放射治疗多叶光栅小野照射时,可以应用针尖电离室作为绝对剂量验证的一个方法。     

体元大小对基于MonteCarlo的剂量计算的影响

目的：在放射治疗计划系统中,剂量计算之前需要对人体密度数据体元化。对于蒙特卡罗方法的模拟过程,当一个自由程跨过体元界面时,会应用自由程近似。选取的体元越小,将导致越多的自由程近似。本文采用蒙特卡罗方法模拟一个虚拟射线源入射到水箱中的反应,计算水箱中的剂量分布,通过比较水箱分层和不分层两种情况下中心轴百分深度剂量分布和离轴比分布,来探讨选用不同大小的体元对剂量分布的影响。方法：本文以6MeV的方形电子射线源为外照射源、以三维水箱为介质模型。使用PENELOPE程序包模拟电子束垂直入射到水箱中引起的电子与物质的相互作用。比较水箱在分层和不分层情况下中心轴百分深度剂量和离轴比分布。结果：通过比较水箱在分层和不分层情况下中心轴百分深度剂量和离轴比分布,发现差异很小。结论：选用不同大小的体元,蒙特卡罗近似处理自由程对剂量计算精度的影响很小。研究结果对蒙特卡罗方法在放射治疗中的临床应用具有指导意义。     

Evaluation of polymer gels and MRI as a 3-D dosimeter for intensity-modulated radiation therapy.

BANG gel (MGS Research, Inc., Guilford, CT) has been evaluated for measuring intensity-modulated radiation therapy (IMRT) dose distributions. Treatment plans with target doses of 1500 cGy were generated by the Peacock IMRT system (NOMOS Corp., Sewickley, PA) using test target volumes. The gels were enclosed in 13 cm outer diameter cylindrical glass vessels. Dose calibration was conducted using seven smaller (4 cm diameter) cylindrical glass vessels irradiated to 0-1800 cGy in 300 cGy increments. Three-dimensional maps of the proton relaxation rate R2 were obtained using a 1.5 T magnetic resonance imaging (MRI) system (Siemens Medical Systems, Erlangen, Germany) and correlated with dose. A Hahn spin echo sequence was used with TR = 3 s, TE = 20 and 100 ms, NEX = 1, using 1 x 1 x 3 mm3 voxels. The MRI measurements were repeated weekly to identify the gel-aging characteristics. Ionization chamber, thermoluminescent dosimetry (TLD), and film dosimetry measurements of the IMRT dose distributions were obtained to compare against the gel results. The other dosimeters were used in a phantom with the same external cross-section as the gel phantom. The irradiated R2 values of the large vessels did not precisely track the smaller vessels, so the ionization chamber measurements were used to normalize the gel dose distributions. The point-to-point standard deviation of the gel dose measurements was 7.0 cGy. When compared with the ionization chamber measurements averaged over the chamber volume, 1% agreement was obtained. Comparisons against radiographic film dose distribution measurements and the treatment planning dose distribution calculation were used to determine the spatial localization accuracy of the gel and MRI. Spatial localization was better than 2 mm, and the dose was accurately determined by the gel both within and outside the target. The TLD chips were placed throughout the phantom to determine gel measurement precision in high- and low-dose regions. A multidimensional dose comparison tool that simultaneously examines the dose-difference and distance-to-agreement was used to evaluate the gel in both low-and high-dose gradient regions. When 3% and 3 mm criteria were used for the comparisons, more than 90% of the TLD measurements agreed with the gel, with the worst of 309 TLD chip measurements disagreeing by 40% of the criteria. All four MRI measurement session gel-measured dose distributions were compared to evaluate the time behavior of the gel. The low-dose regions were evaluated by comparison with TLD measurements at selected points, while high-dose regions were evaluated by directly comparing measured dose distributions. Tests using the multidimensional comparison tool showed detectable degradation beyond one week postirradiation, but all low-dose measurements passed relative to the test criteria and the dose distributions showed few regions that failed.     

Pencil beam approach for correcting the energy dependence artifact in film dosimetry for IMRT verification

The higher sensitivity to low-energy scattered photons of radiographic film compared to water can lead to significant dosimetric error when the beam quality varies significantly within a field. Correcting for this artifact will provide greater accuracy for intensity modulated radiation therapy (IMRT) verification dosimetry. A procedure is developed for correction of the film energy-dependent response by creating a pencil beam kernel within our treatment planning system to model the film response specifically. Film kernels are obtained from EGSnrc Monte Carlo simulations of the dose distribution from a 1 mm diameter narrow beam in a model of the film placed at six depths from 1.5 to 40 cm in polystyrene and solid water phantoms. Kernels for different area phantoms (50 x 50 cm2 and 25 x 25 cm2 polystyrene and 30 x 30 cm2 solid water) are produced. The Monte Carlo calculated kernel is experimentally verified with film, ion chamber and thermoluminescent dosimetry (TLD) measurements in polystyrene irradiated by a narrow beam. The kernel is then used in convolution calculations to, predict the film response in open and IMRT fields. A 6 MV photon beam and Kodak XV2 film in a polystyrene phantom are selected to test the method as they are often used in practice and can result in large energy-dependent artifacts. The difference in dose distributions calculated with the film kernel and the water kernel is subtracted from film measurements to obtain a practically film artifact free IMRT dose distribution for the Kodak XV2 film. For the points with dose exceeding 5 cGy (11% of the peak dose) in a large modulated field and a film measurement inside a large polystyrene phantom at depth of 10 cm, the correction reduces the fraction of pixels for which the film dose deviates from dose to water by more than 5% of the mean film dose from 44% to 6%.     

Investigation of the use of MOSFET for clinical IMRT dosimetric verification

(Received 22 October 2001; accepted for publication 26 March 2002; published 22 May 2002) With advanced conformal radiotherapy using intensity modulated beams, it is important to have radiation dose verification measurements prior to treatment. Metal oxide semiconductor field effect transistors (MOSFET) have the advantage of a faster and simpler reading procedure compared to thermoluminescent dosimeters (TLD), and with the commercial MOSFET system, multiple detectors can be used simultaneously. In addition, the small size of the detector could be advantageous, especially for point dose measurements in small homogeneous dose regions. To evaluate the feasibility of MOSFET for routine IMRT dosimetry, a comprehensive set of experiments has been conducted, to investigate the stability, linearity, energy, and angular dependence. For a period of two weeks, under a standard measurement setup, the measured dose standard deviation using the MOSFETs was +/- 0.015 Gy with the mean dose being 1.00 Gy. For a measured dose range of 0.3 Gy to 4.2 Gy, the MOSFETs present a linear response, with a linearity coefficient of 0.998. Under a 10 x 10 cm2 square field, the dose variations measured by the MOSFETs for every 10 degrees from 0 to 180 degrees is +/- 2.5%. The percent depth dose (PDD) measurements were used to verify the energy dependence. The measured PDD using the MOSFETs from 0.5 cm to 34 cm depth agreed to within +/- 3% when compared to that of the ionization chamber. For IMRT dose verification, two special phantoms were designed. One is a solid water slab with 81 possible MOSFET placement holes, and another is a cylindrical phantom with 48 placement holes. For each IMRT phantom verification, an ionization chamber and 3 to 5 MOSFETs were used to measure multiple point doses at different locations. Preliminary results show that the agreement between dose measured by MOSFET and that calculated by Corvus is within 5% error, while the agreement between ionization chamber measurement and the calculation is within 3% error. In conclusion, MOSFET detectors are suitable for routine IMRT dose verification.     

Dosimetric evaluation of partially overlapping intensity modulated beams using dynamic mini-multileaf collimation

The dose distribution resulting from partially overlapping intensity modulated beams (IMBs) assigned to different isocenters for the treatment of the same planning target volume (PTV) was evaluated. These partially overlapping IMBs are used in static intensity modulated radiation therapy (IMRT) treatments with the Novalis system using the mini-MultiLeaf Collimator (mini-MLC) in Dynamic MultiLeaf Collimation (DMLC) mode. The resultant dose distribution was verified dosimetrically for a cylindrical target defined in a homogeneous cubic phantom. The phantom positioning can introduce dose nonuniformities in the resultant dose distribution by nonperfect positioning of the isocenters in accordance with each other. The dose inhomogeneities are quantified mathematically by summation of the dose profiles of the used IMBs and experimentally by measurement of the resulting dose profiles with radiographic film and thermoluminescent detectors (TLD). The mathematical estimation of the resulting dose profile of the treatment with a perfect positioning of the isocenters showed a good agreement with the planned dose profile. The magnitude of the maximum dose inhomogeneities introduced by the simulated supplementary shifts between the isocenters decreases by -8.54% mm(-1) as the shift changes from -0.30 +/- 0.10 cm to +0.30 +/- 0.10 cm. The TLD measurements showed a similar variation of the magnitude of the maximum dose inhomogeneities: -8.77% mm(-1). The amount of dose variation was underestimated with the radiographic film measurements, which showed a variation of -7.17% mm(-1). The film measurements demonstrated that the magnitude of the introduced maximum dose inhomogeneities did not alter significantly throughout the PTV. The approach of using partially overlapping IMBs assigned to different isocenters to enlarge the treatment region introduces smaller dose inhomogeneities in the resultant dose distribution than when abutting treatment fields are used. The resultant dose distribution of this treatment technique is less sensitive to positioning errors of the used treatment isocenters.     

Analysis of various beamlet sizes for IMRT with 6 MV photons

Application of intensity modulated radiation therapy (IMRT) using multileaf collimation often requires the use of small beamlets to optimize the delivered radiation distribution. Small-beam dose distribution measurements were compared to dose distributions calculated using a commercial treatment planning system that models its data acquired using measurements from relatively large fields. We wanted to evaluate only the penumbra, percent depth-dose (PDD) and output model, so we avoided dose distribution features caused by rounded leaf ends and interleaf leakage by making measurements using the secondary collimators. We used a validated radiochromic film dosimetry system to measure high-resolution dose distributions of 6 MV photon beams. A commercial treatment planning system using the finite size pencil beam (FSPB) dose calculation algorithm was commissioned using measured central axis outputs from 4.0x4.0 to 40.0x40.0 cm2 beams and radiographic-film profile measurements of a 4.0x4.0 cm2 beam at twice the depth of maximum dose (dmax). Calculated dose distributions for square fields of 0.5x0.5 cm2, and 1.0x1.0 cm2, to 6.0x6.0 cm2, in 1.0x1.0 cm2, increments were compared against radiochromic film measurements taken with the film oriented parallel to the beam central axis in a water equivalent phantom. The PDD of the smaller field sizes exhibited behavior typical of small fields, namely a decrease in dmax with decreasing field size. The FSPB accurately modeled the depth-dose and central axis output for depths deeper than the nominal dmax of 1.5 cm plus 0.5 cm. The dose distribution in the build-up and penumbra regions was not accurately modeled for depths less than 2 cm, especially for the fields of 2.0x2.0 cm2 and smaller. Using the gamma function with 2 mm and 2% criteria, the dose model was shown to accurately predict the penumbra. While for single small beams the compared dose distributions passed the gamma function criteria, the clinical appropriateness of these criteria is not clear for a composite IMRT plan. Further investigation of the cumulative impact of the observed dose discrepancies is warranted. We speculate that the observed differences in the penumbra regions arise from some energy dependent artifact in the radiographic-film profiles used for commissioning. In the future, radiochromic film based commissioning might provide a more accurate data set for dose modeling.     

An experimental MOSFET approach to characterize (192)Ir HDR source anisotropy

The dose anisotropy around a (192)Ir HDR source in a water phantom has been measured using MOSFETs as relative dosimeters. In addition, modeling using the EGSnrc code has been performed to provide a complete dose distribution consistent with the MOSFET measurements. Doses around the Nucletron 'classic' (192)Ir HDR source were measured for a range of radial distances from 5 to 30 mm within a 40 x 30 x 30 cm(3) water phantom, using a TN-RD-50 MOSFET dosimetry system with an active area of 0.2 mm by 0.2 mm. For each successive measurement a linear stepper capable of movement in intervals of 0.0125 mm re-positioned the MOSFET at the required radial distance, while a rotational stepper enabled angular displacement of the source at intervals of 0.9 degrees . The source-dosimeter arrangement within the water phantom was modeled using the standardized cylindrical geometry of the DOSRZnrc user code. In general, the measured relative anisotropy at each radial distance from 5 mm to 30 mm is in good agreement with the EGSnrc simulations, benchmark Monte Carlo simulation and TLD measurements where they exist. The experimental approach employing a MOSFET detection system of small size, high spatial resolution and fast read out capability allowed a practical approach to the determination of dose anisotropy around a HDR source.     

A thermoluminescence system for the intercomparison of absorbed dose and radiation quality of X-rays with a HVL of 0-1 to 3-0 mm Cu.

A TLD system is described which permits the measurement of absorbed X-ray doses in a water phantom, together with the quality of the incident X-ray beam. The system has been developed for dose and energy intercomparison studies between centres with deep therapy X-ray machines. A distinction has been made between deep therapy treatments and treatments at or near the surface. For beam qualities with a HVL above 1-1 mm Cu, the deep therapy region, measurements have been performed at 5 cm depth in water using CaF2: Mn and LiF (TLD 700). For beam qualities with a HVL of 0-11-1-4 mm Cu, these qualities include the superficial therapy region, measurements with LiF dosemeters at 2 and 10 cm depth in water have been carried out. The uncertainty in the absorbed dose value for X-ray beams with a HVL of 0-11-3-0 mm Cu amounts to +/- 4%; the uncertainty in the determination of the effective energy of the incident beam is +/- 3 to +/- 7%.     

Conversion of measured percentage depth dose to tissue maximum ratio values in stereotactic radiotherapy

For many treatment planning systems tissue maximum ratios (TMR) are required as input. These tissue maximum ratios can be measured with a 3D computer-controlled water phantom; however, a TMR measurement option is not always available on such a system. Alternatively TMR values can be measured 'manually' by lowering the detector and raising the water phantom with the same distance, but this makes TMR measurements time consuming. Therefore we have derived TMR values from percentage depth dose (PDD) curves. Existing conversion methods express TMR values in terms of PDD, phantom scatter factor (Sp), and inverse square law. For stereotactic treatments circular fields ranging from 5-50 mm (19 cones) are used with the treatment planning system XKnife (Radionics). The calculation of TMR curves for this range is not possible with existing methods. This is because PDD curves of field sizes smaller than 5 mm (smallest cone size) are needed, but these cones are not provided. Besides, for field sizes smaller than 40 mm, the phantom scatter factor is difficult to determine and will introduce significant errors. To overcome these uncertainties, an alternative method has been developed to obtain TMR values from PDD data, where absolute doses are expressed in terms of PDD, total scatter factor and inverse square law. For each depth, the dose as a function of field size is fitted to a double exponential function. Then the TMR is calculated by taking the ratio of this function at the depth of interest and the reference depth, for the correct field size. For all 19 cones the total scatter factor and PDDs have been measured with a shielded diode in water for a 6 MV photon beam. Calculated TMR curves are compared with TMR values measured with a diode. The agreement is within 2%. Therefore this relatively simple conversion method meets the required accuracy for daily dose calculation in stereotactic radiotherapy. In principle this method could also be applied for other small field sizes such as those formed with a mini multileaf collimator.