Dependence of the tray transmission factor on collimator setting and source-surface distance

Comparison of the ESTRO formalism for monitor unit calculation with a Clarkson based algorithm of a treatment planning system and a traditional "full-scatter" methodology

The ESTRO formalism for monitor unit (MU) calculations was evaluated and implemented to replace a previous methodology based on dosimetric data measured in a full-scatter phantom. This traditional method relies on data normalised at the depth of dose maximum (Zm), as well as on the utilisation of the BJR 25 table for the conversion of rectangular fields into equivalent square fields. The treatment planning system (TPS) was subsequently updated to reflect the new beam data normalised at a depth ZR of 10 cm. Comparisons were then carried out between the ESTRO formalism, the Clarkson-based dose calculation algorithm on the TPS (with beam data normalised at Zm and ZR), and the traditional "full-scatter" methodology. All methodologies, except for the "full-scatter" methodology, separated head-scatter from phantom-scatter effects and none of the methodologies; except for the ESTRO formalism, utilised wedge depth dose information for calculations. The accuracy of MU calculations was verified against measurements in a homogeneous phantom for square and rectangular open and wedged fields, as well as blocked open and wedged fields, at 5, 10, and 20 cm depths, under fixed SSD and isocentric geometries for 6 and 10 MV. Overall, the ESTRO Formalism showed the most accurate performance, with the root mean square (RMS) error with respect to measurements remaining below 1% even for the most complex beam set-ups investigated. The RMS error for the TPS deteriorated with the introduction of a wedge, with a worse RMS error for the beam data normalised at Zm (4% at 6 MV and 1.6% at 10 MV) than at ZR (1.-9% at 6 MV and 1.1% at 10 MV). The further addition of blocking had only a marginal impact on the accuracy of this methodology. The "full-scatter" methodology showed a loss in accuracy for calculations involving either wedges or blocking, and performed worst for blocked wedged fields (RMS errors of 7.1% at 6 MV and 5% at 10 MV). The origins of these discrepancies were quantified and the shortcomings of these MU calculation methodologies are discussed in the paper.

Formalisms for MU calculations, ESTRO booklet 3 versus NCS report 12

Although the relevance and importance of quality assurance and quality control in radiotherapy is generally accepted, only recently, methods for monitor unit (MU) calculation and verification have been addressed in recognized recommendations, published by the European Society of Therapeutic Radiation Oncology (ESTRO) and by the Netherlands Commission on Radiation Dosimetry (Dutreix A, Bjärngard BE, Bridier A, Mijnheer B, Shaw JE, Svensson H. Monitor unit calculation for high-energy photon beams. Physics for clinical radiotherapy. ESTRO Booklet No. 3. Leuven: Garant, 1997; Netherlands Commission on Radiation Dosimetry (NCS). Determination and use of scatter correction factors of megavoltage photon beams. NCS report 12. Deift: NCS, 1998). Both documents are based on the same principles: (i) the separation of the output factor into a head and a volume (or phantom) scatter component; (ii) the use of a so-called mini-phantom to measure and verify the head scatter component; and (iii) the recommendation to use a single reference depth of 10 cm for all photon beam qualities. However, there are substantial differences between the approach developed in the IAEA-ESTRO task group and the NCS approach for MU calculations, which might lead to confusion and/or misinterpretation if both reports are used simultaneously or if data from the NCS report is applied in the algorithms of the ESTRO report without careful consideration. The aim of the present paper is to discuss and to clearly point out these differences (e.g. field size definitions, phantom scatter parameters, etc.). Additionally, corresponding quantities in the two reports are related where possible and several aspects concerning the use of a mini-phantom (e.g. size, detector position, composition) are addressed.