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Lens dose is a concern during the treatment of facial lesions with anterior electron beams. Lead shielding is routinely employed to reduce lens dose and minimize late complications. The purpose of this work is twofold: 1) to measure dose pro-files under large-area lead shielding at the lens depth for clinical electron energies via film dosimetry; and 2) to assess the accuracy of the Pinnacle treatment planning system in calculating doses under lead shields. First, to simulate the clinical geometry, EBT3 film and 4 cm wide lead shields were incorporated into a Solid Water phantom. With the lead shield inside the phantom, the film was positioned at a depth of 0.7 cm below the lead, while a variable thickness of solid water, simulating bolus, was placed on top. This geometry was reproduced in Pinnacle to calculate dose profiles using the pencil beam electron algorithm. The measured and calculated dose profiles were normalized to the central-axis dose maximum in a homogeneous phantom with no lead shielding. The resulting measured profiles, functions of bolus thickness and incident electron energy, can be used to estimate the lens dose under various clinical scenarios. These profiles showed a minimum lead margin of 0.5 cm beyond the lens boundary is required to shield the lens to ≤ 10% of the dose maximum. Comparisons with Pinnacle showed a consistent overestimation of dose under the lead shield with discrepancies of ~ 25% occur-ring near the shield edge. This discrepancy was found to increase with electron energy and bolus thickness and decrease with distance from the lead edge. Thus, the Pinnacle electron algorithm is not recommended for estimating lens dose in this situation. The film measurements, however, allow for a reasonable estimate of lens dose from electron beams and for clinicians to assess the lead margin required to reduce the lens dose to an acceptable level.

A laminated beam-spot camera of length 20 cm and effective cross-sectional area 2.5 cm × 3 cm was designed and constructed for the measurement of X-ray beam-spot sizes on different models of Siemens accelerators. With the accelerator gantry at 180° and camera positioned on an accessory tray holder, an XV film placed in contact with the camera at the distal end of it detected those X-rays that were transmitted through the camera. The FWHM of the detected X-ray intensity profile in the gun-target (G-T) direction or the orthogonal A-B direction was used as a measure of the beam-spot size in that direction. Siemens Mevatron MXEs exhibited a beam-spot size of 1.7 ± 0.2 mm in both the in-plane and cross-plane directions for 6 MV photon beams. The beam-spot size observed for a Mevatron MDX-2 was larger by up to 1 mm, and also was different for the in-plane and cross-plane directions. For Siemens PRIMUS accelerators, the beam-spot size in the in-plane direction was found to fall in the range 2.0-2.2 ± 0.2 mm, whereas the beam-spot size in the cross-plane direction fell within 1.7-1.9 ± 0.2 mm for 6, 10, and 18 MV photon beams. Assessment of long-term stability of the beam-spot size shows the spot size remains fairly stable over time.

In this work, leakage radiation from EA200 series electron applicators on Siemens Primus accelerators is quantified, and its penetration ability in water and/or the shielding material Xenolite-NL established. Initially, measurement of leakage from 10 x 10 - 25 x 25 cm2 applicators was performed as a function of height along applicator and of lateral distance from applicator body. Relative to central-axis ionization maximum in solid water, the maximum leakage in air observed with a cylindrical ion chamber with 1 cm solid water buildup cap at a lateral distance of 2 cm from the front and right sidewalls of applicators were 17% and 14%, respectively; these maxima were recorded for 18 MeV electron beams and applicator sizes of >or=20 x 20 cm2. In the patient plane, the applicator leakage gave rise to a broad peripheral dose off-axis distance peak that shifted closer to the field edge as the electron energy increases. The maximum peripheral dose from normally incident primary electron beams at a depth of 1 cm in a water phantom was observed to be equal to 5% of the central-axis dose maximum and as high as 9% for obliquely incident beams with angles of obliquity

A methodology for the dosimetric verification of micro-multileaf collimator MMLC) based intensity modulated radiation therapy (IMRT) plans intended for stereotactic applications is described. The procedure is similar to that of conventional IMRT patient-specific quality assurance with some notable exceptions. Relative dosimetry measurements are performed with radiographic film, a commercial film-scanning system and a dose-image registration program. Film dosimetry results are within +/- 3.0% of calculated distributions or within 2.0 mm distance to agreement. Absolute dosimetry measurements are performed with a small volume ion-chamber and a commercially available stereotactic phantom. The cumulative dose from all beams is within +/- 2.0 % of the prescribed dose. Large deviations may be observed from individual beams since the smaller IMRT fields tend to have very few high-dose and low-gradient regions. An independent program that examines the treatment MLC file is used to estimate the central axis dose from each beam and provide a dose image that can be assessed alongside the intended fluence distribution prior to treatment. Tolerances for relative and absolute dosimetry of MMLC-based IMRT treatments are tighter than what is typically reported for conventional MLC-based IMRT. Also, the time commitment for the IMRT QA is slightly longer than of conventional MLC-based IMRT due to QA processes which check the mechanical alignment of the MMLC device with the laser and radiation isocentre.