Comparison of the penumbra between focused and nondivergent blocks--implications for multileaf collimators.

The penumbra from a 10-MV x-ray beam has been measured using various field-shaping blocks located in the normal blocking tray position and compared to the penumbra of the adjustable photon jaws of the machine. The results showed that the penumbra was substantially degraded by these blocks only for field sizes greater than 15 x 15 cm2 and at the depth of maximum dose, dmax. At depths of 11 cm or greater, there was a significant difference only for the same range of field sizes in the 80% to 50% dose region. There was no significant difference at these depths for either the 95%-50% or the 90%-50% dose regions. No significant difference was observed between the use of lead and tungsten blocks and also between lead blocks with a straight edge and those with either an 0.5-mm or a 1-mm step in the face. Since the width of the 95% dose relative to the 50% dose is of greatest interest clinically, straight-edged blocks are as effective as divergent blocks in most situations. These results imply that the design and complexity of a multileaf collimator can be greatly simplified from a double focusing device to one that is single focusing in the plane orthogonal to the leaves.