George Seby, Ponmalar Y Retna, Godson Henry Finlay, Kumar A Sathish, Ravindran B Paul
Department of Radiation Oncology, Christian Medical College, Vellore, Tamil Nadu, India.
J Med Phys. 2022 Jan-Mar;47(1):65-72. doi: 10.4103/jmp.jmp_111_21. Epub 2022 Mar 31.
The experimental determination of relative output factors presents the greatest challenge, especially for small fields with different detectors. The aim of this study is to evaluate the influence of jaw positions on small-field output factors for the fields defined by micro-multileaf collimator and circular cones with different detectors.
The stereotactic output factors were measured on Primus linear accelerator with BrainLab micro-multileaf collimator (mMLC) and circular cones as add-on tertiary collimators. Square field sizes ranging from 0.6 cm × 0.6 cm to 9.8 cm × 9.8 cm and circular fields of diameter ranging from 1.0 cm to 4.0 cm were defined by mMLC and circular cones, respectively. The influence of jaw position on output factor was assessed for different geometric configurations with three different detectors.
The values obtained with PinPoint ion chamber were consistent with microDiamond detector for fields greater than 24 mm × 24 mm, but an underestimation of 23.9% was noticed in 6 mm x 6 mm field size. For the mMLC defined field size of 6 mm × 6 mm, when the X-Y jaw was moved from 8 mm × 8 mm to 80 mm × 80 mm, an increase in the output by a factor of 1.7 was observed with both microDiamond and stereotactic radiosurgery diode, whereas an increase in output by a factor of 1.9 was noticed with PinPoint ion chamber.
Output factors obtained with different detectors show high differences in the smallest field size for all collimating systems. This study confirms that the position of X and Y jaw above the tertiary collimator significantly influences the small-field output factor.
相对输出因子的实验测定面临着巨大挑战,尤其是对于使用不同探测器的小射野。本研究旨在评估颌部位置对由微多叶准直器和带有不同探测器的圆锥准直器所定义的小射野输出因子的影响。
在配备BrainLab微多叶准直器(mMLC)和作为附加三级准直器的圆锥准直器的Primus直线加速器上测量立体定向输出因子。mMLC和圆锥准直器分别定义了边长从0.6 cm×0.6 cm到9.8 cm×9.8 cm的方形射野以及直径从1.0 cm到4.0 cm的圆形射野。使用三种不同探测器,针对不同几何构型评估颌部位置对输出因子的影响。
对于大于24 mm×24 mm的射野,使用PinPoint电离室获得的值与微金刚石探测器一致,但在6 mm×6 mm射野尺寸下发现低估了23.9%。对于mMLC定义的6 mm×6 mm射野尺寸,当X - Y颌从8 mm×8 mm移动到80 mm×80 mm时,微金刚石探测器和立体定向放射外科二极管均观察到输出增加了1.7倍,而PinPoint电离室观察到输出增加了1.9倍。
对于所有准直系统,在最小射野尺寸下,使用不同探测器获得的输出因子显示出很大差异。本研究证实,三级准直器上方X和Y颌的位置对小射野输出因子有显著影响。