Commissioning Measurements of Flattening Filter and Flattening Filter Free Photon Beams Using a TrueBeam Stx® Linear Accelerator

Abstract

Introduction: TrueBeam STx® latest generation linear accelerators (linacs) were installed at Sheikh Khalifa International University Hospital Casablanca, Morocco, this study aimed to present and analyse the dosimetric characteristics obtained during the commissioning. Material and Methods: Dosimetric parameters, including percentage depth dose, profiles, output factor, multileaf collimator (MLC) transmission, and dosimetric leaf gaps (DLG) factors were systematically measured for commissioning. Moreover, six photons beams (i.e., X6MV, X6FFFMV, X10MV, X10FFFMV, X15MV, and X18MV) were examined in this study, and a comparison was made between flattening filter (FF) and flattening filter free (FFF) beams. Results: According to the results, the FF and FFF beams symmetry and flatness were in the tolerance intervals. The unflattness values were estimated at 1.1% and 1.2% for X6FFFMV and X10FFFMV, respectively. Furthermore, tissue phantom ratio(20/10)(TPR) values of the FF beams were X6MV, 0.664; X10MV, 0.738; X15MV, 0.761; and X18MV, 0.778, and the TPR (20/10) values of the FFF beams included 0.632 and 0.703 for 6FFFMV and 10FFFMV, respectively. The results also revealed that the output factor values increased with field size, the surface dose decreased with increasing energy, and the FFF obtained lower mean energy. The MLC transmissions factors were 0.0121, 0.0103, 0.0136, 0.0122, 0.0133, and 0.0121 for X6, X6FFF, X10, X10FFF, X15, and X18, respectively; additionally, the DLG factors were obtained at 0.32, 0.26, 0.41, 0.37, 0.42, and 0.38 mm for X6, X6FFF, X10, X10FFF, X15, and X18, respectively. Conclusion: Photon beams reference dosimetric characteristics were successfully matched with the international recommendations and vendor technical specifications.