Equivalent (uniform) square field sizes of flattening filter free photon beams

Abstract

Various types of treatment units, such as CyberKnife, TomoTherapy and C-arm linear accelerators (LINACs) are operated using flattening filter free (FFF) photon beams. Their reference dosimetry, however, is currently based on codes of practice that provide data which were primarily developed and tested for high-energy photon beams with flattening filter (WFF). The aim of this work was to introduce equivalent uniform square field sizes of FFF beams to serve as a basis of a unified reference dosimetry procedure applicable to all aforementioned FFF machines. For this purpose, in-house determined experimental data together with published data of the ratio of doses at depths of 20 cm and 10 cm in water (D20,10) were used to characterize the depth dose distribution of 6 and 10 MV WFF and FFF beams. These data were analyzed for field sizes ranging from 2 × 2 cm2 to 40 × 40 cm2. A scatter function that takes the lateral profiles of the individual beams into account was fitted to the experimental data. The lateral profiles of the WFF beams were assumed to be uniform, while those of the FFF beams were approximated using fourth or sixth order polynomials. The scatter functions of the FFF beams were recalculated using a uniform lateral profile (the same as the physical profile of the WFF beams), and are henceforth denoted as virtual uniform FFF beams (VUFFF). The field sizes of the VUFFF beams having the same scatter contribution as the corresponding FFF beams at a given field size were defined as the equivalent uniform square field (EQUSF) size. Data from four different LINACs with 18 different beams in total, as well as a CyberKnife beam, were analyzed. The average values of EQUSFs over all investigated LINACs of the conventional 10 × 10 cm2 reference fields of 6 MV and 10 MV FFF beams for C-arm LINACs and machine-specific reference fields for CyberKnife and TomoTherapy were 9.5 cm, 9 cm, 5.0 cm and 6.5 cm respectively. The standard deviation of the mean of these EQUSFs was below 0.1 cm. It has been shown that with the introduction of a VUFFF beam, EQUSFs can be consistently defined for a variety of energies and collimations. These EQUSFs can form the basis for a unified reference dosimetry protocol for all different types of FFF machines.