Abstract

Introduction: Stereotactic radiosurgery is used to treat intracranial lesions with a high degree of accuracy. At the present time, x‐ray energies at or above Co‐60 gamma rays are used. We hypothesize that intermediate energy x‐ray photons (IEP's), combined with small field sizes, produce a reduced radiological penumbra leading to a sharper dose gradient. The purpose of this work is three‐fold: 1.) to produce IEP's using a medical linear accelerator 2.) to characterize the x‐ray energy 3.) to demonstrate reduced radiological penumbra for IEP's compared to 6MV x‐rays.Materials & Methods: A Siemens linear accelerator was modified to produce IEP's. PDD versus depth measurements were done in solid water using a Markus parallel plate ionization chamber (PTW Freiburg) at SSD=100cm for a 2×2cm2 field size. Monte Carlo computer simulations were done using MCNP‐4C. A penumbra measurement device was constructed to examine radiological penumbra for various photon energies, field sizes and depths. Film (Gafchromic EBT) was used to record field edge profiles. These films were scanned using a digital microscope (spatial resolution of 1.87 microns/pixel). Film irradiations were done using SSD=100cm, depth= 2cm, FS=1.1cm2.Results: For the IEP's, PDD values were 55.4%(surface), 62.6%(5cm), and 34.7%(10cm). Monte Carlo simulations suggest a nominal x‐ray energy of 800kV. The 80%–20% penumbra widths were 2.10mm (6MV) and 0.345mm (IEP's).Conclusions: A novel intermediate energy x‐ray beam (800kV) has been produced using a linear accelerator. There is more than a 5‐fold reduction in radiological penumbra for the IEP's versus 6MV x‐rays for the small field size examined.

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