The aim of the study was to quantify the effect of miniphantoms on in-air output ratio measurements, i.e., to determine correction factors for in-air output ratio. Monte Carlo (MC) simulations were performed to simulate in-air output ratio measurements by using miniphantoms made of various materials (PMMA, graphite, copper, brass, and lead) and with different longitudinal thicknesses or depths (2-30 g/cm2) in photon beams of 6 and 15 MV, respectively, and with collimator settings ranging from 3 x 3 to 40 x 40 cm2. EGSnrc and BEAMnrc (2007) software packages were used. Photon energy spectra corresponding to the collimator settings were obtained from BEAMnrc code simulations on a linear accelerator and were used to quantify the components of in-air output ratio correction factors, i.e., attenuation, mass energy absorption, and phantom scatter correction factors. In-air output ratio correction factors as functions of miniphantom material, miniphantom longitudinal thickness, and collimator setting were calculated and compared to a previous experimental study. The in-air output ratio correction factors increase with collimator opening and miniphantom longitudinal thickness for all the materials and for both energies. At small longitudinal thicknesses, the in-air output ratio correction factors for PMMA and graphite are close to 1. The maximum magnitudes of the in-air output ratio correction factors occur at the largest collimator setting (40 x 40 cm2) and the largest miniphantom longitudinal thickness (30 g/cm2): 1.008 +/- 0.001 for 6 MV and 1.012 +/- 0.001 for 15 MV, respectively. The MC simulations of the in-air output ratio correction factor confirm the previous experimental study. The study has verified that a correction factor for in-air output ratio can be obtained as a product of attenuation correction factor, mass energy absorption correction factor, and phantom scatter correction factor. The correction factors obtained in the present study can be used in studies involving in-air output ratio measurements using miniphantoms.
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