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Chapter 10 A System of Dosimetric Calculations

The document discusses several parameters and methods used for calculating dose in radiation therapy, including: - Percent depth dose, tissue-air ratios (TAR), and tissue maximum ratios (TMR) which are used to calculate dose for different treatment techniques. - Dose consists of primary dose from unscattered photons and scattered dose from photons scattered in the phantom. - Tissue phantom ratios (TPR) and scatter-maximum ratios (SMR) relate dose at different depths and field sizes. - Methods are presented for calculating monitor units for different treatment machines, energies, depths, field sizes, and techniques based on calibration conditions and tissue-maximum or percent depth dose values. - Effective field sizes and off-

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Isaul Llamo Torres
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263 views30 pages

Chapter 10 A System of Dosimetric Calculations

The document discusses several parameters and methods used for calculating dose in radiation therapy, including: - Percent depth dose, tissue-air ratios (TAR), and tissue maximum ratios (TMR) which are used to calculate dose for different treatment techniques. - Dose consists of primary dose from unscattered photons and scattered dose from photons scattered in the phantom. - Tissue phantom ratios (TPR) and scatter-maximum ratios (SMR) relate dose at different depths and field sizes. - Methods are presented for calculating monitor units for different treatment machines, energies, depths, field sizes, and techniques based on calibration conditions and tissue-maximum or percent depth dose values. - Effective field sizes and off-

Uploaded by

Isaul Llamo Torres
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Chapter 10 A System of Dosimetric Calculations

Percent depth dose is suitable for SSD treatment technique.


Tissue-air-ratios (TAR) suitable for SAD treatment
technique, but limited to energies no higher than Co-60.
Tissue-maximum-ratios (TMR) and Tissue-phantom-ratios
(TPR) were designed to overcome the limitations of the TAR.

10.1 Dose Calculation Parameters


Dose = Primary dose + Scattered dose
Primary dose (includes those scattered
in the head, so-called collimator scatter)
= dose due to unscattered (in phantom)
photons. Conceptually, primary dose can
be achieved with a beam of zero field
size, or a phantom column of zero
radius. (In both cases, to eliminate
scatter in the phantom.)

P
S

(phantom) Scattered dose = dose due to


photons scattered at least once in the
phantom.
2

SAD

10.1 Dose Calculation Parameters (collimator & phantom


scatter factor)

Buildup
cap

Reference
depth

Reference
field

air

phantom
Sc,p
Sc

Sp = Sc,p / Sc

Reference
field

Field size

Phantom Scatter Factor (Sp)


keeping same
collimator opening

block down
to reference
field size

Reference
depth

r0

D0

phantom

phantom

D(d max ) D fs (r ) BSF (r )

D0 (d max ) D fs (r ) BSF (r0 )

Dfs unchanged, due to same collimator opening


S p (r )

D(d max )
BSF (r )

D0 (d max ) BSF (r0 )

10.1 Dose Calculation Parameters (tissue-phantom &


tissue-maximum ratios)

t0
Dd

rd

TPR (d , rd )

Dt0
Dd
Dt0

Dd
TMR(d , rd )
Dmax

rd

where t0 is the reference depth


if t0 = dmax

TAR, TMR, and TPR depends on depth and field size,


but is SSD independent.

10.1 Dose Calculation Parameters (properties of TMR)

TMR

Like TAR, TMR is independent of SSD, increases with energy and field size.

3030

TMR (d ,0) e ( d t max )

Depth in water

1010
00

Relationship between TMR and TAR

d
Dfs

rd
TAR (d , rd )

dmax
Dd

Dd
D fs

r
Dmax d

rd

TMR(d , rd )

Dmax
BSF (rd )
D fs

Dd
Dmax

TMR (d , rd )

TAR (d , rd )
BSF (rd )

Relationship between TMR and PDD

f
r
PDD(d , r , f ) Dd

100
D0

TMR (d , rd )
PDD(d , r , f ) f d

f d
100
max

r0

dmax

D0
Dd

dmax
r
Dmax d

rd

TMR (d , rd )
2
S p (r0 )

S (r )
p d

f d
D0

Dmax f d max

Dd
Dmax

2
S p (r0 )

S (r )
p d

Scatter-Maximum Ratio (SMR)

D (d , rd ) D1 (d ,0)
SMR(d , rd ) 1
D2 (d max ,0)

SMR(d , rd )

dmax
D1

rd

D2

rd

D1 (d , rd )
D (d , r ) D (d , r )
D1 (d ,0)
2 max d 2 max 0
D2 (d max , rd ) D2 (d max , r0 ) D2 (d max ,0) D2 (d max ,0)

r0 = reference field size


SMR(d , rd ) TMR (d , rd )

S p (rd )
S p (0)

TMR (d ,0)

10.2 Practical Applications (accelerator calculations)


SSD technique:

calibration
conditions

distance
changed

SSD

SAD

SCD

field size
changed

r0
t0

t0

r
r
c
SSD SAD

rc

r
xc
r

Sc(rc)Sp(r)

r
t0

d
Sc(rc)Sp(r)

rc
r'

SCD t

SAD
0

MU

depth
changed

SCD
SSD t 0

PDD(d , r , SSD)
100

TD ( target dose) 100

K PDD(d , r , SSD ) S c ( rc ) S p (r ) SCD SSD t 0 2

10

10.2 Practical Applications (accelerator calculations,


example 1)
SSD technique:
Machine: 4 MV photons
Calibration conditions: SSD = 100 cm, dmax = 1 cm, field size = 10 10 cm.
Calibration dose rate = 1 cGy / MU
Treatment conditions: SSD = 100 cm, d = 10 cm, field size = 15 15 cm,
Sc(1515)=1.020, Sp(1515)=1.010, %DD=65.1, TD = 200 cGy.

Dose/MU at prescription point


= 1 1.02 1.01 65.1/100 = 0.6707
MU = 200 / 0.6707 = 298

11

10.2 Practical Applications (accelerator calculations,


example 2)
SSD technique:
Machine: 4 MV photons
Calibration conditions: SSD = 100 cm, dmax = 1 cm, field size = 10 10 cm.
Calibration dose rate = 1 cGy / MU
Treatment conditions: SSD = 120 cm, d = 10 cm, field size = 15 15 cm,
Sc(12.512.5)=1.010, Sp(1515)=1.010, %DD=66.7, TD = 200 cGy.

Dose/MU at prescription point


= 1 1.01 1.01 [(100+1)/(120+1)]2 0.667 = 0.474
MU = 200 / 0.474 = 422

12

10.2 Practical Applications (accelerator calculations)


SAD technique:
field size
changed

depth
changed

distance
changed

SAD

SCD

calibration
conditions

t0
t0

t0

r0
x
K

MU

r
x r
c

Sc(rc)Sp(r)

r
r'
c

SCD SAD

t0

x r
d

rd

Sc(rc)Sp(rd)
SCD

SAD

TMR(d , rd )

ID (isocenter dose)

K TMR (d , rd ) S c (rc ) S p (rd ) SCD SAD 2

13

10.2 Practical Applications (accelerator calculations,


example 3)
SAD technique:
Machine: 4 MV photons
Calibration conditions: SCD = 100 cm, dmax = 1 cm, field size = 10 10 cm.
Calibration dose rate = 1 cGy / MU
Treatment conditions: SAD = 100 cm, d = 8 cm, field size = 6 6 cm,
Sc(66)=0.970, Sp(66)=0.990, TMR(8, 66)=0.787, TD = 200 cGy.

Dose/MU at prescription point


= 1 0.970 0.990 0.787 = 0.756
MU = 200 / 0.756 = 265

14

10.2 Practical Applications (accelerator calculations,


example 4)
SAD technique:
Machine: 4 MV photons
Calibration conditions: SCD = 101 cm, dmax = 1 cm, field size = 10 10 cm.
Calibration dose rate = 1 cGy / MU
Treatment conditions: SAD = 100 cm, d = 8 cm, field size = 6 6 cm,
Sc(66)=0.970, Sp(66)=0.990, TMR(8, 66)=0.787, TD = 200 cGy.

Dose/MU at prescription point


= 1 0.970 0.990 [(100+1)/(100)]2 0.787 = 0.771
MU = 200 / 0.771 = 259

15

10.2 Practical Applications (Co-60 unit, example 5)


SSD technique:
Machine: Co-60 photons
Calibration conditions: SSD = 80 cm, dmax = 0.5 cm, field size = 10 10 cm.
Calibration dose rate = 130 cGy / min
Treatment conditions: SSD = 100 cm, d = 8 cm, field size = 15 15 cm,
Sc(1212)=1.012, Sp(1515)=1.014, %DD(8,15 15,100)=68.7, TD = 200 cGy.

Dose/MU at prescription point


= 130 1.012 1.014 [(80+0.5)/(100+0.5)]2 68.7/100 = 58.80
MU = 200 / 58.80 = 3.40 min

16

10.2 Practical Applications (irregular fields)


SMR(d , rd ) TMR (d , rd )

S p (rd )
S p (0)

TMR (d ,0)

TMR(d , rd ) TMR (d ,0) SMR(d , rd )

TMR (d ) TMR(d ,0) SMR(d )


1
SMR(d )
n
1
S p (rd )
n

For off-axis
point:

SMR(d , r )

(from slide #9)

S p (0)
S p (rd )

BEV

S p ( 0)
S p (rd )

ri

i 1
n

S
i 1

p ( ri )

TMR (d ) K p TMR(d ,0) SMR(d )

off-axis ratio

S p ( 0)
S p (rd )

17

From slide #8:

f
r

t0
rd

PDD(d , r , f ) f d

TMR (d , rd )

100
f t0

S p (rt0 )

S p ( rd )

(from slide #9)


S p (rd )
SMR(d , rd ) TMR (d , rd )
TMR (d ,0)
S p (0)
(when d = t0)
S p (rd )
SMR(t 0 , rd ) 1
1
S p (0)

S p (rd ) f t 0
P(d , r , f )
K p TMR (d ,0) SMR(d )


100
S p (rd ) S p (rt0 ) f d

S p (0)

f t0
P (d , r , f )
1
K p TMR (d ,0) SMR(d )

100
1 SMR(t 0 , rt0 ) f d

18

10.2 Practical Applications (asymmetric fields)


SSD technique:
Dose / MU = K

SAD
technique:
Dose / MU = K

Sc (rc) Sp(r)

Sc (rc) Sp(rd)

(SSD factor)

(SAD factor)

PDD(d,r)/100

TMR(d,rd)

OARd(x)

OARd(x)

MU = TD / (Dose / MU)

MU = ID / (Dose / MU)
19

10.3 Other Practical Methods of Calculating Depth Dose


Distribution (Irregular fields)
Collimator field vs. effective fields

20

10.3 Other Practical Methods of Calculating Depth Dose


Distribution (off-axis points)
2d

2a
2b

b
a

1
D2 2a 2b
4

2b
a

b
c

2c

1
D3 2a 2c
4

1
D3 2a 2c
4

1
D1 2b 2d
4

Q
2d

2a
Q

d
Q

2c
c

Q
d

1
D4 2d 2c
4

21

10.3 Other Practical Methods of Calculating Depth Dose


Distribution (off-axis points)
Let the dose in free space at P = Dfs(P), then the
dose at P(dmax) =Dfs(P)BSF[(a+d)(b+c)].

b
x

Moreover, let KQ be the off-axis ratio at Q, then


P
c
the dose at Q is:
D fs ( P ) K Q
DQ a d b c
4
[ BSF 2b 2d % DD 2b 2d / 100 BSF 2a 2b % DD 2a 2b / 100
BSF 2a 2c % DD 2a 2c / 100 BSF 2d 2c % DD 2d 2c / 100]
% DQ
DP (d max )

KQ
4 BSF [(a d ) (b c)]

[ BSF 2b 2d % DD 2b 2d BSF 2a 2b % DD 2a 2b
BSF 2a 2c % DD 2a 2c BSF 2d 2c % DD 2d 2c ]

22

a=10
b=5

For a = 10cm, b = 5cm, c = 10cm, d = 5cm and


a Co-60 beam with KQ = 0.98 and SSD = 80cm,
what is %DQ(d=10cm) relative to DP(dmax)?

c=10

Example 6:

d=5
Q

Given:
Field size

10x10

20x10

20x20

15x15

BSF

1.036

1.043

1.061

1.052

%DD(SSD=80cm,d=10cm)

55.6

56.3

60.2

58.4

% DQ
DP (d max )

0.98
[1.036 55.6 1.043 56.3 1.061 60.2 1.043 56.3]
4 1.052

55.8

23

10.3 Other Practical Methods of Calculating Depth Dose


Distribution (points outside the field)
a
b

a
b

c c

2c

a
b

b
2c
1
b


2
1
D a b; c D 2a 2c b D 2c b
2

24

Example 7:

a=15
b=10

For a = 15cm, b = 10cm, c = 5cm, and a


Co-60 beam with SSD = 80cm, what is
%DQ(d=10cm) relative to DP(dmax)?

c=5
Q

Given:
Field size

10x10

40x10

15x10

BSF

1.036

1.054

1.043

%DD(SSD=80cm,d=10cm)

55.6

58.8

56.9

% DQ
DP (d max )

1
[ BSF (40 10) % DD(40 10) BSF (10 10) % DD(10 10)]

BSF (10 15)


2

1
[1.054 58.8 1.036 55.6]

2.1
1.043
2

25

10.3 Other Practical Methods of Calculating Depth Dose


Distribution (points under a block)
b

a
c

D under a block D a b D a c 1 t
t = block transmission

26

b=15

Example 8:
For a = 15cm, b = 15cm, c = 4cm, and Co-60
beam with SSD = 80cm.
Dfs(15x15,f=80.5) = 120 cGy/min
Block transmission = 5%
Tray transmission = 97%.
(a) What is the treatment time to deliver 200 cGy to
P(d=10cm)? (i.e. DP(d=10) = 200 cGy)

a=15

Given:

x
P

Q
c=4

(b) What is the %[DQ(d=10)/DP(d=10)]?


A/ P

15 5.5 8 8
(a) DP time D BSF % DD / 100 trans
% DD(10,8 8,80) 54.0
time 200 / 120 1.029 0.54 0.97 3.09 min
BSF (8 8) 1.029

27

Method 1: Negative weight PDD


b=15

DQ DQ 15 15 DQ 4 15 1 0.05

DQ 4 15 3.09 120 BSF 4 15 % DD 4 15


DQ 39.3 cGy
DQ DP 39.3 200 20%

6.36.3

x
P

a=15

DQ 15 15 3.09 120 BSF 15 15 % DD15 15


Q
c=4

28

Method 2: Negative weight TAR


Field size magnification at d=10cm: (80+10)/10=1.125

15 15 cm 1.125 17 17 cm

b=15
A/ P

4 15 cm 1.125 4.5 17 cm 7 7 cm
5.5 15 cm 1.125 6.2 17 cm 9 9 cm
DQ TAR 10,17 17 TAR 10,7 7 1 trans

DP
TAR 10,9 9
0.771 0.667 1 0.05

20%

x
P

a=15

A/ P

Q
c=4

0.694

29

Method 3: Negative weight TMR


From slide #7: TAR(d,rd) = TMR(d,rd) Sp(rd)

x
P

a=15

b=15

c=4

DQ
DP

TMR10,17 17 S p 17 17 TMR10,7 7 S p 7 7 1 trans


TAR 10,9 9 S p 9 9

0.733 1.02 0.651 0.989 1 0.05

20%
0.672 0.997

30

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