PLUNC Commissioning Guide

Table of Content

Introduction............................................................................................................................... 2
Related Files.............................................................................................................................. 2
Obtain Clinical Data ................................................................................................................. 3
Dose Plotting Tool .................................................................................................................... 5
Basic Operation of Parameter Adjustment ............................................................................... 6
Model a Unit ............................................................................................................................. 7
Set up the file structure ......................................................................................................... 7
Generate treatment plans for the water phantom .................................................................. 8
Modeling procedures .......................................................................................................... 10
Set up the predetermined parameters in the description files: ........................................ 10
Determine the modeled parameters in the description files:........................................... 14
Use the Newly Commissioned Unit........................................................................................ 22

January 2006
PLanUNC Commissioning Guide

Introduction

This document describes how to commission PLanUNC (PLUNC) for a linear accelerator
(linac) using photon beams1. PLUNC treats a linac operating at different photon energy
levels as different units. We will detail the process of modeling a unit with the appropriate
physical and dosimetric parameters that match the dose distribution computed by PLUNC in
the water phantom to the measurements.
A complete set of files of a sample unit, a Siemens Primus linac operating at 6MV, are
provided to facilitate the user’s learning of the commissioning process.
The section Related Files discusses the content of the provided files and their organization.
The section Obtain Clinical Data details the measurements to be taken for modeling a unit,
and a suggested sequence for taking them.
The section Dose Plotting Tool describes how to enable and use the tool from within
PLUNC to compare the measured and computed dose profiles.
The section Basic Operation of Parameter Adjustment provides the basic procedures to
achieve a desired match between the measured and computed dose profiles through adjusting
the parameters of a unit.
The section Model a Unit presents the complete step-by-step process of modeling a unit that
was carried out at the Department of Radiation Oncology at the University of North Carolina
at Chapel Hill.
The section Use the Unit for Treatment Planning describes the final steps to make the
newly commissioned unit available for treatment planning in PLUNC.

Related Files

The symbol $COMMISSION is used to denoted the path to the directory that stores all
commissioning-related information. The files of one linac are stored in a single subdirectory
under $COMMISSION. For the sample linac named primus2, this subdirectory, is
$COMMISSION/primus2/, within which the following file and subdirectories can be
found:
The patient_name file simply records the name of the unit being modeled.
The subdirectory a/ contains the single anastruct file, skin, for the water phantom used for
dose measurement. The skin anastruct contains only one rectangular contour of certain
thickness. The procedure to generate this anastruct is described in Step 9 of the subsection
Set up the File System of the section Model a Unit.
In the subdirectory MACHINES/, two subdirectories are included, one for each of the two
primus2 units, primus2 at 6MV and primus2 at 15MV. They are arbitrarily named as
UNC_P2_6MV and UNC_P2_15MV. Within each subdirectory, the parameters for the
corresponding unit are grouped into six description files in text format. Specifically, these are
1
The linear accelerators using electron beams or the machines using radionuclides, such as a Cobalt-60 unit, are
not covered in this document.

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the accessory, filter, sar, time_calc, tray, and unit files. The parameters
contained in each of the description files are mostly self-explanatory or commented.
Otherwise, they are explained in the subsection Modeling Procedures of the section Model
a Unit when the particular parameter is set or modeled.
The text description files mentioned above need to be converted into binary files before being
used by PLUNC. For instance, the program make_accessory combines the description
file accessory of all units in MACHINES/ into one binary file named accessory that
is stored in the subdirectory phys_dat/. The program make_filter,
make_time_calc, make_tray, or make_unit achieves identical result for the
description file filter, time_calc, tray, or unit, respectively. The TMR (Tissue-
Maximum-Ratio) data of the individual units are converted, by the program make_sar, into
separate binary files named as sar tagged by the corresponding unit_id, the unique
identification number for each unit in PLUNC given by the user.
The subdirectory phys_dat/ can be placed anywhere as long as its path is specified in the
environment variable PHYS_DAT_DIR. In the case of our example, the environment
variable is set to $COMMISSION/primus2/phys_dat/. Refer to the PLUNC
Installation Guide for the instructions on how to do it.
Each time a text description file is modified to better match the computed dose profiles to the
measured ones, the corresponding binary file will need to be rebuilt to take the modification
into effect. This is achieved by running the Perl script rebuild_phys_dat.pl, a process
that is transparent to the user via using the dose-plotting tool in PLUNC.
Two treatment plans for the sample unit primus2 at 6MV are provided to facilitate the user’s
learning process. 1) 6MV_open_fields.plan consists of 6 open-field beams of size 2x2,
5x5, 10x10, 15x15, 20x20, and 40x40; and 2) 6MV_wedges.plan contains a 5x5 beam, a
10x10 beam, and a 20x20 beam, each paired arbitarily with a wedge of 15-degree, 30-degree,
45-degree, or 60-degree. During the commissioning process, each beam will be modified by
all the wedges, one at a time, and the dose profiles be matched via modeling the wedge
parameters.
The subdirectories 6MV_sym_open_fields/, 6MV_wedge/, and
format_conversion/ contain the measurement data files, and will be described in detail
in the following section.

Obtain Clinical Data

A large number of dose profiles in a water phantom need to be acquired for commissioning a
unit. Among them are the cross-plane profiles at all selected depths, the in-plane profiles at
all selected depths, and PDD on the central axis for each of the chosen open fields. The field
sizes measured, as in the given example, are 2x2, 5x5, 10x10, 15x15, 20x20, and 40x40. The
depths measured for each field are dmax, 10 cm, 20 cm, and 30 cm. The data are stored in
three files for each field-size measured - one for the cross-plane profiles at all depths
concatenated in ascending order, one for the in-plane profiles at all depths concatenated in
ascending order, and one for PDD on the central axis.

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In addition, for modeling the wedges of the unit, the cross-plane profiles at all selected
depths and PDD on the central axis are measured for a number of chosen combinations of
field-sizes and wedge-angles. The depths measured are the same as those for the open fields.
The wedged field-sizes measured, in the given example, are 5x5, 10x10, and 20x20 with a
15°, 30°, 45°, or 60° wedge. The data are stored in two files for each field-size and wedge-
angle combination - one for the cross-plane profiles at all depths concatenated in ascending
order, and one for PDD.
The sample files provided in the subdirectories 6MV_sym_open_fields/ and
6MV_wedge/ will serve as practice data, as well as the file format template. Before the data
files generated by a specific dose measurement device can be used by PLUNC, they need to
be converted into the PLUNC-recognizable format. The program well_to_dose_plot is
provided in the PLUNC package to convert files generated by Wellhöfer. Sample files for
individual profiles before and after the conversion for the unit primus2 at 6MV can be found
in the subdirectory format_conversion/. Users are expected to make their own
converters for other file formats used by their profile measurement device.

Following is a suggested data acquisition sequence, presented in pseuso-code syntax:

For each field size, in ascending or descending order –

Measure the open-field PDD profile at central axis.

Determine dmax of the above profile.
Select the value at dmax as the value for normalization for this field.
Normalize the above PDD profile.

For each depth in ascending order –

Measure the open-field cross-plane profile and normalize.

Measure the open-field in-plane profile and normalize.

End of depth

If wedged-field measurements are needed for this field –

For each wedge angle, use the right-pointing wedge –

Measure the wedged-field PDD on the central axis and normalize.

For each depth in ascending order –

Measure the wedged-field cross-plane profile and normalize.

End of depth

End of wedge angle

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End of wedged-field If

End of field size

In addition to dose profile measurements, the following measurements are also needed,
• measure the tray factor of the block trays;
• measure the accessory factor of the accessories;
• measure the base-plate factor for the wedges;
• measure the thickness of the above base-plates in cm;
• measure the profile of the wedges and the base-plates;
• obtain the dose-rate calibration table.

Dose Plotting Tool

This section provides the instruction on how to use the dose plotting tool in PLUNC to
display the measured and the computed dose profiles. The files provided in primus2/ for
the 20x20 open-field beam are used, as examples, to illustrate the operation.

1. If the environment variable PLUNC_PLOT is undefined, set it to anything to enable

dose plotting tool in PLUNC.
2. If it has not been done yet, set the environment variable PHYS_DAT_DIR to
$COMMISSION/primus2/phys_dat.
3. Change directory to primus2/, and start PLUNC. Refer to the PLUNC Installation
Guide for how to install and run PLUNC.
4. On the main control panel, select FILE>Retrieve Plan>6MV sym open fields.
5. Click Dose button. PLUNC displays the dose window (xplandisp).
6. Select Options>Dose Plot. PLUNC displays the Dose Plot window.
7. Select File>Open File. PLUNC displays the Pick a file dialog.
8. Select 6MV_sym_open_fields>20x20_xpl>OK. PLUNC plots the measured cross-
plane profiles in green. The 20x20 beam has four profiles measured at depth dmax,
10 cm, 20 cm, and 30 cm, respectively. Ignore the profiles in red for now.
9. Select File>Beam>20x20 to pick the 20x20 beam. PLUNC plots the computed
profiles for the 20x20 beam in red. By default, the computed cross-plane profiles are
normalized to the middle point of the 1st measured profile, which is, in this case, the
one measured at dmax. Notice the two sets of profiles match closely to each other,
which is expected since this unit has already be fully modeled. For a unit that hasn’t
been modeled yet, there is likely discrepancy between them.
10. Move the mouse to place the cursor at a point of interest in the graph. The text at the
bottom of the window displays the position of the selected point followed by the dose
at this position at all depths plotted, with the 1st line in green for the measured values
and the 2nd line in red for the PLUNC computed values.
11. Repeat Step 7 and 8 to open the 20x20_inp file. PLUNC plots the computed and
measured in-plane profiles for the 20x20 beam. The normalization for the in-plane
profiles is done in the same way as that for cross-plane profiles as described in Step 9.

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12. Repeat Step 7 and 8 to open the 20x20_pdd file. PLUNC plots the computed and
measured PDD profiles. By default, the computed PDD profile is normalized to the
1st point that has the maximum value in the measured profile.

Note that the normalization performed automatically to the computed profile in the above
mentioned manners hides the discrepancy in absolute values between the computed and
measured profiles. Later in the document, methods will be given to obtain the absolute values
in case they are needed.

More options in the File menu of the Dose Plot window:

Menu Option Function

Down Sample data Remove every other data point from the profiles at each
click.
Select norm point Enable the selection of a different normalization position
on the profile using the left mouse button.
Print Print the profiles in hardcopy.
List Points Print the position and the corresponding measured value
and computed value to STDOUT.
Save Computed Save the computed profiles of the current beam to a file
in user-defined name.

Basic Operation of Parameter Adjustment

Before introducing the systematic steps to determine the physical and dosimetric parameters
in the description files to achieve the goal of matching the computed dose profiles to
measurements in a water phantom, the basic operation of adjusting a parameter and
observing its effect on the computed profiles is described below. We will illustrate the steps
using, as an example, the number on line 21 in the sar file of primus2 at 6 MV and the
40x40 cross-plane profiles. These basic steps described below need to be performed every
time a number is changed in a description file and its effect on the profiles is to be evaluated.

1. From the main PLUNC control panel, select File>Retrieve a plan>6MV sym open
fields. Bring up the Dose Plot window to select the 40x40 beam, open the 40x40_xpl
file, and observe the profiles that are closely matched.
2. Open the sar file in primus2/MACHINES/UNC_P2_6MV/ in a text editor of
your choice.
3. Change the number 1.045 on line 21 to 1.145.
4. Save the change to the file.
5. In the Dose Plot window, click Recalc button on the top of the window. PLUNC
rebuilds all of the sar binary files stored in phys_dat/, and re-computes the dose
profiles with the new value set in Step 3.
6. Judge how close the PLUNC computed profiles match the measured ones after the
new value is used.
7. Now change the number to a different value.

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8. Repeat Step 4 to 6 to see whether the computed profiles are in acceptable agreement
with the measured ones.
9. If not, repeat step 7 and 8 until an acceptable match is achieved.
10. To finish this practice example, reset the number to its original value 1.045, and
save the file.

Model a Unit

To completely model a unit for PLUNC involves following the above basic operation steps to
set the appropriate values for all parameters in the six description files. These parameters are
related to the two-source model and the flatness correction for the photon beam
characteristics, Tissue-Maximum Ratio (TMR) tables for the Clarkson integration algorithm
in dose computation, the various attenuation coefficient dependencies for the filter materials,
and dose-rate calibration table, etc. During the modeling process, it is important to recognize
the fact that each parameter may have different impact on different profiles, and some
apparent effects on the profiles may be related to multiple parameters. Consequently,
iterations between modeling multiple parameters may be needed before the overall best
values can be determined.

The procedure used to model the units at the Department of Radiation Oncology at
University of North Carolina at Chapel Hill is illustrated by the following example. The users
are expected to customize this procedure and make it to work in their unique situations.

Set up the file structure

We start with setting up the working directory for the unit to be modeled. It will be a new
unit named machine1 at 6MV whose unit_id is 101. Instead of doing it from scratch, we
simplify this process by duplicating the existing primus2/ folder that has been used earlier,
and then customizing it for the new unit. The description files used to start modeling unit 101
are not produced from scratch either. Instead, they are adopted from those for another unit,
unit 201 that is identified as a similar unit. The users are encouraged to take the same
approach when modeling their units based upon a similar unit already modeled.

1. In $COMMISSION, duplicate primus2/, and rename the new folder as machine1,

which becomes the working directory for unit 101.
2. Open the patient_name file, and change the text in it from primus2 to
machine1. Save the file.
3. Convert the measurement data files for unit 101 to the format recognizable to
PLUNC.
4. Substitute these files for the ones for primus2 in the subdirectory
$COMMISSION/machine1/6MV_open_fields/ for the open-fields and
6MV_wedge/ for the wedged-fields. In our example, we save the effort of file
conversion by using the measurement data files of primus2 at 6MV for unit 101.
5. Copy the subdirectory $COMMISSION/unit_201 that contains the description
files into $COMMISSION/machine1/MACHINES/, and rename the new directory
as UNC_M1_6MV, where M1 stands for machine1.

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6. Replace _id = 201 with _id = 101 in all of the description files in
UNC_M1_6MV/.
7. Modify the comments in the description files to be appropriate for the new unit.
8. Change directory to $COMMISSION/machine1/ and run command

rebuild_phys_dat ./phys_dat ./MACHINES

to add the new unit to the binary description files in phys_dat/, which only
contained the two primus2 units before this step.
9. If the dimensions of the water phantom used for commissioning the new unit are
50x50x50, this step can be skipped since the skin anastruct that exists in the
subdirectory a/ is for that size and suitable for use.

Otherwise, create the skin anastruct of the water phantom as following:

a. Change directory to machine1/a/.

b. Run command

make_anastruct_by_numbers skin

c. Follow the program’s prompts to specify the coordinates of a rectangular

water phantom in the Patient coordinate system2, whose origin is placed at the
center of the anastruct. 50x50x50 are used as the exemplary dimensions
below:
number of contours:
1
z extent (nominal min max):
0 -25 25
vertex count:
4
vertex 0 (x y):
-25 -25
vertex 1 (x y):
-25 25
vertex 2 (x y):
25 25
vertex 3 (x y):
25 -25
d. Change back to machine1/.

Generate treatment plans for the water phantom

The following steps create one open-field plan and one wedged-field plan, which contain the
beams of various sizes used for measuring the new unit. Instead of constructing the beams in
these plans from scratch, we achieve the same result by modifying the existing primus2 plans
introduced earlier:

2
Refer to the document Coordinate systems in PLUNC for more information.

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1. Set the environment variable PHYS_DAT_DIR to the full path of the subdirectory
$COMMISSION/machine1/phys_dat/.
2. Change directory to machine1, and start PLUNC.
3. Retrieve the plan 6MV sym open fields, which was made for priums2 at 6MV.
4. Go through the beam list and decide whether a beam used for primus2 also applies to
the new unit. Make necessary changes to the field size or beam name, if necessary. If
it is an excess beam, delete it.
5. Set the unit association for each of the remaining beams from PRIMUS2 6MV to
MACHINE1 6MV.
6. Skip this step if the skin anastruct for the new unit has the dimensions of 50x50x50.
Otherwise, set the isocenter for each of the beams to the center of the anastruct’s top
surface for an SSD setup using the UNIT control panel PLanUNC:
a. Set the gantry, table, and collimator angles to 0.
b. Set LAT to 0.0, and LONG to 0.0.
c. Unlock isocenter, if it is locked, by clicking the Isocenter LOCKED button.
d. Select Isocenter at centroid>skin(1).
e. Set SSD to 100.
f. Lock isocenter.
g. Notice the height is at 25.0, half of the size in this dimension.
7. Take the following steps to accurately determine the dimensions of a beam using the
width of the profiles rather than the nominal beam size:
a. Choose one beam to start with.
b. Judge whether the width of the computed and measured cross-plane profiles
match at the 50% dose level. The indication that the beam size entered in
PLUNC is larger than the actual beam size is that the edges of the computed
profile are completely outside those of the measured profile without crossing
them at any position.
c. If the match hasn’t been achieved, adjust the position of the x-jaws on the
UNIT control panel PLanUNC, then click the Dose button to refresh the beam
settings.
d. Repeat b and c until the match is satisfactory. Pay attention to the fact that the
actual beam size isn’t always exactly the nominal beam size. Write down the
jaw settings to be used later for the wedged-field plan in Step 9 below.
e. Repeat b to d for the corresponding in-plane profiles, and if necessary, adjust
the position of the y-jaws.
f. Repeat b to e for the next beam.
8. Save the plan as Machine1 6MV open fields.
9. Repeat Step 3 to 6 to create a new plan Machine1 6MV wedges for the wedged-fields
based upon plan 6MV wedges for primus2. Keep in mind the following:
a. The filter selection for each beam can be arbitrary at this point of time, and it
will be set dynamically later during the modeling of the wedges.
b. The wedged-field measurements need to be done right after the open-field
ones for a given field size, and the jaw settings for a wedged-field should, in
theory, be the same as recorded in Step 7 above for the open-field of the same
size.

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Modeling procedures

The following section describes the sequence in which to determine the parameters in the
description files that best match the PLUNC computed profiles to the measured ones. The
new unit, machine1 at 6MV, set up in the above sections is used to illustrate the process. If
the definition of a parameter is not provided in the text below, it is expected to be either self-
explanatory or commented in the containing description file.

Two types of parameters exist in the description files: the ones whose value is predetermined
via user choice or measurement, and the ones whose value is determined via modeling. We
will handle the predetermined parameters first, and then the modeled ones.

Set up the predetermined parameters in the description files:

1. In general, do the following in the accessory file:

a. Understand the definition of each parameter.
b. Make necessary change to the comments or the value of the parameters to reflect
the specifications of your unit.
c. Add more entries, if necessary, to include additional accessories by providing the
needed information as that for the existing ones. Or,
d. Remove the excess accessory items, if present.

In particular for our practice:

Change from Change to

name = "Breastboard flat 0.95" name = "Breastboard flat 0.93"
accessory_factor = 0.950 accessory_factor = 0.930
name = "Breastboard max 0.91" name = "Breastboard max 0.90"
accessory_factor = 0.910 accessory_factor = 0.900

2. In general, do the following in the tray file:

a. Understand the definition of each parameter.
b. Make necessary change to the comments or the value of the parameters to reflect
the specifications of your unit.
c. Add more entries, if necessary, to include additional trays by providing the
needed information as that for the existing ones. Or,
d. Remove the excess tray items, if present.

In particular for our practice:

Change from Change to

tray_factor = 0.940 tray_factor = 0.950

3. In general, do the following in the time_calc file:

a. Understand the definition of each parameter.
b. Make necessary change to the value of dose_rate, date, cal_dist,
cal_depth, end_effect, Sc_x_count, Sc_y_count,

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Sc_x_positions, Sc_y_positions (as the first column of the output

factor table), and the output factor table elements
c. Keep the value of decay_constant and time_units unchanged for a linac
unit.

Notes:
The field size listed in the Sc_x_positions or Sc_y_positions vector of the
output factor table is the half field size. For instance, Sc_x_positions = 5.0 and
Sc_y_position = 20.0 represents a 10 cm x 40 cm field.

In particular for our practice:

Change from Change to

end_effect = 0.10 end_effect = 0.00
current output factor table the output factor table of primus2 at 6MV stored in the time_calc
file in $COMMISSION/primus2/MACHINES/UNC_P2_6MV/

4. In general, do the following in the unit file:

a. Understand the definition of each parameter.
b. Make necessary change to the following parameters:
• dmax
• SAD
• x_jaw_count
• y_jaw_count
• x-jaw parameters as defined in the first line:
• type (MULTILEAF, INDEPENDENT, or SYMMETRIC)
• the extent of travel for x-jaws
ƒ min_1 and max_1 for the left jaw or multi-leaves
ƒ min_2 and max_2 for the right jaw or multi-leaves
ƒ if MLC, the leaf width
• y-jaw parameters as defined in the second line:
• type (INDEPENDENT or SYMMETRIC)
• the extent of travel for y-jaws
ƒ min_1 and max_1 for the bottom jaw
ƒ min_2 and max_2 for the top jaw
• gantry angle specifications
ƒ gantry_sense
ƒ gantry_offset
ƒ gantry_minimum
ƒ gantry_maximum
• table angle specifications
ƒ table_sense
ƒ table_offset
ƒ table_minimum
ƒ table_maximum
• collimator angle specifications
ƒ collimator_sense

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ƒ collimator_offset
ƒ collimator_minimum
ƒ collimator_maximum

Notes:
1) The definition of the gantry, table, or collimator angle parameters can be found in the
document Coordinate systems in PLanUNC.
2) The value of the parameters used in the two-source model will be determined later via
the modeling process. They are PSD (primary-to-secondary source distance),
source_dima1 (primary source diameter), source_diam2
(secondary/scattering source diameter), source_ratio (percentage of photon from
the primary source), and SDD (source-to-diaphragm/collimator distance) of x-jaw and
y-jaw.

In particular for our practice: Nothing needs to be changed.

5. In general, do the following in the filter file:

a. Understand the definition of each parameter. In particular:

Parameter Definition
mu Base linear attenuation coefficient of the filter material.
mu_dx Change in attenuation coefficient with thickness due to beam
hardening effect of the filter material. This is usually a small
negative number.
mu_dr Change in attenuation coefficient as moving off-axis since the beam
is usually softer off-axis after the flattening filter. This is usually a
small positive number.
mu_da Change in attenuation coefficient with field size due to scattering
effects.
hvl_slope Change in half-value layer of water, therefore, TMR and PDD, due
to beam hardening by the filter material.

b. Always set version = 5

c. Do the following to the Material properties list:
• Make sure the comment for each filter material is applicable for the new unit.
If not, make necessary modifications.
• Remove excess material or add additional material, if necessary, to the list.
• Give each remaining material in the list the desired mat number, which will
be called by the related filter(s) later in the file.
• If not present, add mu_da = 0.0 after the line of mu_dr to the wedge
material. This parameter is needed for the version 5 wedge filters.
• Provide mu of the base-plate materials. It is derived from the base-plate factor
(α) and base-plate thickness (d) using mu = −(ln α ) / d .
• Set mu_dx, mu_dr, and hvl_slope of the base-plate materials to 0.0.

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• mu, mu_dx, mu_dr, mu_da, and hvl_slope of the wedge materials are
modeled parameters, and the determination of their values will be discussed
later.
• mu, mu_dx, mu_dr, and hvl_slope of the compensator materials are also
modeled parameters. However, the determination of their values will not be
discussed in this document.
d. Do the following to the wedge list:
• Notice that there are 16 unique wedge filters described in the filter file. They
result from the combination of four different angles (15°, 30°, 45°, or 60°) in
four orientations (North, South, East, or West-pointing). Each wedge is
described in an identical data block.
• Understand the definition of the wedge parameters provided in the file.
Reference the document on coordinate systems in PLanUNC for the definition
of the wedge filter coordinate system.
• Make necessary changes to the name of the wedge, the orientation of the
wedge, and the jaw limits imposed by the wedge for each of the wedges in the
list.
• Make sure the actual distance from the source to the surface where the wedge
is mounted is used in place of the number 41.2 in the transformation
matrices.
• Provide the actual physical profiles of the wedges and the baseplates.

In particular for our practice:

Change from Change to

version = 4 version = 5
mat = 1 mat = 1
mu = 0.125 mu = 0.135
vertex_count = 7 1) vertex_count = 8 for all 30 degree wedge profiles
2) add 5.461, -0.10 as the second vertex of the wedge profiles

e. Do the following to the bolus list:

• Notice jaw limits imposed by a bolus is the same as the original jaw limits.
• Make no change to the transformation matrix.
• Keep in mind that the default bolus profile gives the nominal bolus thickness.
The actual bolus profile is determined dynamically within PLUNC.
• Add or remove bolus from the list as needed.

In particular for our practice: Nothing needs to be changed in this file.

6. In general, do the following to the sar file,

a. Always set version = 5.
b. Set type = TMR for TMR dose calculation. This is the only type currently
supported.
c. Make necessary change to the collimator transmission coefficient, tran.

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d. The rest of the parameters and tables in this file, to be determined via modeling,
are flatness_depth_count, flatness_radius_count,
flatness_vec, depth_count, radius_count, radius_vec,
TMR0_depth_count, TMR0_depth_vec, TMR0.

In particular for our practice: Nothing needs to be changed in this file.

Determine the modeled parameters in the description files:

The following are the general steps taken at UNC to model a unit for the open fields. Use
the open-field plan, Machine1 6MV open fields, for our practice below:

Step 1:
Goal: Match the largest (i.e. 40x40 in our example) open-field cross-plane and in-
plane profiles at dmax.
General action:
a. Set the flatness vector at depth 0.0 and radius 0.0 to 1.000.
b. Adjust the number at other radii in the flatness vector one at a time and from
the small radius to the large radius.
Notes:
i. If two different values are needed for a number to match the in-plane or the
out-plane profile, choose the average value as a compromise.
ii. Do not be concerned about matching the profiles at other depths for the 40x40
beam at this time, since they will be looked at more closely later and handled
with flatness vectors at additional depths, if necessary.
iii. When only the flatness vector at 0.0 cm depth is provided, the off-axis
hardening algorithm3 is used to determine the flatness profile at other depths.
If the resultant flatness at other depths cannot be modeled satisfactorily with
this approach, additional flatness vectors at larger depths are needed for
extrapolation method, instead.
iv. Add additional radii to the flatness vector, if desired. Change
flatness_radius_count accordingly.
v. The radius vector needs to include entries beyond the dimensions of the beam
in order to account for the diagonals of the collimator that are larger than the
sides.
vi. Be less critical about the match around the beam’s edge at this time, since the
parameters of the two-source model to be determined in a later step will affect
the penumbra.

In particular for our practice:

Change from Change to

3
“Correction for off-axis photon beam energy change" in Proceedings of the 32nd Annual ASTRO Meeting
1048 (pg 249).

January 2006 14 of 22
PLanUNC Commissioning Guide

8.0 1.060 8.0 1.055

12.5 1.080 12.5 1.090
15.0 1.105 15.0 1.100
17.5 1.110 17.5 1.090
20.0 1.000 20.0 1.020

Step 2:
Goal: Match the smallest (i.e. 2x2 in our example) open-field PDD profile.
General action:
a. Adjust the numbers in the TMR0 vector. The number at dmax must remain
1.000.
Notes:
i. If additional depths are needed to achieve the acceptable match, add the
wanted depths to the TMR0_depth_vec and the suitable number to the
corresponding location in the TMR0 vector. Change TMR0_depth_count
accordingly.

In particular for our practice:

Change from 0.350 0.720 0.940 0.983 1.000 0.998 0.983 0.939 0.898 0.858
0.820 0.783 0.748 0.716 0.684 0.653 0.624 0.595 0.568 0.542
0.518 0.495 0.472 0.452 0.431 0.412 0.394 0.375 0.360 0.342
0.272 0.216
Change to 0.350 0.700 0.950 0.983 1.000 0.998 0.992 0.948 0.905 0.865
0.823 0.789 0.752 0.719 0.687 0.656 0.626 0.601 0.573 0.547
0.523 0.500 0.478 0.456 0.436 0.418 0.398 0.380 0.364 0.348
0.275 0.219

Step 3:
Goal: Match the open-field PDD profiles one at a time from small to large field.

General action:
a. Set the numbers at dmax always to 0.000.
b. Adjust the numbers in the SMR table one radius at a time from small to large.
Noting that the farther away the radius is from the beam size, the less it
contributes to the profile matching.
Notes:
i. If additional depths are needed to achieve the acceptable match, add them to
the depth_vec, which is, implicitly, the vector before the SMR table and
separated from it in colons. Change depth_count accordingly.
ii. If additional radii are needed to achieve the acceptable match, add them to the
radius_vec. Change radius_count accordingly.

In particular for our practice:

Change from current SMR table adopted from unit 201

Change to final SMR table, same as that of primus2 at 6 MV

January 2006 15 of 22
PLanUNC Commissioning Guide

Step 4:
Goal: Match the cross-plane profile for the largest open field at depths other than
dmax, one at a time and from small depth to large.

There is possibility that this goal has already been met, after finishing Step 1, with the
flatness table containing only depth 0 vector. Otherwise, one or more flatness vectors
need to be added to the flatness table at strategic depths so the off-axis hardening of the
beam can be determined using extrapolation method.

General action:
a. Choose one additional depth at which to add the flatness vector.
b. Change flatness_depth_count accordingly.
c. Adjust the values for the added flatness vector to match all profiles at the
depth up to the depth of this new vector via interpolation.
d. Examine how close the match is for the profiles at the depth beyond the depth
of the added flatness vector, noting that extrapolation is used in this cases.
e. If the result of the action above is not satisfactory, repeat Action a to c to add
more depths to satisfy all profiles.
Notes:
i. Each unit may require different numbers of depth to model its off-axis
hardening effect.
ii. Three depths, at 0.0, 10.0, and 25.0 cm, are used in the flatness table for
primus2 at 6 MV and unit 101 to match the profiles at depth of dmax, 10, 20,
and 30 cm.

In particular for our practice:

Change from current one-depth flatness table adopted from unit 201
Change to final 3-depth flatness table, same as that of primus2 at 6 MV

Step 5:
Goal: Model the slope of the penumbra for the open-field cross-plane profiles.
General action:
a. Set SDD of x-jaw and y-jaw to their mechanical measurements.
b. Choose the open-field cross-plane profiles of an intermediate field size.
c. Change source_diam1 in the unit file, and observe its impact on the
slope of the penumbra: the smaller the source_diaml is, the steeper the
slope is.
d. Repeat b and c until the match for the profiles at all depths is satisfactory.
e. Observe the match for the profiles of other field sizes.
f. If the result of e is not satisfactory, repeat b to e until a compromise is
achieved among all field sizes.
Notes:
i. The slope of the penumbra is determined by the middle portion of the
penumbra. It is usually set to be the portion between 10% to 90% or 20% to

January 2006 16 of 22
PLanUNC Commissioning Guide

80% of the total magnitude of the profile, depending upon the individual
user’s preference.
ii. The slope of the penumbra is determined primarily by the size of the primary
source since the intensity of the primary source is generally much larger than
that of the secondary source.

In particular for our practice:

Change from Change to

source_diam1 = 0.30 source_diam1 = 0.36

Step 6:
Goal: Model the curvature of the penumbra for the open-field cross-plane profiles.
General action:
a. Choose the open-field cross-plane profiles of an intermediate field size.
b. Change source_diam2 in the unit file, and observe its impact on the
curves on both sides of the straight portion of the penumbra: the smaller the
source_diam2, the shaper the curves are.
c. Repeat b until the match for the profiles at each depth is satisfactory, while
weighing the lower curve more that the upper one.
d. Observe the match for the profiles of other field sizes.
e. If the result of d is not satisfactory, repeat b to d until a compromise is
achieved among all field sizes.
Notes:
i. source_diam2 is the size of the apparent secondary source characterizing
the scattering components in the head of the unit.
ii. It has dominant effect on the curvatures of the penumbra (0 – 20% tail and 80
– 100% shoulder of the profile) due to its large size in comparison to that of
the primary source.

In particular for our practice:

Change from Change to

source_diam2 = 2.9 source_diam2 = 2.8

Step 7:
Goal: Model the intensity of the tail of the penumbra for the open-field cross-plane
profiles.
General action:
a. Choose the open-field cross-plane profiles of an intermediate field size.
b. Change source_ratio in the unit file, and observe its impact on the
intensity or height of the tail: the smaller the source_ratio, the higher the
tail, which indicates more contribution from the secondary source.
c. Repeat b until the match for the profiles at each depth is satisfactory.
d. Observe the match for the profiles of other field sizes.

January 2006 17 of 22
PLanUNC Commissioning Guide

e. If the result of d is not satisfactory, repeat b to d until a compromise is

achieved among all field sizes.
Notes:
i. source_ratio is defined as the percentage of photons from the primary
source.
ii. The larger the value is, the stronger the relative intensity of the primary source
is, and vice versa.

In particular for our practice:

Change from Change to

source_ratio = 0.900 source_ratio = 0.885

Step 8:
Goal: Further improve the modeling of the penumbra for the open-field cross-plane
profiles.
General action:
c. Choose the open-field cross-plane profiles of an intermediate field size.
d. Change PSD in the unit file, and observe its impact on the horizontal shift of
the tails: they move outwardly as PSD increases, and vice versa.
e. Repeat b until the match for the profiles at each depth is satisfactory.
f. Observe the match for the profiles of other field sizes.
g. If the result of d is not satisfactory, repeat b to d until a compromise is
achieved among all field sizes.
Notes:
i. PSD is the distance between the primary and secondary sources. The more the
sources are separated, the more the penumbra of the secondary source is
shifted from that of the primary source.
ii. This effect compounds with the other effects mentioned earlier on the tail of
the overall penumbra.

In particular for our practice:

Change from Change to

PSD = 5.0 PSD = 4.0

Step 9:
Goal: Further improve the modeling of the penumbra for the open-field in-plane
profiles.
General action:
h. Choose the open-field in-plane profiles of an intermediate field size.
i. Change SDD of the y-jaw in the unit file, and observe its impact on the
penumbra: the smaller the SDD is, the sharper the penumbra is. Avoid making
adjustments to the other parameters set earlier.
j. Repeat b until the match for the profiles at each depth is satisfactory.

January 2006 18 of 22
PLanUNC Commissioning Guide

k. Observe the match for the profiles of other field sizes.

l. If the result of d is not satisfactory, repeat b to d until a compromise is
achieved among all field sizes.
Notes:
i. SDD of y-jaw attributes to the difference in the sharpness of the penumbra
between cross-plane and in-plane profiles.

In particular for our practice:

Change from Change to

SDD = 23.5 (y-jaw) SDD = 25.5 (y-jaw)

Step 10:
Goal: Further improve the match of the profiles, particularly near the edges, for the
largest field and at all depths, after the penumbra has been matched.
General action:
a. Adjust the numbers at large radii in the flatness table, only if the computed
and the corresponding measured profiles are not yet well matched near the
edge.

In particular for our practice: Nothing needs to be changed.

The following are the general steps taken at UNC to model a unit for wedged fields. Use
the wedged-field plan, Machine1 6MV wedges, for our practice below:

Step 11:
Goal: Match the smallest wedged-field cross-plane profiles at dmax with the proper
mu and mu_dx of the wedge material.
General action:
a. Set mu_dx, mu_dr, mu_da and hvl_slope for the wedge material to 0.0
in the filter file, so as to focus on finding the right mu first.
b. In the cross-plane measurement data file for the smallest wedge angle and
field size, find the number at central axis (position = 0.0) for depth of dmax. It
is the attenuation to the beam due to wedge filtering in the mentioned
condition. In our example, this number is 68.4 at depth of 1.8 cm in the file
w15_5x5_xpl in $COMMISSION/machine1/6MV_wedge.
c. Determine the corresponding computed value in PLUNC using the ratio of
MU (monitor unit) needed to deliver the prescribed dose in open-field to that
in wedged-field. The steps to achieve this goal involves –
i. In the main control panel, select the beam of the chosen field size.
ii. Select “no filter” from the FILTERS menu.
iii. Select Dose>Options>Dose Plot to take any parameter change into
effect. If need to examine the profiles displayed in the window, pay
attention to which beam and which data file is currently in use.

January 2006 19 of 22
PLanUNC Commissioning Guide

Otherwise, the profiles may be different from what you want to see
and be rather confusing.
iv. Select Dose>Spreadsheet, and record MU for the chosen beam. Ignore
the beams of other size on the spreadsheet.
v. Close the modal Spreadsheet dialog box in order to continue.
vi. Repeat ii to select the right-pointing wedge of the chosen angle.
vii. Repeat iii to v for the same-sized beam, only now added with a wedge.
Make sure the dose prescription remains the same.
viii. Divide the 1st MU (open-field) by the 2nd MU (wedged-field) to yield
the attenuation of the wedge being used.
d. If the computed value obtained in Step c is smaller than the measured one
found in Step b, decrease mu of the wedge material in the filter file, or
vice versa, and repeat Step c until the former is just barely smaller than the
latter, indicating the beam is just a little more attenuated. The discrepancy is
left to be compensated later by mu_dx.
e. Repeat Step b to c for the same field size but of different wedge-angles, one
angle at a time, to make sure the same mu works for all wedges. The
discrepancy as described in Step d is expected to be larger for a larger-angled
wedge, since the compensation due to mu_dx is more for a thicker wedge.
f. After the goal in Step e is achieved, in the Dose Plot window, compare the
slope of the computed profile at dmax to that of the measured one, with one
wedge used at a time. The former is expected to be steeper than the latter since
the attenuation yet to be reduced by the negative mu_dx is more on the
left/thicker side of the wedge than on the right/thinner side of the wedge. Set
mu_dx to the proper negative number, via trial and error, to generate the best
match for both the normalized profiles and the absolute attenuation at central
axis for all wedges.
g. If the proper mu_dx cannot be found in Step f, the user may need to adjust mu
and repeat Step c to f. An Excel workbook, “Determine mu and mu_dx.xls”, is
provided in $COMMISSION to illustrate the process of searching for the best
mu and mu_dx for our exemplary unit machine1.
Notes:
i. Since the dose plotting tool in PLUNC automatically normalize the computed
profiles as mentioned earlier in this document, the absolute wedge attenuation
can only be determined by following Step c.
ii. mu has the most impact on wedge attenuation, and needs to be determined
before the minor modifications of it due to thickness, off-axis distance, field
size, and beam-hardening can be made effectively using mu_dx, mu_dr,
mu_da and hvl_slope.
iii. Iterations may be needed when determining the best mu and mu_dx, since it
is difficult to differentiate their effects on beam attenuation in relationship to
wedge thickness in a single step.
iv. After this step, the profiles may still curve up, and the central axis attenuation
for larger fields and the profiles at other depth may still mismatch. These will
be further corrected with mu_dr, mu_da and hvl_slope later.

Step 12:

January 2006 20 of 22
PLanUNC Commissioning Guide

Goal: Improve the match of the wedged-field central axis attenuation at dmax for
larger fields with the proper mu_da of the wedge material.
General action:
a. Select “no filter” for each of the beams in the beam list on the main control
panel.
b. Select Dose>Spreadsheet, and record MU for each of the beams.
c. Close the modal Spreadsheet dialog box in order to continue.
d. Repeat a to c, but with a right-pointing wedge added, one wedge angle at a
time.
e. Observe the discrepancy between the computed and measured central axis
attenuation as the field size increases. The computed values when mu_da is
0 are lower than the measured ones, in our example, and the larger the field
the more so before they are corrected with an appropriate mu_da.
f. Adjust mu_da by trial and error to reduce the discrepancy in the above
mentioned quantities. Make compromise, if necessary, to bring the best match
with a single value. In our example, mu_da is determined to be -0.0025.

Step 13:
Goal: Improve the match of the large wedged-field cross-plane profiles at dmax with
the proper mu_dr of the wedge material.
General action:
a. Select the beam with the largest field size on the main control panel.
b. Select a right-pointing wedge, one angle at a time.
c. Observe the corresponding computed dose profile at dmax. Due to the fact
that the beam is softer off-axis after passing the flattening filter, the computed
profiles most likely will curve upwards before the additional off-axis
attenuation is corrected using mu_dr.
d. Adjust mu_dr by trial and error to eliminate the curvature in the profiles.
Make compromise, if necessary, to bring all profiles straight with a single
value.

Step 14:
Goal: Match the wedged-field PDD profiles with the proper hvl_slope of the
wedge material.
General action:
a. Select a beam and a right-pointing wedge, one at a time for all possible
combinations of beam size and wedge angle, on the main control panel.
b. Observe the difference between the computed and measured PDD profile. Due
to the fact that the beam is hardened by the wedge filter, the PDD of the beam
increases in proportion to the thickness of the wedge. The computed PDD
profiles most likely will be lower than the measured ones, and the larger the
wedge angle the more the difference, before the increase in PDD is made
using hvl_slope.

January 2006 21 of 22
PLanUNC Commissioning Guide

c. Adjust hvl_slope by trial and error to match the PDD profiles. Make
compromise, if necessary, to bring all profiles into reasonable match with a
single value.

In particular for our practice of Step 11 to 14:

Change from Change to

mat = 0 mat = 0
mu = 0.332 mu = 0.332
mu_dx = -0.004 mu_dx = -0.002
mu_dr = 0.0015 mu_dr = 0.0015
mu_da = 0.0 mu_da = -0.0025
hvl_slope = 0.04 hvl_slope = 0.035

Use the Newly Commissioned Unit

Once the above procedures are complete, a set of six description files are ready to be used for
treatment planning in PLUNC for the unit modeled. Since the files used for commissioning
are stored independently from the ones used for treatment planning, the subdirectory
$COMMISSION\machine1\MACHINES\UNC_M1_6MV that contains the final description
files of the new unit needs to be moved into $UP/MACHINES.

To update the binary description files in $UP/phys_dat with this new unit, make $UP the
working directory, and run command
rebuild_phys_dat ./phys_dat ./MACHINES

PLUNC is now ready to work with the newly modeled unit for treatment planning, and the
computed results should accurately represent the output of the linac.

January 2006 22 of 22