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Electron Beam MU Calculation

Electron Beam MU Calculation

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17 views27 pages

Electron Beam MU Calculation

Electron Beam MU Calculation

Uploaded by

siti07416
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Electron Beam MU Calculation

Dwi Seno K. Sihono


Introduction

 Electron MU calculations are inherently simpler to work but still


follow the main concepts of photon beam MU calculations.
 The main difference is that with electrons, you typically
prescribe to a percentage of maximum dose.
 This coresponds to a depth but it is best for the physician to
specify that he/she wants dose to a percent (of maximum)
 Only PDDs (not TMR) are used for electrons.
 The electron PDDs (beyond dmax are not SSD dependant) over
the useful range of clinical SSDs.
s
 Electron output calibration is performed at a depth of dmax
for each individual energy, using a 10 x 10 open cone and
an SSD set to 100 cm.
 Example:
Suppose a physician wants to deliver 180 cGy to dmax (PDD = 100%)
using a 10 x 10 open cone, 6 MeV, and 100 cm SSD. What are the
monitor units needed?
Electrons at Another Depth

 Suppose the physician wants to treat a chest wall tumor


and decides that the energy that gives best coverage while
minimizing dose to the underlying lung is 9 MeV. However,
due to the dose fall-off, she wants to treat 200 cGy to the
90% IDL (she wants to deliver 200 cGy where the nominal
90% PDD occurs). Determine the MU using a 10 x 10
cone and 100 cm SSD.
Electrons at Another SSD

 It will occur in every therapists career that things don't


always work perfectly. For instance, suppose you want to
treat a posterior cervical neck node with electrons. But due
to the patient’s shoulder being in the way, you cannot get
100 cm SSD, the best you can get is 110 cm SSD.
 There is an inverse square effect on the output at ~ (1.000
cGy/MU) that must be considered. Since your output is
specified at dmax, your inverse square is between dmax at
the nominal SSD and dmax at the extended SSD. Note that
extended SSDs also modify the beam profile as well.
Electrons at Another SSD

 Since electrons are treated with electron cone applicators,


the scattering pattern is significantly different from X-Rays.
 From the perspective of the point of calculation inside the
patient, it appears as if the electrons originate from a point
other than the target in the head of the linac. This gives
rise to virtual and effective SSDs.
 They are different concepts as described in your main
textbook, but in some institutions, the two terms are used
interchangeably. For our purposes here, we will refer to the
effective SSD as VSSD and use that concept for our
inverse square calculations when not treating at 100 cm
SSD. VSSD is energy and cone size dependent.
Electrons at Another SSD

 Due to patient anatomy, a 10 x 10 cone cannot be used at


100 cm SSD to treat a PCS (posterior Cervical Strip) area.
Instead, 108 cm is used. What is the inverse square factor
and the MU needed to deliver 200 cGy to dmax with a 10 x
10 cone and 12 MeV? Assume the VSSD for 10 x 10 and
12 MeV is 84.5 cm and 12 MeV dmax is 2.8 cm.
 Inverse Square: 108 cm is used, which is 8 cm greater
than "standard." Do not use 100 cm for the calculation, but
use the VSSD and the 8 cm difference:
Electrons Using Another Cone

 As with X-Rays, there is a field size dependence with


electrons. Since your field size is usually defined by
electron applicator cones, most dosimetry tables are
organized by cone size and energy only.
 Since changing the X-Ray collimators (X and Y jaws) has
a massive change on electron output, most modern
machines will sense the cone used and energy selected
and automatically set the jaws correctly.
 One simply looks up the cone used and the energy
prescribed then applies the cone output factor in the
denominator of the MU calculation.
Additional Blocking

 Custom blocking is accomplished by using cerrobend


inserts that fit into the bottom of the cone in place of
standard square inserts. These custom cone inserts can
modify the output of the beam as well as the profile of the
beam (penumbra).
 In general, if any dimension in the field as created by the
custom block is less than the practical range (practical
range is defined by: Rp (in cm) = E (MeV) / 2) of the
electrons being used, a blocking factor may need to be
used.
Example

 Assume that the physician wants to treat a PCS to 180 cGy


using 9 MeV. Adequate coverage of the volume and minimal
dose to the cervical spinal cord can be achieved if the doctor
prescribes the 180 cGy to the 95% isodose line. In order to get
the 15 x 15 cone in place, the simulation therapist advises the
physician that the best he can do is 105 cm SSD.
 After reviewing the shape of the treatment field, the dosimetrist
requests the physicist make an electron block measurement.
The physicist measures the output of the block using the 15 x
15 cone, 9 MeV at 105 cm SSD. The physicist then compares
the blocked field output (with 15 x 15 cone at 105 cm SSD) to
the 15 x 15 open cone output using 9 MeV and 105 cm SSD
also. He determines that the block decreases the output by
8.5% (blocking factor is 0.915).
Thank you for your attention

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