Powers, Marcus, and Baines, John (2023) A comparison of measured and treatment planning system out-of-field dose for a 1.5 T MR linac. Physics in Medicine and Biology, 68 (20). 20NT01.

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Abstract

Objective: Dose due to the electron streaming effect (ESE) is a significant contribution to out-of-field dose on the Elekta Unity MR-Linac. The aim of this work is to provide a systematic comparison of calculated and measured streaming dose for this system.

Approach: Beams 1.0 × 1.0 cm2 to 5.0 × 5.0 cm2, gantry 90.0°, 1000 MU, were incident on an in-house phantom. At the beam entrance and exit surfaces of the phantom, ESE was generated in the Y-direction (IEC 61217). EBT3 film, orientated within the X-Z plane and at 14.0 mm depth in a solid water block, was used to determine ESE dose 5.0 cm beyond the phantom. The experimental arrangement was simulated in the Monaco v5.4 treatment planning system (TPS), utilising a CT phantom dataset with differing relative electron densities (RED) for the surrounding air. Horizontal (Xdirection) and vertical (Zdirection) film dose profiles were compared to the corresponding TPS profiles.

Main results: For each field, the maximum ESE dose was observed at the beam exit, the magnitude of which decreases with decreasing field size. For the 5.0 × 5.0 cm2field, the exit and entry ESE doses were 19.6% and 7.0% of the Dmax dose to water, respectively. Across horizontal profiles, differences (simulated-measured) were reduced with smaller fields and lower RED. The maximum absolute profile difference was 1.7% of the Dmax dose to water for optimal RED and isocentre location. In vertical profiles an offset consistent with the Lorentz force was observed relative to the X-Y isoplane.

Significance: For the fields investigated, maximum absolute differences (simulated-measured) ≤ 5.2% occurred in peak regions of ESE, at the beam entrance and exit from the phantom. Generally, there is good agreement between Monaco simulated and measured ESE. Simulated out-of-field dose is sensitive to the RED assigned to air structures and unforced RED optimises out-of-field dose calculation accuracy.

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