Adriana Dalea February 8, 2014 DOS 422/522

Attenuation Project 30 Degrees Enhanced Dynamic Wedge Objective: To determine the wedge a!tor or "0 degree# $nhan!ed Dynami! %edge &$D%' and a((ly it in a monitor unit !al!ulation or a treatment (lan) Purpose: The wedge# are ilter# that are (la!ed in the (ath o the beam and they a!t a# ti##ue !om(en#ator#* in treatment (lanning the wedge# are u#ed to modi y the i#odo#e di#tribution)1 The wedge will ab#orb gradually the (hoton# and will de!rea#e their luen!e) The luen!e i# de ined a# the number o (arti!le# (a##ing through a !ro## #e!tional area) %edge# !an be (hy#i!al or dynami!) +n thi# (ro,e!t + will addre## the $nhan!ed Dynami! %edge in!or(orated in the -arian .ina! 21 $/) Dynami! wedge# !reate the (hy#i!al wedge# e e!t to the i#odo#e !ur0e# by !lo#ing the !ollimator 11 and 12 ,aw# while the beam i# on)2 They ha0e a range o angle# anywhere rom 0 to 20 degree#) +n order to (ro(erly !al!ulate the monitor unit# re3uired deli0ering a !ertain do#e to a (atient, we need to in!or(orate the !orre!tion %edge Fa!tor #o we !an obtain a 0alid treatment (lan) The %edge Fa!tor i# de ined a# the ratio between the do#e with the wedge and the do#e without the wedge at a (oint in a (hantom along the !entral a/i# o the beam)
WEDGE FACTOR = Dose with Wedge Dose without the Wedge

Methods and Materia s: The mea#urement# were (er ormed u#ing a -arian 21 $/ .inear A!!elerator, or two di#tin!t beam energie# o 2 4- and 18 4-) 5lo!6# o 10 / 10 !m ield #i7e #olid water were #ta!6ed and a Farmer ty(e ioni7ation !hamber wa# (la!ed at a 10 !m de(th and it wa# u#ed to mea#ure the !harge* SSD wa# #et at 80 !m and

SAD wa# 100 !m) The ioni7ation !hamber wa# !onne!ted to an ele!trometer at the room !ontrol (anel* the !harge wa# mea#ured in nano9oulomb# &n9') A total o 12 mea#urement# were (er ormed deli0ering 100 4: ea!h) For the 2 mega0olt# &4-' beam energy " mea#urement# were ta6en in o(en ield and " with the "0 degree# $nhan!ed Dynami! %edge, $D%* 2 additional mea#urement# were made or the 18 mega0olt# &4-' beam, " in o(en ield and " with the "0 degree# $D%)

!mage ": The #et u( in the room with the ioni7ation !hamber and the #olid water (hantom# (la!ed on the treatment table)

!mage #: The ele!trometer u#ed to mea#ure the !harge#) $esu ts: The reading# or the 12 mea#urement# are re!orded in Table 1 below, and the two %edge Tran#mi##ion Fa!tor# or the 2 4- beam energy and 18 4- re#(e!ti0ely, were !al!ulated with the ormula (re#ented abo0e and re!orded in Table 2) %ab e ": &eam Energies 2 4Open 'ie d $eadings (n)* 2)85 2)85 2)84 8)54/" ; #+,- n) (average* 18 4")11 ")10 ")11 8)"2/" ; 3+"" n) (average* 30 Degrees EDW $eadings (n)* 2)45 2)45 2)45 <)"5/" ; #+.- n) (average* 2)<8 2)<8 2)<< 8)""/" ; #+/, n) (average*

WEDGE FACTOR =

Dose with Wedge Dose without the Wedge

%ab e #: &eam Energies 2 418 4=e ading with Wedge =e ading without Wedge

Wedge 'actor 0)82 0)88

2)45 2)84 2)<8 ")11

Discussion: The inding# demon#trate that the wedge a!tor o 0)82 or the 2 4- beam will allow 82> and or the 18 4- beam 88 > o the radiation to (a## through to the target when we u#e a "0 degree $D%) + we would ha0e mea#ured or a higher degree wedge angle, we would ha0e noti!ed an in!rea#e in the wedge a!tor, be!au#e a higher degree wedge angle would attenuate more o the beam) ) inica App ication: + a##umed a (atient i# treated or uterine malignant neo(la#m, and a 4 ield (el0i# treatment (lan i# !reated) The (re#!ribed do#e i# 4820!?y in 2< ra!tion#, 180 !?y/ ra!tion) The 2 4- beam energy i# u#ed) There are 2 ield# A@/@A and 2 ield# le t lateral and right lateral) For the lateral ield# there were added "0 degree# $D% to attenuate the hot#(ot# !reated and the better di#tribute the do#e) The 4: ormula i#A
M = prescribed dose Sc Sp TPR Cf WF OAF ISF

+n thi# #ituation, S! ; 1)011 i# the !ollimator #!atter a!tor, S( ; 1)04" i# the (hantom #!atter a!tor, T@= ; 1)022 i# the ti##ue (hantom ratio, 9 ; 0)850 !?y/mu i# the !alibration a!tor, OAF ; 1 i# the o a/i# a!tor, and +SF ; 1 i# the in0er#e #3uare a!tor) %F or 2 4-, ba#ed on our mea#urement#, i# 0)82)

5a#ed on the ield weighting, the do#e or the .T .ateral ield #hould be 22)8 !?y) The manual !al!ulation or the 4: i# a# ollow#A
M = 22)8cG" 22)8 = =// (0ith the 30 1)011 1)04" 1)022 0)850cG" / !u 0)82 1 1 0)82

degrees EDW inc uded*+

M = 22)8cG" 22)8 = =11 (0ithout the 30 1)011 1)04" 1)022 0)850cG" / !u 1 1 0)85

degrees EDW*+ @er the#e !al!ulation#, we !an determine that the when we ha0e the $D% in!luded in the treatment (lan, we need to deli0er a higher number o monitor unit#A
M with EDW << = =1)12 M without EDW 22

To re(re#ent thi# a# a (er!entage, we will ha0eA 1)12 / 100 ; 112> There ore, i we will introdu!e the $D% i# the (lan or thi# ield, we will need to in!rea#e the 4: with 12> to deli0er the #ame amount o do#e) )onc usion: Thi# (ro,e!t hel(ed me under#tand the attenuation (ro(ertie# o a dynami! wedge, the way it i# (hy#i!ally !al!ulated and the im(a!t that the determined wedge a!tor ha# on the amount o monitor unit# deli0ered to the (atient) + the a!tor i# omitted rom the !al!ulation, the (atient will not re!ei0e the (re#!ribed do#e due to the a!t that the number o 4: will be lower) The o((o#ite e e!t will be when the $D% will not be in!luded in the (lan and the ield will get a higher do#e than ne!e##ary) +t i# 0ery im(ortant to alway# !on#ider the wedge# and !om(en#ator# we ha0e a0ailable when we !reate a treatment (lan, and it i# mandatory to (ay attention to all the !oe i!ient# that ha0e to be in!luded in the 4: !al!ulation in order to obtain an a!!urate !o0erage o the 0olume we need to treat) Any #mall error !an lead to a negati0e im(a!t to the o0erall re#ult or the (atient)

$e2erences: 1) Bhan F4) The#Ph"sics#of#Radiation#Therap") 4th ed) 5altimore, 4DA .i((in!ott, %illiam#, and %il6in#* 2010) 2) @odgor#a6 $5) =adiation on!ology (hy#i!#A a handboo6 or tea!her# and #tudent# ) +A$A %eb #ite) htt(A//wwwC naweb)iaea)org/nahu/D4=@/do!ument#/#lide#/9ha(terD02D@hotonDbeam#)(d ) 2002) A!!e##ed February 8, 2014)