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Empirical formulation for small circular electron fields

To cite this article: Imran Khan et al 2020 Biomed. Phys. Eng. Express 6 065023

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 Biomed. Phys. Eng. Express 6 (2020) 065023 https://doi.org/10.1088/2057-1976/abc18b

PAPER

Empirical formulation for small circular electron fields

RECEIVED
8 July 2020
REVISED
Imran Khan1,2 , Sunil Kumar2,∗ , Sushil Kumar3, Tuhin Datta2 and Bipin Singh Koranga4
30 September 2020 1
Department of Physics, Cornell University, Ithaca NY, United States of America
2
ACCEPTED FOR PUBLICATION Department of Physics, Ramjas College, University of Delhi, New Delhi, India
3
15 October 2020 Department of Physics, Hansraj College, University of Delhi, New Delhi, India
4
PUBLISHED
Department of Physics, Kirorimal College, University of Delhi, New Delhi, India
∗
29 October 2020 Author to whom any correspondence should be addressed.
E-mail: skumar@ramjas.du.ac.in

Keywords: electron beam therapy, small circular fields, therapeutic depth, prescription depth, Monte Carlo method, least square fitting,
EGSnrc/BEAMnrc

Abstract
An empirical model for small circular electron fields was developed. This can be of great help in the
treatment planning process for small circular electron fields. A complete dosimetric analysis of the
circular fields defined by electron cutouts diameters (2 cm–9 cm) was done for nominal electron
energies ranging between 6 MeV and 20 MeV using a 3D water phantom and a pin-point ion chamber.
Properties studied included depth dose, in-air inverse-square fall-off, and beam profiles. The Varian
Clianc 2100 C accelerator was modelled, benchmarked and Monte Carlo simulations were performed
using the EGSnrc/BEAMnrc code for the small circular cutouts. A simple exponential model was
found to accurately predict the very important therapeutic depth (90% of Dmax) for the small circular
field size within an accuracy of better than 2 mm in most cases. The model has only two parameters
(d90 and ‘b’). Also, the penumbra widths (90% of the off-axis profiles) of these small circular electron
fields were studied and least square fitted to a simple quadratic model. Full dosimetric profiles of these
small circular electron fields were further studied using the benchmarked Monte Carlo simulations.
This study presents a simple model to predict the very important therapeutic depth (90% of Dmax)
and a recipe to develop such an electron treatment model for any linear accelerator system. Such
predictions can be extremely valuable and time saving prior to treatment planning involving not only
small circular shaped electron fields but also irregularly shaped electron fields.

1. Introduction breast, upper respiratory and digestive tract. Small

The surge in commercial development and applica-
tions of the linear accelerators during the seventies for
cancer therapy also led to a surge in use of electrons for
therapy. Work carried out at some of the premier
institutions during this time, showed that in some
common situations, there was no alternative treat-
ment to the electron beam therapy. Electrons are
charged particle with a finite range and therefore are
suitable for treatment of superficial and shallow
targets. Electron beam therapy offers some distinct
advantages over megavoltage photon beam therapy
[1, 2]. Electrons deliver a reasonably uniform dose
from the surface to a specific depth, after which the
dose falls off rapidly to a near zero value unlike the
megavoltage photon beams. Electrons are useful in
treating cancer of the skin and lips, head and neck,
electron fields, shaped using circular cutouts made of
Cerrobend are frequently used for treating superficial
tumors, which are not too deep in the body. Clinically
it is extremely important to know the depth dose
characteristics and off-axis profiles of these small
circular electron cutouts as they can vary to a great
extent with the electron energy and the diameter of the
circular cutouts [3]. A lot of laborious measurements
in this regard may need to be performed before
deciding upon the right electron energy and the
circular cutout size for a particular case. Previous
studies have been performed in this respect to get
Output Factors using the Monte Carlo method [4].
Prediction of Output Factors have also been obtained
using a parametric form [5] and pencil beam algorithm
[6]. Several studies have been done on measuring
dosimetric properties of small electron fields.

© 2020 IOP Publishing Ltd

Biomed. Phys. Eng. Express 6 (2020) 065023
Figure 1. Circular Cerrobend Electron Cutouts of diameter ranging from 2 cm to 9 cm.
However most of the studies are missing on estimating
a very important parameter for electron treatment that
is the therapeutic depth (90% of Dmax). The ther-
apeutic depth, which is the 80% to 90% of the depth of
the depth dose curve coming after Dmax is the most
useful range for any electron field. The therapeutic
depth (90% of Dmax) is given by the depth of the 90%
depth dose coming after Dmax, for that particular field
size. This is very important as the dose decreases
abruptly beyond the 90% dose level after Dmax. The
therapeutic depth (90% of Dmax) and the required
electron energy must be chosen very carefully. In this
study we have characterized the dosimetric properties
of small electron cutouts with diameter ranging from
2 cm to 9 cm for a Varian Clinac 2100 C. We have
arrived at a simple analytical model, which using a
single curve fitted coefficient : ‘b’ can be used for
predicting the very important: therapeutic depth (90%
of Dmax) for small circular cutouts made of Cerro-
bend. Also, we have measured and fitted equations to
the 90% field width at SSD of 110 cm, which can be
very useful to decide the energy and cutout size based
on the intended target coverage area. The empirical
formation developed in this study can be used
effectively for deciding the right electron energy and
the right circular cutout diameter after deciding upon
the right therapeutic depth (90% of Dmax). Similar
measurements may be performed for any linear
accelerator system to use the simple exponential
expression with machine specific parameters includ-
ing the fitting parameter ‘b’. This approach can be used
for making optimal and swift treatment planning for
cases involving small circular electron fields and
shallow targets.
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I Khan et al
2. Methods
A set of circular electron cutouts, made of Cerrobend
with physical diameters from 2 cm to 9 cm were
constructed in the usual clinical manner (figure 1). A
full dosimetric analysis of the circular fields defined by
each cutout was done for nominal electron energies
ranging from 6 MeV to 20 MeV for a Varian Clinac
2100 C. The dosimetric data was collected using a
pinpoint chamber and 3D water phantom as the same
equipment/process was used in the commissioning
process of the linear accelerator. Properties studied
included depth dose, in-air inverse-square fall-off, and
beam profiles. A linear accelerator model was built in
EGSnrc/BEAMnrc [7] for the Varian Clinac 2100 C.
The geometry of the linear accelerator (position of
scattering foil, x-y jaws, applicators etc) was obtained
directly from Varian Medical Systems of Palo Alto,
California. After appropriate benchmarking, these
properties were further studied with Monte Carlo
model of the accelerator developed using the EGSnrc/
BEAMnrc code [7]. From the physical data and
simulations, the following parameters were deter-
mined for each cutout/energy combination: R50, R90,
widths of 90% and 95% isodose surfaces, effective
SSD, and dose output factor. Selected parameters were
then correlated with collimator size to arrive at an
exponential model, which accurately predicts the
therapeutic depth (90% of Dmax). For projected
circular cutout sizes smaller than 2 cm, the measure-
ments are very hard to perform, therefore the results
from benchmarked Monte Carlo simulations were
used to fill in the points in order to develop the
complete empirical model. This set of crucial data
Biomed. Phys. Eng. Express 6 (2020) 065023
Figure 2. 90% Depth (y) beyond Dmax versus projected circular cutout diameter (x) for SSD of 100 cm. For x<2 cm, the data points
were generated through benchmarked Monte Carlo accelerator model.
Table 1. Values of fitted parameters evaluated using least square regression analysis.
Parameters Energy=6 MeV Energy=9 MeV
d90 1.846 3.005
b 0.7517 0.5086
points (x<2 cm) are necessary to arrive at the
functional form of equation (1).
3. Results
The following simple exponential model (equation (1))
had been found to accurately predict the commonly used
the therapeutic depth (90% of Dmax) for the circular
field size with projected diameter x (at SSD = 100 cm),
within an accuracy of better than 2 mm in most cases.
y = d 90[1 - e-b.x ]
Here y is the 90% depth for the circular cutout with
projected diameter: x, d90 is the 90% therapeutic or
prescription depth (90% of Dmax) for the open cutout
(10×10 cm2 field), which is normally measured
during the commissioning process. This d90 can also
be estimated approximately by E/3.2 cm, where E is
the most probable energy in MeV of the electron beam
at the patient/phantom surface [8]. Figure 2 shows
the plot of measured values and also those obtained
from Monte Carlo modelling for projected diameter:
x<2 cm. The predicted curves are plotted as well by
curve fitting the functional form using least square
method for electron beam energies ranging from
6 MeV to 20 MeV. The only real unknown in this
model here is the parameter ‘b’, to be determined
using least curve fitting. The coefficient of determina-
tion for the curve fitting (R2 value) was close to 0.99 for
all the electron energies [9].
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I Khan et al
Energy=12 MeV Energy=16 MeV Energy=20 MeV
4.247 5.475 6.061
0.4105 0.3536 0.3759
Table 1 shows the values of the least square fitted
parameter ‘b’, d90 for all the nominal electron energies
for the therapeutic depth (90% of Dmax). These values
can be easily obtained for any particular linear accel-
erator by performing measurements for a few circular
electron cutouts and a few Monte Carlo simulations.
The parameter ‘b’ depends on the beam energy and
has been least square fitted to a quadratic model (cubic
term coefficient is close to zero) as shown in figure 3
with coefficient of determination : R2=0.998. This
model can be developed for any accelerator system and
(1)
used to predict the ‘b’ parameter for a particular
energy to be used the main modeled equation (1) for
calculating the therapeutic depth (90% of Dmax).
Penumbra widths, which are defined as the 90%
field width at the depth of maximum dose were eval-
uated and are presented in figure 4. These are plotted as
a function of electron cutout size (x) and nominal elec-
tron energy at 110 cm SSD. The data was least square
curve fitted to set of quadratic expressions (shown in
figure 4) for each electron energy. The coefficient of
determination (R2 value), which is a measure of how
good the fitting [10] has been calculated and in almost all
cases are very close to the ideal number of one.
Figure 5 shows the measured and Monte Carlo
generated data for 12 MeV central axis, percent depth
doses for all the small circular cutouts of diameters
ranging from 2 cm to 10 cm. Figure 6 shows a compar-
ison of the measured and the Monte Carlo generated
Biomed. Phys. Eng. Express 6 (2020) 065023
Figure 3. The parameter ‘b’ of the equation (1) as a function of electron energy along with a least square fitted quadratic model for
predicting it for any console energy: E.
Figure 4. Measured and fitted quadratic equations for 90% penumbra widths at 110 cm SSD.
data for off-axis profiles of 9 MeV electron beams
again for all the circular cutouts of diameter ranging
from 2 cm to 10 cm. The simulations were done using
100 million histories to give error bars of sizes less than
±1%. The simulation time taken for each cutout was
around 2 to 3 hours on an Intel i5-4570@3.2 GHz pro-
cessor with 4GB RAM.
The Monte Carlo method needs to be able to predict
a dose distribution in agreement with the measurement
within clinically acceptable tolerance level [11, 12]. A
commonly accepted accuracy level is ±2% or ±2 mm as
stated in ICRU Report 42. [13]. Great agreements (dif-
ferences less than 2%) between the measurements and
the Monte Carlo data have been found in both the cases
studied in figures 5 and 6. The agreement for very small
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I Khan et al
circular sizes of 2 cm and 3 cm is not as great as the
agreement for field sizes higher than 3 cm. This slight
disagreement may be due the uncertainties involved in
measurement for very small field sizes. The bench
marked Monte Carlo data for percent depth dose may
be trusted more in these cases.
4. Discussion and conclusions
The formulation developed in this work accurately
describes the clinical dosimetric properties of small
circular electron fields. It can be used to select the
circular cutout diameter needed to provide the desired
coverage (using 90% field widths) at the very impor-
tant therapeutic depth (90% of Dmax), beyond which
Biomed. Phys. Eng. Express 6 (2020) 065023 I Khan et al

Figure 5. Measured and Monte Carlo data for 12 MeV, central axis percent depth dose profiles.

Figure 6. Measured and Monte Carlo data for 9 MeV off-axis profiles for circular cutouts with diameters ranging from 2 cm to 5 cm.

the dose falls off very rapidly. This can be done without
relying on usually used approximate rules i.e. estimat-
ing it as E/3.2 cm, where E is the most probable energy
in MeV of the electron beam at the patient/phantom
surface [8] or trying various combinations of energy
and cutout size in a treatment planning system. This
formulation can greatly help in providing adequate
dose at the right target depth under the skin and have
intended target coverage.
Equation (1) can be effectively used for predicting
the depth (90% of Dmax), represented as: y for small
circular cutouts with projected diameter: x and greatly
help in the decision of choosing the right circular cut-
out size and energy. Once a set of relevant cutout sizes
and energies have been narrowed down, the fitted
equations of the measured data for penumbra widths
can be used to close the search for the right cutout and
the right energy. Modelled equation (1) has only two
parameters that of d90 for the open 10×10 field
(which is usually measured during the commissioning
process) and the independent parameter ‘b’. The pos-
sible values of parameter ‘b’ (shown in table 1) were
determined using the empirical data and nonlinear
regression method [9]. It may be noted that the para-
meter ‘b’ does not vary much for higher energies ran-
ging from 12 MeV to 20 MeV. Parameter ‘b’ may be
related to the scattering power of the electron beam,
which is higher for lower energies. This parameter can

5
Biomed. Phys. Eng. Express 6 (2020) 065023
easily be obtained by doing measurements for all the
available circular cutouts and filling in the points for
cutout diameter for x<2 cm, using the benchmarked
Monte Carlo simulations. Finally, this ‘b’ parameter
can be predicted using the least curve fitted quadratic
function shown in figure 3. A similar functional form
can be easily developed for any accelerator system.
The Monte Carlo method relies on fundamental
physics principles governing interaction of particles in
media and has been proved to be capable of accurately
modeling electron beams in radiation therapy [11, 12].
A lot of improvement has been attained in this regard
[9]. Final choice of the circular cutout size and energy
can be used as input into the benchmarked Monte
Carlo model to get the full dosimetric properties of the
cutout: percent depth dose (figure 5) and off axis pro-
files (figure 6) at the chosen energy. Processing time
may be saved in performing benchmarked Monte
Carlo simulations by using phase-space files. A phase-
space file is a collection of data specifying properties
such as the position, direction, energy and the type for
each particle crossing a plane defined as a phase-space
plane. These phase-space files are usually compatible
with the International Atomic Energy Agency (IAEA)
format for clinical electron energies just above the
jaws. These are provided for some of the new systems
such as the Trubeam Linacs from Varian. Complete
studies of small electron fields using such a phase space
file approach has been demonstrated [14]. This recipe
may be followed for any of the commercial linear
accelerator, thereby greatly cutting down the treat-
ment planning time and effort without compromising
on the optimization of the planning process. Similar
studies and modelling may be designed to be carried
out for other symmetrically shaped small electron cut-
outs such as triangular, square or rectangular shaped.
This study was specially carried for small circular elec-
tron cutouts but can be useful for irregularly shaped
electron fields as well. The benchmarked Monte Carlo
models (tested for small circular cutouts) may be
relied upon to get the full dosimetric properties of any
irregularly shaped field.
I Khan et al
ORCID iDs
Imran Khan https://orcid.org/0000-0002-4058-8561
Sunil Kumar https://orcid.org/0000-0001-8240-0945
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