Attenuation Lab

Introduction
The objective of this lab and handout is for the student to understand the principle of attenuation
of the radiation beam as it passes through an object placed in the path of the beam and how to
calculate the transmission factor appropriately which will be used in a patient treatment
calculation.
This guide will walk you through the fundamental process of photon attenuation. It will also
provide measured data which will be used by the student in the attenuation lab analysis. When
you have reached the end of this handout you will have to answer questions to test your
understanding of the topic.
As photons traverse matter some are removed from the beam by either absorption or scatter.
When the photon is absorbed the energy of the photon is deposited into the medium. When the
photon scatters it interacts with the medium and deflects from its original path. Both of these
phenomenon result in a loss in intensity of the beam.
A photon beam is often described in terms of intensity, which is essentially the number of
photons in a given beam. The intensity 𝐼(𝑥) will be decreased when the beam traverses a
medium of given thickness 𝑥 before the point of detection as shown in Figure 1. When the
medium is sufficiently far away from the point of detection this is often described as a “good
geometry” or “narrow beam geometry” because the only photons which reach the detector are
primary photons. Those photons which have been absorbed or scattered are not measured.

Figure 1: Narrow beam geometry where on the primary photons are measured by the detector courtesy of
Khan [1].

Every medium has its own inherent ability to attenuate photons at specific energies which is
often described in terms a linear attenuation coefficient 𝜇. This quantity’s units are photons per
unit length. To determine the intensity which will reach the detector we can use Eq ( 1 ).
𝐼(𝑥) = 𝐼0 𝑒 −𝜇𝑥
Eq ( 1 )
Where, 𝐼0 = 𝐼𝑛𝑖𝑖𝑎𝑙 𝐼𝑛𝑡𝑒𝑛𝑠𝑖𝑡𝑦, 𝐼(𝑥) = 𝐹𝑖𝑛𝑎𝑙 𝐼𝑛𝑡𝑒𝑛𝑠𝑖𝑡𝑦, 𝑥 = 𝑡ℎ𝑖𝑐𝑘𝑛𝑒𝑠𝑠 𝑜𝑓𝑚𝑒𝑑𝑖𝑢𝑚, and 𝜇 =
𝑙𝑖𝑛𝑒𝑎𝑟 𝑎𝑡𝑡𝑒𝑛𝑢𝑎𝑡𝑖𝑜𝑛 𝑐𝑜𝑒𝑓𝑓𝑖𝑐𝑖𝑒𝑛𝑡. As you can see, the number of photons will decrease
exponentially as the beam traverses the medium. However, keep in mind this scenario is with
regards to a “monoenergetic” beam. Most clinical photon beams are polyenergetic which will
result in the attenuation being no longer exactly exponential. Lower energy photons are more
readily absorbed or scattered. This behavior is shown in Figure 2. As the low energy photons
are attenuated, the beam is hardened because the higher energy photons are less likely to
interact.

Figure 2. Attenuation of a polyenergetic beam courtesy of Khan [1].

The second thing to keep in mind is, the concept of “good geometry” is often difficult to replicate
in a clinical environment. We typically are dealing with “broad beam geometry” where there are
scattered photons which reach the point of detection as shown in Figure 3.
 Initial Photon
Intensity

Detector

Figure 3. Broad beam geometry where photons are being scattered to the detector.

When we look to quantify the attenuation of a material, we end up measuring transmission. For
example, if you take a measurement of an open field without the material let’s say you count 10
photons. When you put the material in the field you take another measurement and you count 4
photons. The transmission is the ratio of the final number of photons or intensity 𝐼 and the initial
𝐼0 , see Eq ( 2 ).
𝐼
𝑇𝑟𝑎𝑛𝑠𝑚𝑖𝑠𝑠𝑖𝑜𝑛 =
𝐼0
Eq ( 2 )

For our simplistic example, the transmission is

4 𝑝ℎ𝑜𝑡𝑜𝑛𝑠
𝑇𝑟𝑎𝑛𝑠𝑚𝑖𝑠𝑠𝑖𝑜𝑛 = = 0.40 𝑜𝑟 40% 𝑜𝑓 𝑡ℎ𝑒 𝑝ℎ𝑜𝑡𝑜𝑛𝑠 𝑟𝑒𝑎𝑐ℎ 𝑡ℎ𝑒 𝑑𝑒𝑡𝑒𝑐𝑡𝑜𝑟
10 𝑝ℎ𝑜𝑡𝑜𝑛𝑠
In this example, we understand that 6 photons were absorbed or scattered. The attenuation is
related to the transmission by using Eq ( 3 ).
𝐴𝑡𝑡𝑒𝑛𝑢𝑎𝑡𝑖𝑜𝑛 = 1 − 𝑇𝑟𝑎𝑛𝑠𝑚𝑖𝑠𝑠𝑖𝑜𝑛
Eq ( 3 )

For all the factors we measure in this lab, we will be measuring the transmission. As we are
concerned with the amount of radiation which transmits through the material and reaches the
patient.
Clinically we will often encounter scenarios where objects are placed in between the x-ray
source and the patient. These objects can be wedges, tray, blocks, compensators, treatment
couches, or bolus, just to name a few. The perturbation these objects cause the radiation beam
are accounted for in the MU calculation formalism Eq ( 4 ). Take note there is a wedge (WF)
and a tray factor (TF).
 𝐷
𝑀𝑈 =
𝑆𝑆𝐷0 + 𝑑0 2
𝐷0′ ∗ 𝑆𝑐 ∗ 𝑆𝑝 ∗ 𝑇𝑃𝑅 ∗ 𝑊𝐹 ∗ 𝑇𝐹 ∗ 𝑂𝐴𝑅 ∗ ( 𝑆𝐴𝐷 )
Eq ( 4 )

The factors are utilized to account for objects which would perturb the beam. The wedge factor
(WF) is defined as the ratio of the dose rate with the wedge in the beam and without for the
same field size.
𝐷𝑊𝑒𝑑𝑔𝑒
𝑊𝐹 =
𝐷𝑁𝑜 𝑊𝑒𝑑𝑔𝑒

Eq ( 5 )

The two kinds of wedges which will be explored in this lab will be physical and non-physical
wedges.
Physical wedges are classified into two types, which is distinguished by their placement relative
to the secondary collimator. Internal wedges are located above the collimator jaws and use a
single large wedge angle (600). The internal wedge is placed in to the field and the desired
wedge angle is created using a combination of the wedge and open field. The larger the desired
wedge angle the longer the wedge will be left in the field. The second physical wedge is placed
below the secondary collimator and is manually inserted into the collimator head of the linear
accelerator. A physical wedge factor will depend on the effective field size if there is additional
MLC blocking, and the depth of the point of calculation. The depth dependence has been
attributed to both beam hardening and the dose falloff. According to McCullough et al. [2] at
depths of less than 10 cm the error in the wedge factor error is less than 2%. However, this
error can differ by up to 5% at depths greater than 10 cm. This necessitates the measurement
of the physical wedge factor at depths greater than 10 cm.
Non-physical wedges are created by moving the collimator in conjunction with the adjustment of
the dose rate. The two major vendors for this implementation are Varian’s “enhanced dynamic
wedge” (EDW) and Siemens “virtual wedge” (VW). The major difference between the physical
and non-physical wedges is for physical wedges you are actually placing an object between the
x-ray source and the patient, whereas a non-physical wedge you are “modulating” the beam by
preferentially closing portions of the open field to create the wedge gradient. Non-physical
wedges depend on the effective field size, but are considered depth dose independent as the
concept of beam hardening is eliminated.
In this lab, we will also explore the tray factor (TF) which has commonly been utilized when a
block is inserted into the field. The block is attached to the tray and the tray is mounted to the
gantry.
𝐷𝑇𝑟𝑎𝑦
𝑇𝐹 =
𝐷𝑁𝑜 𝑇𝑟𝑎𝑦

Eq ( 6 )

The tray factor is often considered independent of field size, depth, and SSD. A constant value
is typically assigned in most cases. The presence of this device will perturb the dose build-up
region by producing secondary electrons and absorbing secondary electrons which are created
upstream in the linear accelerator’s head. It is recommended the tray factor should be
measured at a depth beyond the maximum range of the electron contamination (=>5cm).
The question and purpose of this lab is to understand how to account for when objects are
between the x-ray source and the patient.
We will be measuring the transmission of a 60-degree physical wedge, 60-degree EDW, and a
tray factor for a Varian TruebeamTM linear accelerator. This handout and the data which is
collected will be used to help you complete the questions regarding this lab.

Methods and Materials

The measurement setup will be the same for the 3 factors we are looking to quantify. A PTW
Farmer Ionization Chamber will be connected to a PC Electrometer. A bias voltage of +300V
was applied. All the data will be reported in terms of nanocoulombs. This ion chamber will be
placed inside of a material know as “Solid Water”. The material is assumed to be water
equivalent. The ion chamber is placed inside of a slab of material at CAX at 100 cm SAD.
Subsequent slabs are placed above and below, which results in the ion chamber being at an
effective depth of 10 cm from the surface and 10 cm from the treatment couch. The additional
slabs below the ion chamber are to ensure we have adequate backscatter from the beam. A
depth of 10 cm was chosen because it should provide a fairly accurate factor for the physical
wedge and we are well beyond the range of electron contamination when we will look at the tray
factor. This setup is shown in Figure 4.
 Figure 4. Experimental setup for measurement of all transmission factors.

Initial open field measurements were taken for both 6 MV and 15 MV photon beams. The field
size used was set to 10x10 cm2 and 100 MU were delivered. The dose rate for three
measurements were taken and averaged. These results are shown in Table 1.
Table 1. Open field measurements for a 10x10 cm2 field size, 100cm SAD, and 100 MU delivered

Energy (MV) Reading 1 (nC) Reading 2 (nC) Reading 3 (nC) Average (nC)
6 12.17 12.15 12.15 12.16
15 14.14 14.15 14.15 14.15

Physical Wedge
A 60-degree wedge (Figure 5) was inserted into the head of the linear accelerator. The field size
was kept constant and 100 MU were delivered. The measured charge with the physical wedge
in the beam is summarized in Table 2.
Table 2. Measurements with the 60-degree physical wedge for a 10x10 cm2 field size, 100cm SAD, and
100 MU delivered

Energy (MV) Reading 1 (nC) Reading 2 (nC) Reading 3 (nC) Average (nC)
6 4.941 4.941 4.956 4.946
15 6.241 6.237 6.236 6.238
 Figure 5. Varian 60-degree wedge

Non-physical Wedge
A 60-degree enhanced dynamic wedge was initialized in Service Mode. The collimator was
turned to 90 degrees. This was done because for Varian EDWs the wedge distribution is
created by moving the Y-jaw across the field. If the collimator was left at 0 degrees the toe of
the wedge would irradiate the stem of the detector, which would lead to greater uncertainty in
the measurement. The field parameters (10x10 cm2 field size, 100 cm SAD, and 100 MU) were
kept constant and 3 measurements were recorded and averaged. The results are summarized
in Table 3.
Table 3. Measurements with the 60-degree EDW for a 10x10 cm2 field size, 100cm SAD, and 100 MU
delivered

Energy (MV) Reading 1 (nC) Reading 2 (nC) Reading 3 (nC) Average (nC)
6 7.997 8.002 7.999 7.999
15 10.14 10.13 10.13 10.13

Blocking Tray
A blocking tray was inserted into the head of the linear accelerator Figure 6. The beam
parameters were kept constant and 3 measurements were recorded and averaged. The results
are summarized in Table 4.
 Figure 6. A blocking tray was inserted into the TruebeamTM linac head

Table 4. Measurements with a blocking tray for a 10x10 cm2 field size, 100cm SAD, and 100 MU
delivered

Energy (MV) Reading 1 (nC) Reading 2 (nC) Reading 3 (nC) Average (nC)
6 11.65 11.69 11.67 11.67
15 13.70 13.79 13.70 13.73
Results
A final table was created to summarize all the data acquired. This is shown in Table 5.
Table 5. Average readings for an 10x10 field size, 100 SAD and 100 MU delivered. The open field
readings are taken with no dose modifying device in the beam. All readings were taken 3 times and
averaged for the given 4 delivery scenarios.

Average Charge Reading per Attenuating Device

Energy (MV) Open Field 60-degree 60-degree Blocking Tray
Physical Wedge EDW
6 12.16 nC 4.95 nC 7.999 nC 11.67 nC
15 14.15 nC 6.24 nC 10.13 nC 13.73 nC

Now that we have the results, let’s look at a couple of example calculations. These examples
should be able to help you answer the questions regarding this handout.
To calculate the 60-degree physical Wedge Factor for our 15MV beam let’s use Eq ( 5 ) and the
data from Table 5.
𝐷𝑤𝑒𝑑𝑔𝑒 (15𝑀𝑉) 6.24 𝑛𝐶
𝑊𝑒𝑑𝑔𝑒 𝐹𝑎𝑐𝑡𝑜𝑟 = = = 0.441
𝐷𝑁𝑜 𝑊𝑒𝑑𝑔𝑒 (15𝑀𝑉) 14.15 𝑛𝐶

Given the 60-degree wedge thickness on central axis, could we calculate the linear attenuation
coefficient of this material for a 6MV beam? Let’s say the thickness of the wedge is 1.5cm at the
central axis. We will refer back to Eq ( 1 ).
𝐼(𝑥) = 𝐼0 𝑒 −𝜇𝑥

For this equation, we will need the initial intensity without the wedge 𝐼0 , the final intensity with
the wedge 𝐼(𝑥) and the thickness of the material. We will assume the initial intensity is 12.16
nC, the final intensity is 4.95 nC, the thickness 𝑥 is 1.5cm. To answer this question, we will have
to solve for 𝜇.
Before we start I am going to drop the notation of (𝑥) from the final intensity 𝐼(𝑥). This notation
is utilized to simply show the final intensity depends on the thickness of the material. Let’s first
start by dividing 𝐼0 and moving it to the left side of the equation.
𝐼 𝐼0
= 𝑒 − 𝜇𝑥
𝐼0 𝐼0

This will result in

𝐼
= 𝑒 − 𝜇𝑥
𝐼0
To get to the exponent we will take the natural log ln() of both sides
𝐼
ln ( ) = ln (𝑒 − 𝜇𝑥 )
𝐼0

The natural log ln () and the exponential portion 𝑒 of the right-hand side of the equation will
cancel and we will be left with just the exponent.
𝐼
ln ( ) = ln (𝑒 − 𝜇𝑥 )
𝐼0

𝐼
ln ( ) = −𝜇𝑥
𝐼0

Divide both sides by the material thickness −𝑥

𝐼
ln (𝐼 ) −𝜇𝑥
0
=
−𝑥 −𝑥

Let’s flip the right and left side of the equation to make the final result look cleaner
𝐼
ln ( )
𝐼0
𝜇=−
𝑥

Plug in the given data

4.95 𝑛𝐶
ln (12.16 𝑛𝐶 )
𝜇=− = 0.599 𝑐𝑚−1
1.5𝑐𝑚
References

[1] F. M. Khan, The Physics of Radiation Therapy, 4 ed., Baltimore, MD: Lippincott Williams &
Wilkins, 2010.

[2] C. McCullough, J. Gortney and C. R. Blackwell, "A depth A depth dependence

determination of the wedge transmission factor for 4-10 MV photon beams," Med Phys, vol.
15, no. 4, pp. 621-623, 1988.