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Poster — Thurs Eve‐32: Dose errors related to the treatment couch
Author(s) -
Niedbala M,
Nyiri B,
Gerig L
Publication year - 2008
Publication title -
medical physics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.473
H-Index - 180
eISSN - 2473-4209
pISSN - 0094-2405
DOI - 10.1118/1.2965951
Subject(s) - siemens , attenuation , nuclear medicine , beam (structure) , radiation treatment planning , dosimetry , linear particle accelerator , physics , optics , materials science , medicine , radiation therapy , radiology , quantum mechanics
Modern radiotherapy linacs often use carbon fibre for their couch tops due to its radio translucent properties. Beam attenuation by the couches is often ignored during planning and MU calculation. This work examines beam attenuation and loss of “skin sparing” (dose build up region) when various photon beams transit either the MedTec (Siemens) or Medical Intelligence (Elekta) couches. Additionally, measured doses were compared to CMS treatment planning system (XiO version 4.33.02) predictions. We found the two couches to have different structures, resulting in different attenuation signatures as a function of gantry angle. For normal beam incidence the Siemens and Elekta couches had radiological thicknesses of 4.5 mm and 6.0 mm, respectively. For a normal incidence 10×10 cm 2 6MV beam the surface dose after couch transmission was 93% vs. 83% for Elekta and Siemens, respectively. Conversely, the increased mass on the lateral edge of the Siemens couch resulted in a maximum attenuation (6 MV 5×5 cm 2 beams) of 8% compared to 5% by the Elekta couch. Incorporating the treatment couch as part of the patient planning CT allowed the CMS TPS model to calculate couch attenuation within 1% of measurement, except at the very edge of the Siemens couch, where the attenuation is strongly gantry angle dependent. The CMS beam model was also able to predict the loss of skin sparing within 1%. In conclusion, the two patient couches are different, but both can significantly affect patient dose which can be accounted for in the CMS TPS.

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