Investigating treatment dose error due to beam attenuation by a carbon fiber tabletop.
ABSTRACT Carbon fiber is commonly used in radiation therapy for treatment tabletops and various immobilization and support devices, partially because it is generally perceived to be almost radiotransparent to high-energy photons. To avoid exposure to normal tissue during modern radiation therapy, one must deliver the radiation from all gantry angles; hence, beams often transit the couch proximal to the patient. The effects of the beam attenuation by the support structure of the couch are often neglected in the planning process. In this study, we investigate the attenuation of 6-MV and 18-MV photon beams by a Medtec (Orange City, IA) carbon fiber couch. We have determined that neglecting the attenuation of oblique treatment fields by the carbon fiber couch can result in localized dose reduction from 4% to 16%, depending on energy, field size, and geometry. Further, we investigate the ability of a commercial treatment-planning system (Theraplan Plus v3.8) to account for the attenuation by the treatment couch. Results show that incorporating the carbon fiber couch in the patient model reduces the dose error to less than 2%. The variation in dose reduction as a function of longitudinal couch position was also measured. In the triangular strut region of the couch, the attenuation varied +/- 0.5% following the periodic nature of the support structure. Based on these findings, we propose the routine incorporation of the treatment tabletop into patient treatment planning dose calculations.
Article: Increased beam attenuation and surface dose by different couch inserts of treatment tables used in megavoltage radiotherapy.[show abstract] [hide abstract]
ABSTRACT: The use of solid carbon fiber table materials in radiotherapy has become more common with the implementation of image-guided radiotherapy (IGRT), since the solid materials give less imaging artifacts than the so-called tennis racket couchtops. The downside of the solid carbon fiber couch inserts is that they increase the beam attenuation, resulting in increased surface doses and inaccuracies in determine the dose in the patient. The purpose of this study was to evaluate the interaction of 6 and 15 MV photons with eight different couch inserts. The presented results enable direct comparison of the attenuation properties of the studied couchtops. With a direct posterior beam the maximum attenuations reach 3.6% and 2.4% with 6 and 15 MV, respectively. The measured maximum attenuation by a couchtop with an oblique gantry angle was 10.8% and 7.4% at 6 and 15 MV energies, respectively. The skin-sparing effect was decreased substantially with every couchtop. The highest increases in surface doses were recorded to be four- and threefold, as compared to the direct posterior open field surface doses of 6 and 15 MV, respectively. In conclusion, the carbon fiber tabletops decrease the skin-sparing effect of megavoltage photon energies. The increased beam attenuation and skin doses should be taken into account in the process of treatment planning.Journal of Applied Clinical Medical Physics 01/2011; 12(4):3554. · 1.29 Impact Factor