SU-F-T-577: Comparison of Small Field Dosimetry Measurements in Fields Shaped with Conical Applicators On Two Different Accelerating Systems.

PURPOSE: To investigate small field dosimetry measurements and associated uncertainties when conical applicators are used to shape treatment fields from two different accelerating systems.

METHODS: Output factor measurements are made in water in beams from the CyberKnife radiosurgery system, which uses conical applicators to shape fields from a (flattening filter-free) 6 MV beam, and in a 6 MV beam from the Elekta Precise linear accelerator (with flattening filter) with BrainLab external conical applicators fitted to shape the field. The measurements use various detectors: (i) an Exradin A16 ion chamber, (ii) two Exradin W1 plastic scintillation detectors, (iii) a Sun Nuclear Edge diode, and (iv) two PTW microDiamond synthetic diamond detectors. Profiles are used for accurate detector positioning and to specify field size (FWHM). Output factor measurements are corrected with detector specific correction factors taken from the literature where available and/or from Monte Carlo simulations using the EGSnrc code system.

RESULTS: Differences in measurements of up to 1.7% are observed with a given detector type in the same beam (i.e., intra-detector variability). Corrected results from different detectors in the same beam (inter-detector differences) show deviations up to 3 %. Combining data for all detectors and comparing results from the two accelerators results in a 5.9% maximum difference for the smallest field sizes (FWHM=5.2-5.6 mm), well outside the combined uncertainties (∼1% for the smallest beams) and/or differences among detectors. This suggests that the FWHM of a measured profile is not a good specifier to compare results from different small fields with the same nominal energy.

CONCLUSION: Large differences in results for both intra-detector variability and inter-detector differences suggest potentially high uncertainties in detector-specific correction factors. Differences between the results measured in circular fields from different accelerating systems provide insight into sources of variability in small field dosimetric measurements reported in the literature.