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    Flattening Filter Free

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    The document discusses flattening filters and flattening filter free (FFF) photon beams. Flattening filters create a uniform beam intensity by attenuating the higher intensity center more than the edges. For IMRT and VMAT, beam uniformity is not needed as intensity can vary. Many machines now offer FFF mode which removes the flattening filter, increasing dose rate up to 2400 MU/min for treatments like SBRT and SRS that require high doses.

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    Flattening Filter Free

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    api-337168367
    164 views2 pages
    The document discusses flattening filters and flattening filter free (FFF) photon beams. Flattening filters create a uniform beam intensity by attenuating the higher intensity center more than the edges. For IMRT and VMAT, beam uniformity is not needed as intensity can vary. Many machines now offer FFF mode which removes the flattening filter, increasing dose rate up to 2400 MU/min for treatments like SBRT and SRS that require high doses.

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    The document discusses flattening filters and flattening filter free (FFF) photon beams. Flattening filters create a uniform beam intensity by attenuating the higher intensity center more than the edges. For IMRT and VMAT, beam uniformity is not needed as intensity can vary. Many machines now offer FFF mode which removes the flattening filter, increasing dose rate up to 2400 MU/min for treatments like SBRT and SRS that require high doses.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    164 views2 pages

    Flattening Filter Free

    Uploaded by

    api-337168367
    The document discusses flattening filters and flattening filter free (FFF) photon beams. Flattening filters create a uniform beam intensity by attenuating the higher intensity center more than the edges. For IMRT and VMAT, beam uniformity is not needed as intensity can vary. Many machines now offer FFF mode which removes the flattening filter, increasing dose rate up to 2400 MU/min for treatments like SBRT and SRS that require high doses.

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    Flattening Filter Free (FFF) Beam Dosimetry

    The profile of a photon beam is not flat and uniform. Rather, it is has a higher intensity in the
    center of the beam and it is less intense around its boarders. 1 To achieve uniformity across the beam, a
    flattening filter may be inserted into the path of the beam. 1,2 Flattening filters resemble the shape of a
    sombrero in that they are thicker in the center and thinner near the edges (figures 1 and 2). They align
    with the beam so that the part of the beam with the higher intensity, which requires increased attenuation,
    is going through the thickest part of the flattening filter, resulting in a flatter, more uniform beam profile
    (figure 3). Although a uniform intensity across a field is important for 3D treatment techniques, it is
    essentially irrelevant for intensity modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT)
    because, inherently, intensity is not flat for these techniques and this variation in intensity can be accounted
    for during inverse optimization.1,2

    With beam uniformity not being an issue for IMRT and VMAT treatment techniques, many vendors
    have begun introducing machThe profile of a photon beam is not flat and uniform. Rather, it is has a higher
    intensity in the center of the beam and it is less intense around its boarders. 1 To achieve uniformity across
    the beam, a flattening filter may be inserted into the path of the beam. 1,2 Flattening filters resemble the
    shape of a sombrero in that they are thicker in the center and thinner near the edges (figures 1 and 2).
    They align with the beam so that the part of the beam with the higher intensity, which requires increased
    attenuation, is going through the thickest part of the flattening filter, resulting in a flatter, more uniform
    beam profile (figure 3). Although a uniform intensity across a field is important for 3D treatment
    techniques, it is essentially irrelevant for intensity modulated radiotherapy (IMRT) and volumetric arc
    therapy (VMAT) because, inherently, intensity is not flat for these techniques and this variation in intensity
    can be accounted for during inverse optimization.1,2

    With beam uniformity not being an issue for IMRT and VMAT treatment techniques, many vendors
    have begun introducing machines that offer a flattening filter free (FFF) mode. 2 By removing the flattening
    filter from the beams path, the mean energy is decreased, which results in increased skin dose, and the
    dose rate is increased, up to 2400 monitor units (MU) per minute for 10 MV FFF.1 The FFF mode can be
    utilized to deliver treatments with high doses, including stereotactic body radiation therapy (SBRT) and
    stereotactic radiosurgery (SRS).1 With its higher dose rate, FFF provides an advantage for treatments
    requiring gating as it would take less time to deliver the radiation treatment.

    Figure 1. Flattening Filter


    https://www.astro.org/Affiliate/ARRO/Resident-Resources/Educational-Resources/Image-Challenge/Content-
    Pieces/Physics-1/
    Figure 2. Sombrero
    http://globalconnections.champlain.edu/2014/11/26/sombrero/

    Figure 3. Comparison of a 10 MV beam profile with a flattening filter in its path (the red line) and a beam
    profile without a flattening filter (the blue line).
    http://sudentas.com/physics/varian-truebeam/flattening-filter-free/

    References
    1. Pardo E, Castro Novais J, Lpez MYM, Ruiz Maqueda S. On flattening filter-free portal
    dosimetry. Journal of Applied Clinical Medical Physics. 2016;17(4):132-145.
    2. Khan FM. The Physics of Radiation Therapy. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins;
    2014.

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