Beam Modifiying Devices in Teletherapy Machines: Nilesh Kumar PG Radiation Physics Department of Radiation Physics

BEAM MODIFIYING DEVICES

IN TELETHERAPY MACHINES
NILESH KUMAR
PG RADIATION PHYSICS
DEPARTMENT OF RADIATION PHYSICS
BEAM MODIFICATION

• It is defined as the useful modification in the occupying space

for distribution of radiation within the patient by insertion of
any material in the beam path
• Because ; to protect normal tissues

uniform dose distribution
acute normal tissue reaction
Compensators
• A beam modifying device which evens out the skin surface

contours, while retaining the skin-sparing advantage.
• It allows normal depth dose data to be used for such irregular

surfaces.
• Compensators can also be used for
– To compensate for tissue heterogeneity.
– To compensate for dose irregularities arising due to

reduced scatter near the field edges (example mantle
fields), and horns in the beam profile.
• The dimension and shape of a compensator must be adjusted to
account for :
– Beam divergence.
– Linear attenuation coefficients of the filter material and soft tissue.
– Reduction in scatter at various depths due to the compensating

filters, when it is placed at the distance away from the skin.
• To compensate for these factors a tissue compensator is always has an

attenuation less than that required for primary radiation.
• The thickness ratio depends on:
– Compensator to surface distance.
– Thickness of the missing tissue.
– Field size.
– Depth.
– Beam quality.
Wedge filters
• A beam modifying device, which causes a progressive

decrease in intensity across the beam, resulting in tilting the
isodose curves from their normal positions.
• Degree of the tilt depends upon the slope of the wedge filter.
• Material: tungsten, brass. Lead or steel.
• Usually wedges are mounted at a distance of 15 centimeters

from the skin surface , to avoid distroying the skin-sparing
effect
• The sloping surface is made
either straight or sigmoid in
shape
• A sigmoid shape produces a

straighter isodose curve.
• Mounted on trays which are

mounted on to the head of
the gantry.
working principle
• wedge pair fields
• for treatment using perpendicular beam arrangement the

superficial region of tumor receives higher dose or hot spot
occurs.
• to avoid this , wedges are placed with thick ends adjacent to

each other to get uniform distribution.
• it helps to uniform distribution of dose.

Types of wedge systems:
Individualized wedge .
Universal wedge.
Dynamic wedges
Virtual wedges
Pseudo wedges
wedges can be two types :
I. Individualized wedge
II. universal wedge
Individual wedges
• Individual wedges are useful in Cobalt beams AND LINAC ( Varian )
• Using bigger wedges than necessary will reduce output of the machine
→ increased treatment time.
• The width (W) of the wedge is fixed and important.
• The same wedge can however be used for fields with lesser lengths or
breadths.
• All systems have the following four angles 15°, 30°, 45°, 60°.
Universal wedges
• Universal wedges are designed so that the same wedge can be used
with all field sizes.
• This is useful as it saves time.
• However not suitable for cobalt beams because of excessive

reduction of beam output with smaller fields.
• Come in one size of 20 x 30 cms (except 60°).
• Wedge angles used are: 60°, 45°, 30° & 15°.

wedge isodose angle
• it is also called wedge angle
• it is defined as the “ the angle through which an isodose curve

is tilted at the ray of beam at specified depth”
• or wedge angle is the angle between isodose curve and normal

to the central axis
• it is also defined as the angle between the 50 ％ isodose

curve and normal to the central axis
• Reference depth of using wedge filter is 10 cm.

• hinge angle :
• the angle between the

central axes of two beams
• θ is wedge angle
• Φ is hinge angle
• wedge transmission factor ( wedge factor)
• presence of wedge filter decreases the output of the machine.
• to compensate this , we using wedge factor :
• WTF = Dose with the wedge/ Dose without the wedge (at a
point in the phantom, along the central axis of the beam).
• MOTORIZED WEDGE
• motor wedge is angle 60°

physical wedge which
generates desidbwedge angle
from 0 - 60° by the
combination of open and
wedged beam
• it is mounted above the

asymmetrical collmator and it
can be moved in and out of
the radiation feild to create
the different wedged profiles
Flattening filters
• A beam flattening filter reduces the central exposure rate relative to

that near the edge of the beam.
• Used for Linear accelerators.
• The filter is designed so that the thickest part is in the centre.
• Material: copper or brass.
• Not required In cobalt beams , as :
– The beam is almost mono energetic.

– Source emits uniform radiation all around.
• Bolus
• A tissue equivalent material used to reduce the depth of the

maximum dose (Dmax).
• Better called a “build-up bolus”.
• A bolus can be used in place of a compensator for kilo voltage

radiation to even out the skin surface contours.
• In megavoltage radiation bolus is primarily used to bring up

the buildup zone near the skin in treating superficial lesions.
• The thickness of the bolus used varies according to the energy
of the radiation.
• In megavoltage radiation:
– Co60 : 2 - 3 mm
– 6 MV : 7- 8 mm
– 10 MV : 12 - 14 mm
– 25 MV: 18 - 20 mm
• Commonly used materials are:
– Cotton soaked with water.

– Paraffin wax.
• Penumbra Trimmers:
• Penumbra refers the region at the edge of beam where dose

rate changes rapidly as function of distance from beam axis.
 Types of penumbra :
 Geometric
 Transmission
 Physical
• Transmission penumbra is the region irradiated by photons
which are transmitted through the edge of the collimator
blocks
• Geometrical penumbra :
• it is formed due to dimension of source.
• It is formed due to finite source size and must be concern in

teletherapy machines where the sources is between 1 – 2 cm in
size.
• trimmers consists of extensible , heavy metal bars to attenuate

the beam in the penumbra region.
• Conclusions :
 penumbra increases with increase in source diameter , SSD ,

and depth.
 Penumbra width decreases with a increase in SSD
 Physical penumbra is the combination of geometrical

,transmission penumbra and electron scattering at the beam
edge .
• Electron beam modifiers
 Electron travelling in a medium losses energy due to :

> ionization and excitation
> Bremsstrahlung radiation
 Electrons are generated in a similar way to photon in a linear

accelerator , with the major difference being :
 Lack of tungsten target

 A scattering foil instead of a flattening filter
 An electron applicator or electron cone which provides added
collimation of beam
• To avoid variation in output and electron scatter, jaws cannot
be used to collimate electron beams.
• An electron beam cone is therefore used to provide the

collimation.
• A primary collimator is provided close to source – defines the

maximum field size.
• A secondary collimator, near the patient defines the treatment

field.
Scattering foil
• A device to widen the thin pencil beam (3 mm) of electrons.
• In the electron mode of linac operation , the beam instead of striking the target
,is made to strike an electron scattering foil to spread the beam as well as get a
uniform electron fluence across the treatment field.
• Metallic plates of tin, lead or aluminum are used.
• Disadvantages:
– Beam attenuation.
– Generation of bremsstrahlung radiation.
• Advantages:
– Less prone to mechanical errors.
– Less expensive.
– Requires less instrumentation.
Scattering foil
• Beam modification increases conformity allowing a
higher dose delivery to the target, while sparing more
of normal tissue simultaneously.
THANK YOU

Beam Modifiying Devices in Teletherapy Machines: Nilesh Kumar PG Radiation Physics Department of Radiation Physics

Uploaded by

Copyright:

Available Formats

Beam Modifiying Devices in Teletherapy Machines: Nilesh Kumar PG Radiation Physics Department of Radiation Physics

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Beam Modifiying Devices in Teletherapy Machines: Nilesh Kumar PG Radiation Physics Department of Radiation Physics

Uploaded by

Copyright:

Available Formats

BEAM MODIFIYING DEVICES

• It is defined as the useful modification in the occupying space

• Because ; to protect normal tissues

• A beam modifying device which evens out the skin surface

• It allows normal depth dose data to be used for such irregular

• Compensators can also be used for

– To compensate for tissue heterogeneity.

– To compensate for dose irregularities arising due to

– Linear attenuation coefficients of the filter material and soft tissue.

– Reduction in scatter at various depths due to the compensating

• To compensate for these factors a tissue compensator is always has an

– Compensator to surface distance.

– Thickness of the missing tissue.

• A beam modifying device, which causes a progressive

• Material: tungsten, brass. Lead or steel.

• Usually wedges are mounted at a distance of 15 centimeters

• A sigmoid shape produces a

• Mounted on trays which are

• wedge pair fields

• for treatment using perpendicular beam arrangement the

• to avoid this , wedges are placed with thick ends adjacent to

• it helps to uniform distribution of dose.

wedges can be two types :

• Individual wedges are useful in Cobalt beams AND LINAC ( Varian )

• The width (W) of the wedge is fixed and important.

• This is useful as it saves time.

• However not suitable for cobalt beams because of excessive

• Come in one size of 20 x 30 cms (except 60°).

• Wedge angles used are: 60°, 45°, 30° & 15°.

• it is also called wedge angle

• it is defined as the “ the angle through which an isodose curve

• or wedge angle is the angle between isodose curve and normal

• it is also defined as the angle between the 50 ％ isodose

• Reference depth of using wedge filter is 10 cm.

• the angle between the

• presence of wedge filter decreases the output of the machine.

• to compensate this , we using wedge factor :

• motor wedge is angle 60°

• it is mounted above the

• A beam flattening filter reduces the central exposure rate relative to

• Used for Linear accelerators.

• The filter is designed so that the thickest part is in the centre.

• Material: copper or brass.

• Not required In cobalt beams , as :

– The beam is almost mono energetic.

• A tissue equivalent material used to reduce the depth of the

• Better called a “build-up bolus”.

• A bolus can be used in place of a compensator for kilo voltage

• In megavoltage radiation bolus is primarily used to bring up

• Commonly used materials are:

– Cotton soaked with water.

• Penumbra refers the region at the edge of beam where dose

• it is formed due to dimension of source.

• It is formed due to finite source size and must be concern in

• trimmers consists of extensible , heavy metal bars to attenuate

 penumbra increases with increase in source diameter , SSD ,

 Penumbra width decreases with a increase in SSD

 Physical penumbra is the combination of geometrical

 Electron travelling in a medium losses energy due to :