Abstract
In this study, we propose a novel wedged field using a half-field flattening filter-free beam without a metallic filter or a moving jaw, and investigate the characteristics of the proposed technique. Dose distributions of the proposed method were first determined in virtual-water or anthropomorphic phantom using a radiotherapy planning system. We evaluated the wedge angle as a function of the field size, collimator rotation, and depth. The wedge angle at 10 MV was observed to be greater than that at 6 MV. The minimum angles at 6 and 10 MV were 17.7° and 40.4°, respectively, while the maximum angles were 33.9° and 48.4°, respectively. We determined that the wedge angle depended on the nominal beam energy and field size, and we verified that the proposed method is capable of delivering a gradient dose distribution and reducing treatment time.
Similar content being viewed by others
References
O'Brien PF, Gillies BA, Schwartz M, Young C, Davey P. Radiosurgery with unflattened 6-MV photon beams. Med Phys. 1991;18:519–21. https://doi.org/10.1118/1.596656.
Georg D, Knoos T, McClean B. Current status and future perspective of flattening filter free photon beams. Med Phys. 2011;38:1280–93. https://doi.org/10.1118/1.3554643.
Bayouth JE, Kaiser HS, Smith MC, Pennington EC, Anderson KM, Ryken TC. Image-guided stereotactic radiosurgery using a specially designed high-dose-rate linac. Med Dosim. 2007;32:134–41. https://doi.org/10.1016/j.meddos.2007.01.010.
Lang S, Shrestha B, Graydon S, Cavelaars F, Linsenmeier C, Hrbacek J, Klöck S, Studer G, Riesterer O. Clinical application of flattening filter free beams for extracranial stereotactic radiotherapy. Radiother Oncol. 2013;106:255–9. https://doi.org/10.1016/j.radonc.2012.12.012.
Prendergast BM, Fiveash JB, Popple RA, Clark GM, Thomas EM, Minnich DJ, Jacob R, Spencer SA, Bonner JA, Dobelbower MC. Flattening filter-free linac improves treatment delivery efficiency in stereotactic body radiation therapy. J Appl Clin Med Phys. 2013;14:4126. https://doi.org/10.1120/jacmp.v14i3.4126.
Vassiliev ON, Kry SF, Chang JY, Balter PA, Titt U, Mohan R. Stereotactic radiotherapy for lung cancer using a flattening filter free Clinac. J Appl Clin Med Phys. 2009;10:14–211. https://doi.org/10.1120/jacmp.v10i1.2880.
Underberg RW, Lagerwaard FJ, Slotman BJ, Cuijpers JP, Senan S. Benefit of respiration-gated stereotactic radiotherapy for stage I lung cancer: an analysis of 4DCT datasets. Int J Radiat Oncol Biol Phys. 2005;62(2):554–60. https://doi.org/10.1016/j.ijrobp.2005.01.032.
Cashmore J. The characterization of unflattened photon beams from a 6 MV linear accelerator. Phys Med Biol. 2008;53(7):1933–46. https://doi.org/10.1088/0031-9155/53/7/009.
Kragl G, afWetterstedt S, Knausl B, Lind M, McCavana P, Knöös T, et al. Dosimetric characteristics of 6 and 10 MV unflattened photon beams. Radiother Oncol. 2009;93(1):141–6. https://doi.org/10.1016/j.radonc.2009.06.008.
Dalaryd M, Kragl G, Ceberg C, Georg D, McClean B, afWetterstedt S, Wieslander E, Knöös T. A Monte Carlo study of a flattening filter-free linear accelerator verified with measurements. Phys Med Biol. 2010;55(23):7333–444. https://doi.org/10.1088/0031-9155/55/23/010.
Vassiliev ON, Titt U, Ponisch F, Kry SF, Mohan R, Gillin MT. Dosimetric properties of photon beams from a flattening filter free clinical accelerator. Phys Med Biol. 2006;51(7):1907–17. https://doi.org/10.1088/0031-9155/51/7/019.
Kragl G, Baier F, Lutz S, Albrich D, Dalaryd M, Kroupa B, Wiezorek T, Knöös T, Georg D. Flattening filter free beams in SBRT and IMRT dosimetric assessment of peripheral doses. ZeitschriftfürmedizinischePhysik. 2011;21(2):91–101. https://doi.org/10.1016/j.zemedi.2010.07.003.
Kry SF, Titt U, Ponisch F, Vassiliev ON, Salehpour M, Gillin M, Mohan R. Reduced neutron production through use of a flattening-filter-free accelerator. Int J Radiat Oncol Biol Phys. 2007;68:1260–4. https://doi.org/10.1016/j.ijrobp.2007.04.002.
Alongi F, Cozzi L, Arcangeli S, Iftode C, Comito T, Villa E, Lobefalo F, Navarria P, Reggiori G, Mancosu P, Clerici E. Linac based SBRT for prostate cancer in 5 fractions with VMAT and flattening filter free beams: preliminary report of a phase II study. Radiat Oncol. 2013;8:171. https://doi.org/10.1186/1748-717X-8-171.
Stieler F, Fleckenstein J, Simeonova A, Wenz F, Lohr F. Intensity modulated radiosurgery of brain metastases with flattening filter-free beams. Radiother Oncol. 2013;109:448–51. https://doi.org/10.1016/j.radonc.2013.10.017.
Petti PL, Siddon RL. Effective wedge angles with a universal wedge. Phys Med Biol. 1985;30:985–91. https://doi.org/10.1088/0031-9155/30/9/010.
Georg D, Garibaldi C, Dutreix A. Measurements of basic parameters in wedged high-energy photon beams using a mini-phantom. Phys Med Biol. 1997;42:1821–31. https://doi.org/10.1088/0031-9155/42/9/012.
Al-Mamgani A, van Rooij PH, Woutersen DP, Mehilal R, Tans L, Monserez D, Baatenburg de Jong RJ. Radiotherapy for T1-2N0 glottic cancer: a multivariate analysis of predictive factors for the long-term outcome in 1050 patients and a prospective assessment of quality of life and voice handicap index in a subset of 233 patients. Clin Otolaryngol. 2013;38:306–12. https://doi.org/10.1111/coa.12139.
Aaltonen LM, Rautiainen N, Sellman J, Saarilahti K, Mäkitie A, Rihkanen H, Laranne J, Kleemola L, Wigren T, Sala E, Lindholm P. Voice quality after treatment of early vocal cord cancer: a randomized trial comparing laser surgery with radiation therapy. Int J Radiat Oncol Biol Phys. 2014;90:255–60. https://doi.org/10.1016/j.ijrobp.2014.06.032.
Low DA, Harms WB, Mutic S, Purdy JA. A technique for the quantitative evaluation of dose distributions. Med Phys. 1998;25(5):656–61. https://doi.org/10.1118/1.598248.
Shih R, Li XA, Chu JC. Dynamic wedge versus physical wedge: a Monte Carlo study. Med Phys. 2001;28:612–9. https://doi.org/10.1118/1.1359249.
Bortfeld T, Jiang SB, Rietzel E. Effects of motion on the total dose distribution. SeminRadiat Oncol. 2004;14:41–51. https://doi.org/10.1053/j.semradonc.2003.10.011.
Pemler P, Besserer J, Lombriser N, Pescia R, Schneider U. Influence of respiration-induced organ motion on dose distributions in treatments using enhanced dynamic wedges. Med Phys. 2001;28:2234–40. https://doi.org/10.1118/1.1410121.
Gibbons JP, Antolak JA, Followill DS, Huq MS, Klein EE, Lam KL, Palta JR, Roback DM, Reid M, Khan FM. Monitor unit calculations for external photon and electron beams: Report of the AAPM Therapy Physics Committee Task Group No. 71. Med Phys. 2014;41:031501. https://doi.org/10.1118/1.4864244.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare. This article does not contain any studies with human participants and animals.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Tomida, T., Konno, M., Urikura, A. et al. Wedged field using the half-field method with a flattening filter-free photon beam. Radiol Phys Technol 13, 201–209 (2020). https://doi.org/10.1007/s12194-020-00561-8
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12194-020-00561-8