| Summary: | Asymmetric collimation of photon beams produces non-trivial alterations in absolute
output, depth dose and beam profile. The full potential of asymmetric collimation can only be
realized with a proper treatment planning algorithm specific for asymmetric collimation. In
this thesis the dosimetric characteristics of asymmetric fields are investigated and a new
computation method for the dosimetry of asymmetric fields is described and implemented into
an existing treatment planning algorithm. Based on this asymmetric field treatment planning
algorithm, the clinical use of asymmetric fields in cancer treatment is investigated, and new
treatment techniques for conformal therapy are developed. Dose calculation is verified with
thermoluminescent dosimeters in a body phantom.
An asymmetric field is referred to as an off-set radiation field whereby the central axis
of the radiation field does not coincide with the collimator axis as the opposite pair of
collimators no longer are equidistant from the collimator axis. Here, the corresponding
symmetric field is a radiation field centered at the collimator axis with the opposite pair of
collimators set equidistant from the collimator axis and to the largest asymmetric collimator
setting. Usually the dose distribution in an asymmetric field is represented by some form of
beam modeling. In this thesis, an analytical approach is proposed to account for the dose
reduction when a corresponding symmetric field is collimated asymmetrically to a smaller
asymmetric field. This is represented by a correction factor that uses the ratio of the
equivalent field dose contributions between the asymmetric and symmetric fields. The same
equation used in the expression of the correction factor can be used for a wide range of asymmetric field sizes, photon energies and linear accelerators. This correction factor will
account for the reduction in scatter contributions within an asymmetric field, resulting in the
dose profile of an asymmetric field resembling that of a wedged field.
The output factors of some linear accelerators are dependent on the collimator settings
and whether the upper or lower collimators are used to set the narrower dimension of a
radiation field. In addition to this collimator exchange effect for symmetric fields, asymmetric
fields are also found to exhibit some asymmetric collimator backscatter effect. The proposed
correction factor is extended to account for these effects.
A set of correction factors determined semi-empirically to account for the dose
reduction in the penumbral region and outside the radiated field is established. Since these
correction factors rely only on the output factors and the tissue maximum ratios, they can
easily be implemented into an existing treatment planning system. There is no need to store
either additional sets of asymmetric field profiles or databases for the implementation of these
correction factors into an existing in-house treatment planning system. With this asymmetric
field algorithm, the computation time is found to be 20 times faster than a commercial system.
This computation method can also be generalized to the dose representation of a two-fold
asymmetric field whereby both the field width and length are set asymmetrically, and the
calculations are not limited to points lying on one of the principal planes.
The dosimetric consequences of asymmetric fields on the dose delivery in clinical
situations are investigated. Examples of the clinical use of asymmetric fields are given and the
potential use of asymmetric fields in conformal therapy is demonstrated. An alternative head
and neck conformal therapy is described, and the treatment plan is compared to the conventional technique. The dose distributions calculated for the standard and alternative
techniques are confirmed with thermoluminescent dosimeters in a body phantom at selected
dose points. === Science, Faculty of === Physics and Astronomy, Department of === Graduate
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