STANDARD WEDGE AND TRAY TRANSMISSION VALUES FOR VARIAN, SEIMENS, ELEKTA/PHILIPS ACCELERATORS; A QUALITY ASSURANCE TOOL David S. Followill, Nadia Hernandez, and William F. Hanson Introduction The Radiological Physics Center (RPC), through it s on-site dosimetry review visits to institutions participating in NCI cooperative clinical trials, has accumulated wedge and tray transmission data for approximately 5 wedges on nearly 11 Varian, Siemens and Elekta/Philips accelerators since 1985 and nearly 35 tray transmission measurements since 1995. The majority of the wedges used for specific make and models of accelerator are manufactured by the vendor and are similar in design. From time to time, however, the vendor will change its wedge design, which in turn affects the wedge transmission value. The vast majority of the blocking trays, regardless of make and model of accelerator, can be classified as thin or thick trays whose transmission depends solely on the photon beam energy. We believe we can predict the wedge and tray transmission value for a particular nominal energy, wedge angle, tray thickness and make and model of accelerator. The data presented here can be used to predict the wedge and tray transmission for most wedges and trays in clinical use today to within 2%. These data also serve as a redundant QA tool that may identify potential problems. Materials and Methods Measurements were made on a series of Varian, Siemens and Elekta/Philips accelerators. The make and models of those listed here reflect those in current use and most often seen by the RPC. 1. Varian Clinac 4/8, 4/1, 6/1, 6, 6C, 18, 18, 2, 21C, 23C, and 25. 2. Siemens Mevatron 6, 12, 2, 6, 63, 64, 67, 674, 74, 77, KD series, MD series, and MX series. 3. Elekta/Philips SL 75-5, 18, 2 and 25. Nominal energies from 4-25 MV, wedge angles from 15 6 and thin and thick trays. The RPC tray transmission factor (TF) is defined as: TF (1x1, 5* cm) = tray ioniz. (1x1, 5 cm) open ioniz. (1x1, 5 cm) The RPC wedge transmission factor (WTF) is defined as: WTF(1x1, 5*cm) = wedged ioniz. (1x1, 5cm) open ioniz. (1x1, 5cm) At 1 cm SSD/SAD in a water phantom. The WTF s ionization readings are averaged over heel-in and heel-out wedge orientations (if applicable) and centering of ion chamber is assured by measurements in multiple collimator orientations. *For energies>15 MV, depth is 7 cm and after 1/2 for all energies, depth is 1 cm.
Standard Wedge and Tray Transmission Values for Varian, Seimens, etc... Page 2 Results The wedge transmission data for the manufacturer s standard wedges on most makes and models of accelerators exhibit a gaussian distribution with a standard deviation of ± 2%. The distribution of the wedge transmission factor data is often bimodal exhibiting more than one standard factor for each wedge angle. Some of the wedge transmission data for differing makes and models of accelerators for a specific manufacturer, dependent on energy and wedge angle, are in good agreement. The tray transmission data, is not dependent on make and model of accelerator, but rather the beam energy. There appear to be two types of trays in clinical use today; thin and thick trays. Conclusions 1. For each combination of nominal wedge angle, energy, and accelerator make and model, a standard wedge transmission factor can be assigned. 2. Frequently, there is more than one standard wedge transmission factor for a given make and model of accelerator. (The RPC has not captured data to determine whether the different wedges represent different sizes, composition or location of wedges). 3. The same or similar wedges are used on different makes and models of accelerators by the same manufacturer. 4. There are two types of blocking trays in clinical use today, thin and thick trays. 5. These mean standard wedge and tray transmission values provide a good redundant check of an institution s own measured values. 6. With few exceptions, these data can be used to predict the wedge and tray transmission factors for most wedges and trays in clinical use today to within ± 2%.
Standard Wedge and Tray Transmission Values for Varian, Seimens, etc... Page 3 Table I: Standard Values for Varian Accelerators 15 deg wedge 3 deg wedge 45 deg wedge 6 Machine Model Energy Ion Ratio Std Dev N WTF Std Dev N WTF Std Dev N WTF Std Dev N WTF Cl 4 4 MV.619.9 9.795.6 21.755.9 77.578.12 89.489 Cl 4/1 4 MV.631.6 31.776.8 7.736.4 6.495.11 1.491.85.6 16.764.6 16.589.5 16 Cl 6C 4 MV.632.5 8.769.11 4 Insufficent Data.477.4 5.394 Cl 6, Cl 6X 6 MV.664.12 38.78.8 3.627.3 5.617.8 9.425.827.3 8.777.9 17.651.8 11.459.873.4 6 Cl 6/1 6 MV.661.6 14.78.2 9.643.15 27.481.1 32.418.823.6 8.74.5 4.569.6 6.455.783.7 78.614.8 98 Cl 6C 6 MV.665.5 66.78.2 8.545.3 8.499.7 62.418.78.2 27.631.4 37 Cl 18 1 MV.733.5 63.892.7 45.752.9 8.696.7 2.511.83.5 5 Cl-18 6 MV.687.24 89.788.13 49.638.6 52.485.6 72.419.76.9 9.572.8 13 Cl-18 1 MV.739.3 16.814.4 6.681.2 6.536.6 1.451.85.4 5.751.5 4.626.7 6 Cl-18 15 MV.76.2 18.824.3 12.697.3 12.556.3 15.449 Cl-18 18 MV.784.2 52.83.4 25.76.4 28.514.1 7.443.57.4 4.652.7 5. Cl-2 15 MV.758.7 2.854.4 1.758.4 11.642.6 17.452 Cl-2 18 MV.78.4 14.859.2 1.767.3 1.65.3 13.442 Cl-21, 6 MV.674.4 18.711.4 14.547.3 6.493.9 178.414-21 C, 21 CD.783.7 53.632.8 94.57.6 24 Cl-21 1 MV.735.3 38.751.2 3.62.2 3.53.6 34.448-21 C, 21 CD.813.2 16.68.3 16 Cl-21 15 MV.761.2 28.82.8 18.692.8 23.527.4 23.445-21 C, 21 CD.554.3 5 Cl-21 18 MV.782.9 11.768.3 12.629.2 15.521.5 88.439-21 C, 21 CD.827.6 42.73.5 54.566.3 19 Cl-23 6 MV.674.4 35.773.7 12.625.8 15.493.12 33.48 l-23c, 23 CD Cl-23 15 MV.762.3 1.813.5 6.684.5 6.531.14 9 Ins l-23c, 23 CD Cl-23 18 MV.783.2 15 Insufficent Data.7.5 6.519.3 8.43 l-23c, 23 CD Cl-25, 25C 6 MV.675.5 23.783.4 11.635.5 12.489.6 13.419.821.3 6.79.5 7.577.5 8 Cl-25, 25C 24 MV.85.3 22.832.5 11.71.4 11.58.4 5.428.861.4 6.77.6 7.578.3 7.658.6 9
Standard Wedge and Tray Transmission Values for Varian, Seimens, etc... Page 4 Table 2: Standard Values for Siemens Accelerators 15 deg wedge 3 deg wedge 45 deg wedge 6 Machine Model Energy Ion Ratio Std Dev N WTF Std Dev N WTF Std Dev N WTF Std Dev N WTF Mev 12 8 MV.716.8 6 Insufficent Data Insufficent Data.694.7 5 Ins Mev 12 1 MV.736.8 13 Insufficent Data.719.4 9.696.8 11.685 Mev 2 15 MV.767.5 5 Insufficent Data Insufficent Data.64.6 5.611 Mev 6 6 MV.672.9 13 Insufficent Data.684.9 12.636.8 3 Ins Mev 6, 63, 64 4 MV.611.16 9.75.3 6.638.7 3.513.6 6.481 Mev 67, 674 6 MV.675.6 43.685.4 5.523.5 5.317.7 11.35.742.5 2.714.5 25.563.5 31.535 Mev 74, 77 1 MV.742.6 33.782.2 19.757.3 25.388.7 5.592.62.3 28 Mev 77 15 MV.766.3 12.794.2 1.77.3 11.637.5 12.68 Mev 77 18 MV.785.4 7.82.3 5.777.2 5.647.3 6.619 Mev KD, KD2, KDS 6 MV.682.7 57.683.4 13.518.7 21.316.9 35.342.745.3 13.716.4 17.565.5 21.538 Mev MD, MD2 6 MV.674.4 39.684.5 11.518.6 9.313.5 17.339.74.4 7.713.5 6.56.3 6.533 Mev MX, MX2, MXE 6 MV.678.5 22 Insufficent Data Insufficent Data.317.7 5.346.338.6 5 Table 3: Standard Values for Elekta/Philips Accelerators 6 deg wedge Machine Model Energy Ion Ratio Std Dev N WTF Std Dev N SL 18 6 MV.761.8 7.269.5 7 SL18 15 MV.761.8 7.283.4 7 SL 2 6 MV.68.8 19.271.7 13 SL 2 18 MV.776.4 12.279.7 11 SL 25 6 MV.681.1 15.27.4 14 SL 25 25 MV.8.3 12.268.5 13 SL 75-5 6 MV.68.3 15.261.1 14 Standard Average Mevatron and Philips Thin Tray Factors.98.975 Ave. Thin Tray Factor.97.965.96 y =.1517x +.855 R 2 =.954.955.95.66.68.7.72.74.76.78.8 Ionization Ratio
Standard Wedge and Tray Transmission Values for Varian, Seimens, etc... Page 5 Standard Average Clinac Thin Tray Factors.99.985 Ave. Thin Tray Factor.98.975.97.965 y =.115x +.8931 R 2 =.8729.96.955.6.65.7.75.8.85 Ionization Ratio 7 6 5 4 3 2 Varian Clinac 6/1, 6C, 18 21C, 23C, 25 6 MV 6 degree wedge.416.7 336 1.385.395.45.415.425.435.445.455.465.475
Standard Wedge and Tray Transmission Values for Varian, Seimens, etc... Page 6 18 16 14 12 1 8 6 Siemens Mevatron KD series 3 degree wedge.518.7 21.716.4 17 4 2.5.52.54.56.58.6.66.68.7.72.74 6 5 4 3 2 Philips/Elekta SL 25 6 degree wedge.27.4 14 1.259.262.265.268.271.274.277.28
Standard Wedge and Tray Transmission Values for Varian, Seimens, etc... Page 7 6 5 4 3 2 Varian Clinac 6/1 45 degree wedge.481.1 32.569.6 6.614.8 98 1.46.48.5.52.54.56.58.6.62.64.66 7 6 5 4 3 2 Varian Clinac 21C 6 MV 6 degree wedge.414.6 147 1.39.395.4.45.41.415.42.425.43