Determination

of Absorbed dose to water Dw at the water surface

Determination of Absorbed dose to water Dw at

the water surface under a Lead Cutout
Jewish General Hospital method


This paper deals with the method used at the Jewish General Hospital to determine
the absorbed dose to water Dw(E,A) at the water surface (at point A) for a cutout of
aperture size C, used with an applicator of size F, for a beam quality E.

The absorbed dose to water Dw(E,A) at the water surface can be approximated by
the water kerma at the surface of the water phantom !!"!!"# , with the
assumption of the existence of charged particle equilibrium and the negligible
difference between kerma and collision kerma:

Determination of Absorbed dose to water Dw at the water surface

! , = ! ,
! , = !!"!!"# , . ! ,
So :

! , = !!"!!"# , . ! ,

(1)

! , = !!"!!"# , . ! ,

(2)

Where ! , is the absorbed dose to water at point A,

Where ! , is the absorbed dose to water at point F,
! (, ) is the water-kerma based backscatter factor for field size A,
! (, ) is the water-kerma based backscatter factor for field size F,

Therefore the ratio of equation (1) to (2) is such that:

!! !,!
!! !,!

! !"!!"# !,!

= !!!"!!"#
!

!"#

. !"#!

!,!

!,!
!,!

(3)

Hence equation (3) becomes:
!"#

!,!

! , = ! , . !"#!

!,!

! !"!!"# !,!

. !!!"!!"#
!

!,!

(4)

The water kerma in air !!"!!"# is a quantity measured free in air, i.e. free of any
scatter. It is hence independent of field size. Therefore in ideal condition, the ratio of
Kermas can be equated by just a geometrical concept, i.e. by using the inverse
square factor !! . So we have:
!!"!!"# ,
= !!
!!"!!"# ,

!! is the inverse square factor to go from point F to point A as described
below:

Determination of Absorbed dose to water Dw at the water surface

Hence equation (4) becomes:

!"# (!,!)

! , = ! , . !"#! (!,!) . !! (5)

!

The absorbed dose to water ! , ) at the water surface for every
applicator open field (ie without lead cutout) & added filter combinations at
the bottom of every cones, is known and has been measured using the AAPM
protocol TG-61.

Using as well the AAPM protocol TG-61 Table V, the water-kerma based
backscatter factor ! (, ) for every applicator open field (i.e. without
lead cutout) & added filter combinations also is known.

Therefore, in order to determine the absorbed dose to water ! , ) in equation
(5) at the water surface with a lead cutout of aperture size C, the user needs hence
to determine for every lead cutout patients:

The water-kerma based backscatter factor ! (, ) for the patient cutout.

And the standOff/In (SSD) for the patient set-up to determine the inverse
square factor to go from point F to point A, i.e !!

! (, ) ,the water-kerma based backscatter factor defined for a field size and
beam quality E, as the ratio of water kerma at the surface of the water phantom to
water kerma at that point A in the absence of the phantom. The scatter condition
will change with the introduction of a lead cutout. It means that equation (5) is a
good approximation, but will break down in some situation, in particular for very
small lead cutouts. There are various ways one can estimate the lead cutout scatter
contribution. One method used at the Jewish General Hospital, is direct
measurement for every patient lead cutouts. Equation (5) hence becomes:

! , = ! , .

!!"#$"# (!,!)
!!"#$ (!,!)

. !! (6)

Determination of Absorbed dose to water Dw at the water surface

Where !"#$"# (, ) represents the raw measurement made at the bottom

of the cutout (point A) with the presence of Solid Water,
And !"#$ (, ) represents the raw measurement made at the bottom of the
cone (point F) with the presence of Solid Water,
Where ! , is the absorbed dose to water at point P,
Where ! , is the absorbed dose to water at point F,
And !! is the inverse square factor to go from point F to point P

This method means that the ratio of

!!"#$"# (!,!)
!!"#$ (!,!)

, not only includes:

!"# (!,!)

The ratio of water-kerma based backscatter factors !"#! (!,!),

But also the scatter contribution due to the introduction of the lead cutout
even for very small opening.

These raw measurements are made with an End-window Parallel-Plate ionization
Chamber PTW Soft X-ray chamber Type 23342 0.2 cc as followed:

Determination of Absorbed dose to water Dw at the water surface