Characterization of the effect of a new commercial transmission detector on radiation therapy beams

Purpose: To evaluate the influence of a new commercial transmission detector on radiation therapy beams.

Methods and materials: A transmission detector designed for online treatment monitoring was characterized on a TrueBeam STx linear accelerator with 6-MV, 6-flattening filter free, 10-MV, and 10-flattening filter free beams. Measurements of percentage depth doses, in-plane and cross-plane off-axis profiles at different depths, transmission factors, and skin dose were acquired with 3 × 3, 5 × 5, 10 × 10, 20 × 20, and 40 × 40 cm² field sizes at 100 cm and 80 cm source-to-surface distance (SSD). A CC04 chamber was used for all profile and transmission factor measurements. Skin dose was assessed at 100, 90, and 80 cm SSD using a variety of detectors (Roos and Markus parallel-plate chambers and optically stimulated luminescent dosimeters [OSLDs]). Skin dose was also assessed for various patient sample plans with OSLDs.

Results: The percentage depth doses showed small differences between the unperturbed and perturbed beams for 100 cm SSD (≤4 mm depth of maximum dose difference, <1.2% average profile difference) for all field sizes. At 80 cm SSD, the differences were larger (≤8 mm depth of maximum dose difference, <3% average profile difference). The differences were larger for the flattened beams and larger field sizes. The off-axis profiles showed similar trends. Field penumbras looked similar with and without the transmission detector. Comparisons in the profile central 80% showed a maximum average (maximum) profile difference between all field sizes of 1.0% (2.6%) and 1.4% (6.3%) for 100 and 80 cm SSD, respectively. The average measured skin dose increase at 100 cm (80 cm) SSD for a 10 × 10 cm² field size was <4% (<35%) for all energies. For a 40 × 40 cm² field size, this increased to <31% (≤63%). For the sample patient plans, the average skin dose difference was 0.53% (range, -6.6% to 10.4%).

Conclusions: The transmission detector has minimal effect on clinically relevant radiation therapy beams for intensity modulated radiation therapy and volumetric arc therapy (field sizes 10 × 10 cm² and less). For larger field sizes, some perturbations are observable that would need to be assessed for clinical impact.