Determination of small-field output factors for beam-matched linear accelerators using various detectors and comparison of detector-specific output correction factors using IAEA Technical Report Series 483 protocol

BACKGROUND: Beam matching is widely used to ensure that linear accelerators used in radiotherapy have equal dosimetry characteristics. Small-field output factors (OF) were measured using different detectors infour beam-matched linear accelerators and the measured OFs were compared with existing treatment planning system (TPS) Monte Carlo algorithm calculated OFs. MATERIALS AND METHODS: Three Elekta Versa HD(TM) and one Elekta Infinity(TM)linear accelerators with photon energies of 6 MV flattening filter (FF), 10 MVFF, 6 MV flattening filter free (FFF) and 10 MVFFF were used in this study. All the Linac’swere beam-matched, Dosimetry beam data were ± 1% compare with Reference Linac. Ten different type of detectors (four ionizationchambers and six diode detectors) were used for small-field OF measurements. The OFs were measured for field sizes of 1 × 1 to 10 × 10 cm(2), and normalized to 10 × 10 cm(2) field size. The uncorrected and corrected OFs were calculated from these measurements. The corrected OF was compare with existing treatment planning system (TPS) Monte Carlo algorithm calculated OFs. RESULTS: The small-field corrected and Uncorrected OF variations among the linear accelerators was within 1% for all energies and detectors. An increase in field size led to a reduction in the difference between OFs among the detectors, which was the case for all energies. The RSD values decreased with increasing field size. The TRS 483 provided Detector-specificoutput-correction factor (OCF) reduced uncertainty in small-field measurements. CONCLUSION: It is necessary to implement the OF-correction of small fields in a TPS. Special care must be taken to incorporate the corrected small-field OF in a TPS.