Quantitative analysis of in-air output ratio

Output factor (S(cp)) is one of the important factors required to calculate monitor unit (MU), and is divided into two components: phantom scatter factor (S(p)) and in-air output ratio (S(c)). Generally, S(c) for arbitrary fields are calculated using several methods based on S(c) determined by the absorbed dose measurement for several square fields. However, there are calculation errors when the treatment field has a large aspect ratio and the opening of upper and lower collimator are exchanged. To determine S(c) accurately, scattered photons from the treatment head and backscattered particles into the monitor chamber must be analyzed individually. In this report, a simulation model that agreed well with measured S(c) was constructed and dose variation by scattered photons from the treatment head and by backscattered particles into the monitor chamber was analyzed quantitatively. The results showed that the contribution of scattered photons from the primary collimator was larger than that of the flattening filter, and backscattered particles were affected by not only the upper jaw but also the lower jaw. In future work, a new S(c) determination algorism based on the result of this report will be proposed.