LAUSR

BACKGROUND There is a major conceptual difference between small-field and large field dosimetry i.e., different definition of the field size. The dosimetry protocol IAEA TRS-483 recommends the use of the field size defined by measured dose profiles (full-width half maximum, FWHM) that is significantly different from conventional field size definition by the geometric field opening of MLC/Jaw at the isocenter. The application of the effective field size concept, Sclin , was introduced by Cranmer-Sargison et al (Radiother Oncol 109(3), 2013) as a reporting mechanism for field output factors of rectangular fields. The study by Das et al. (Med Phys 49(6), 2022) indicated the limitations of obtaining the field size by experimentally measuring FWHM, e.g., the measured FWHM is smaller than beam geometric size, which is contradictory to what is expected as a result of partial occlusion of the primary photon source by the collimating devices. Cranmer-Sargison et al and Das et al suggested that additional investigations are needed to evaluate its limitations. PURPOSE This study investigates validity of the field size definition by FWHM and by MLC/Jaw opening and finds pros and cons between these two methods to resolve the controversial issue. METHODS The FWHM can be obtained by measuring or by calculating dose profiles. Using Monte Carlo simulations this study compares the field size obtained by FWHM and by field geometric field opening. The EGSnrc system is used to simulate 6 MV beam to generate square and rectangular fields from 5 - 30 mm with every possible permutation (keeping one jaw fixed and varying other jaw from 5 mm to 30 mm). The calculated FWHM and output factors are compared with measurements obtained by a microSilicon detector. RESULTS The results show that field width (FWHM) derived from MC calculations generally agree with machine geometric field width within 0.5 mm for square or rectangular fields with minimum field width of ≥ 8 mm. For the extremely small fields with minimum field width of 5 mm the discrepancies are up to 1.6 mm. The field width (FWHM) obtained by measuring dose profiles are unreliable for small fields due to the measurement uncertainties for extremely small field. Effect of partial occlusion of the primary photon source by the jaws on the beam axis is clearly observed in the calculated dose profiles. For the extremely small field width of 5 mm, Monte Carlo predicted up to 10% exchange factor differences which are confirmed by the measurements. CONCLUSION The field size defined by geometric opening of the beam defining system, is still valid for small fields. The field size defined by geometric opening is independent of measurement uncertainties, independent of machine design and highly reproducible. It is feasible to accurately tabulate the output factors as a function of geometric field opening thus eliminating user and detector choice for FWHM measurements. The field output factor of a small rectangular field cannot be related to an equivalent field size without considering the exchange factor due to partial occlusion of the photon source. This article is protected by copyright. All rights reserved.