The purpose of this study was to compare three computed tomography (CT) images under different conditions—average intensity projection (AIP), free breathing (FB), mid‐ventilation (MidV)—used for radiotherapy contouring and planning in lung cancer patients. Two image sets derived from four‐dimensional CT (4DCT) acquisition (AIP and MidV) and three‐dimensional CT with FB were generated and used to plan for 29 lung cancer patients. Organs at risk (OARs) were delineated for each image. AIP images were calculated with 3D conformal radiotherapy (3DCRT) and intensity‐modulated radiation therapy (IMRT). Planning with the same target coverage was applied to the FB and MidV image sets. Plans with small and large tumors were compared regarding OAR volumes, geometrical center differences in OARs, and dosimetric indices. A gamma index analysis was also performed to compare dose distributions. There were no significant differences (P > 0.05) in OAR volumes, the geometrical center differences, maximum and mean doses of the OARs between both tumor sizes. For 3DCRT, the gamma analysis results indicated an acceptable dose distribution agreement of 95% with 2%/2 mm criteria. Although, the gamma index results show distinct contrast of dose distribution outside the planning target volume (PTV) in IMRT, but within the PTV, it was acceptable. All three images could be used for OAR delineation and dose calculation in lung cancer. AIP image sets seemed to be suitable for dose calculation while patient movement between series acquisition of FB images should be considered when defining target volumes on 4DCT images.

The McCall method has been used to measure neutron leakage from the Mevatron 77, 18- and 15-MV photon beams. Gold foil activation has been used employing a beta counting technique for the 18-MV beam and a gamma counting technique for both the 18- and 15-MV beam. The two counting techniques were used to evaluate their relative merit. The measurements were made at various locations in the patient-treatment plane for different field sizes. The results show that the thermal-neutron dose equivalent contributes only about 1%-2% of the total neutron dose equivalent. At 100 cm, the neutron dose equivalent for the 18-MV beam is approximately six times that of the 15-MV beam, slightly exceeding the 0.1% of the useful beam criteria used by some of the regulatory agencies. In light of the uncertainty in fluence to dose equivalent conversion factors, the increased dose equivalent above 0.1% is insignificant.

Abstract. The study aimed to determine appropriate detectors for output factor measurement of small fields in 6 and 10 MV flattening filter free photon beams using five different detectors. Field sizes were varied between 0.6 × 0.6 and 4.0 × 4.0 cm 2 . An indirect method (daisy-chaining) was applied to normalize the output factors. For the smallest field size, the variations of output factors compared among the detectors were 13%. Exradin A16 had the lowest output factor and increasing in sequence with CC01, microDiamond, microLion and EDGE detectors, respectively, for both energies. The similarity between CC01 and microDiamond output factor values were within 1.6% and 1% for all field sizes of 6 and 10 MV FFF, respectively. EDGE and microLion presented the highest values while ExradinA16 gave lowest values. In conclusion, IBACC01, Exradin A16, microLion, microDiamond and EDGE detectors seem to be the detectors of choices for small field output factor measurement of FFF beams down to 1.6×1.6 cm 2 . However, we could not guarantee which detector is the most suitable for output factor measurement in small field less than 1.6 × 1.6 cm 2 of FFF beams. Further studies are required to provide reference information for validation purposes.

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