Effect of density on the 10 MV photon beam penumbra

An investigation into the density dependence of the penumbra of the Varian Clinac 18/10 10 MV photon beam has been carried out. A water/lung phantom was constructed of polystyrene (r = 1.04 g cm-3) and cork (r = 0.23 g cm-3), in which interfaces exist both parallel and perpendicular to the beam axis. The irradiation of the phantom was also simulated using the EGS4 Monte Carlo system with a cartesian voxel geometry. Experimental (TLD) and Monte Carlo dose profiles are in close agreement, and show a large degree of penumbral broadening in the lung region. This broadening is due primarily to lateral electronic disequilibrium occurring at a larger distance from the geometric beam edge in lung than in water. This disequilibrium can also cause the dose in lung to drop below the dose in water at the same depth and off axis distance, even though the radiological depth is less in lung. Monte Carlo simulations were also performed where the dose is separated into primary and scattered components, for homogeneous media of densities 0.25, 0.50, 0.75 and 1.00 g cm-3. The penumbral width of the primary dose profile was found to be almost constant with depth for a point source of photons (after the initial build-up region), where the lateral distances from the 95-50% and 50-5% dose levels on the dose profile (normalized to the dose at the central axis) are equal in all cases. Also, primary penumbra width was found to be almost inversely proportional to density. The primary penumbra for a unit density material can be fitted accurately by an exponential forming function with empirical determined coefficients. The penumbral shape for the lower densities can then be closely fitted by scaling the coefficients in proportion to density. This scaling method has application in treatment planning, where the predicted primary penumbra shape should take account of inhomogeneities, and is particularly important in matching adjacent fields. When the scattered dose component is added to give the total dose, penumbral width increases because the scattered dose penumbra is wider than that of the primary dose. Also, the inverse proportionality of the penumbra width with density does not hold for the scattered dose. The relative contribution of the scattered dose increases with density. Therefore, the inverse proportionality of penumbra width with density does not hold for the total dose.