Dose monitoring and output correction for the effects of scanning field changes with uniform scanning proton beam

Purpose: The output of a proton beam is affected by proton energy, Spread-Out Bragg Peak (SOBP) width, aperture size, dose rate, and the point of measurement. In a uniform scanning proton beam (USPB), the scanning field size is adjusted (including the vertical length and the horizontal width) according to the treatment field size with appropriate margins to reduce secondary neutron production. Different scanning field settings result in beam output variations that are investigated in this study. Methods: The measurements are performed with a parallel plate Markus chamber at the center of SOBP under the reference condition with 16 cm range, 10 cm SOBP, and 5 cm air gap. The effect of dose rate on field output is studied by varying proton beam current from 0.5 to 7 nA. The effects of scanning field settings are studied by varying independently the field width and length from 12 x 12 to 30 x 30 cm(2). Results: The results demonstrate that scanning field variations can produce output variation up to 3.80%. In addition, larger output variation is observed with scanning field changes along the stem direction of the patient dose monitor (PDM). By investigating the underlying physics of incomplete charge collection and the stem effects of the PDM, an analytical model is proposed to calculate USPB output with consideration of the scanning field area and the PDM stem length that is irradiated. The average absolute difference between the measured output and calculated output using our new correction model are within 0.13 and 0.08% for the 20 and 30 cm snouts, respectively. Conclusions: This study proposes a correction model for accurate USPB output calculation, which takes account of scanning field settings and the PDM stem effects. This model may be used to extend the existing output calculation model from one snout size to other snout sizes with customized scanning field settings. The study is especially useful for calculating field output for treatment without individualized patient specific measurements. (C) 2011 American Association of Physicists in Medicine. [DOI: 10.1118/1.3609417]