E-ISSN 2305-1620 | ISSN 2221-0288
 

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istan Journal of Nuclear Medicine (Volume 7, issue 1)

https://doi.org/10.24911/EJBCMS.7.4

Behaviour of wedges for different field sizes and depths

Sajjad Ahmed Memon*, Naeem Ahmed Laghari, Fayaz Hussain Mangi

Nuclear Institute of Medicine And Radiotherapy (NIMRA), Jamshoro, Pakistan

Address for correspondence

Sajjad Ahmed Memon

Nuclear Institute of Medicine & Radiotherapy (NIMRA) Jamshoro, Pakistan

Tel: +92-22-9213381-84

Email: physicistsajjad@hotmail.com


ABSTRACT

Background:

The relative dosimetry plays vital part in treatment planning of patients. Factors such as percent depth doses, tissue maximum ratios, tray factors, wedge factors, etc., determined from the relative dosimetry, affects the patient dose. The current study intended at measuring and evaluating the wedge factor for different field sizes and depths for 60Co teletherapy unit GWXJ80 of NPIC China.


Methods:

The measurements for 15o, 30o, 45o and 60o wedges for different field sizes and depths on 60Co teletherapy unit GWXJ80 of NPIC China installed at Nuclear Institute of Medicine and Radiotherapy (NIMRA), Jamshoro, Pakistan, were done in water phantom of 30x30x30 cm3 dimension at 80 cm Source-to-Surface Distance (SSD) by using calibrated Farmer’s NE 2570 electrometer with NE 2571 0.6 cc ionization chamber.


Results:

The evaluation of data showed that there was no significant difference in factor of each of wedge being analyzed for different field sizes and depths.


Conclusion:

The current study suggests that wedge factor for a particular wedge is approximately a constant value irrespective of field size and depth. The measurement for only one field size at one depth is sufficient to calculate the wedge factor for a particular wedge.


Keywords:

60Co, Quality assurance, Relative dosimetry, Field size, Depth.

INTRODUCTION

In radiotherapy, absolute dosimetry or simply dosimetry, is a systemic procedure for measuring the absorbed dose (also termed as calibration) in unit of Gy (Gray) of teletherapy machine directly under reference conditions (same field size at same depth with constant gantry and collimator angles and at a fixed SSD). All further measurements are then compared to this known dose under specific conditions termed as relative dosimetry [1]. From these relative dosimetry variables, wedge filters are one of beam modifying devices and are being used to optimize the dose distribution in patients’ target tissues [2-5]. Due to the presence of wedge filter in the path of radiation beam, attenuation occurs in the beam intensity which can be expressed in the form of wedge factor (WF) at the central axis of the radiation beam [2, 4]. This attenuation is taken into consideration for calculating the patient dose and treatment time (TT) or monitor units (MU) [4-6].

Most of the times single WF is used for the patients’ TT or MUs, with usually measurements made for the reference field size of 10 × 10 cm2 at reference depth of dmax or d5 or d10 [3]. Various researchers [2-32] have conducted studies on wedge factors for LA (Linear Accelerator), 60Co (cobalt-60) or for both type of treatment machines (LA, 60Co) as sumarized in Table 1. As seen from Table 1, several studies [2, 3, 6-23] have been conducted for LA only, whereas other studies [24-27] for both (LA and 60Co) and still other studies [4, 5, 28-32] for 60Co only. This study aimed at computing and comparig the differences in WFs of different wedges for different field sizes at different depths.

MATERIAL AND METHODS

The WF of different wedge angles (15°, 30°, 45° and 60°) on different field sizes at depths of 05 and 10 cm were studied for GWXJ80 of NPIC China installed at Nuclear Institute of Medicine and Radiotherapy (NIMRA) Jamshoro Pakistan were done in water phantom with 30x30x30 cm3 dimension at 80 cm Source to Surface Distance (SSD) using calibrated NE 2570 Farmer Electrometer and 0.6 cc Farmer ionization chamber NE 2571. All of the measurements were performed at 0° gantry and collimeter angles [33, 34]. The setups for non-wedged and wedged beams are shown in Figures 1 and 2.

The calculation of WF for a specific field size at particular depth in water phantom was done by using the formula:

Figure 1. Measurement setup for open beam or non wedged beam

Figure 2. Measurement setup for open beam or non wedged beam

The measurement for specific wedge is to be one at same set of parameters (like for same field size at same depth, for the same dose or time of exposure with constant gantry and collimator angles and at fixed SSD [2, 27, 33, 34].

RESULTS

The WF for different field sizes at different depths (05 and 10 cm) along with their means and standard deviations (SD) for 60Co teletherapy unit GWXJ80 of NPIC China installed at Nuclear Institute of Medicine and Radiotherapy (NIMRA) Jamshoro Pakistan have been congregated into in Tables 2 and 3 whereas their graphical representation have been shown in figures 3 to 6.

DISCUSSION

The results from other researchers on wedge factors for LA, 60Co or for both type of treatment machines (LA, 60Co) along with current study on 60Co teletherapy machines [2-9, 11,13, 14, 16-19, 22,23,25, 27-32] has been summarized in Table 4. As seen in the table 4, studies [2, 3, 6-9, 11, 13, 14, 16-19, 22] shows WF for LA only, whereas studies [23, 25, 27] shows factor for both (LA and 60Co) and studies [4, 5, 28-32] for 60Co only. For LA, the WF differed is between 1% to 25%, whereas for both (LA and 60Co) and for 60Co only including current study, the difference in WFs is between 2%-9% and 0.5%-5.5% respectively.

The current study is comparable and judged to other studies done for WF for 60Co only or with all other data available for LA, or for both (LA and 60Co). Most of the available data (specially for 60Co only) did not show any significant influence on the Wedge factor [2, 16].

Small negligible variations within about ±2.5% for most of WF have been observed which can affect little bit on dose of the patient. The overall error in dose delivery to patients should not go beyond to ±5% [33] on recommendations of reports of International Commission on Radiation Units and Measurements (ICRU) [35, 36] and the Nordic Association Of Clinical Physicists (NACO) [37].

CONCLUSION

The current study presents a comparison of WF for Wedges supplied with the teletherapy unit. The data evaluation showed that non significant difference in WF of each of wedge being analyzed for different field sizes at different depths. This study suggested that WF for a specific wedge is approximately a constant ratio irrespective of field size and depth. The measurement for only one field size at one depth is adequate to calculate the WF for a specific wedge.

Table 1. List of various studies done on wedge factor for LA only, 60Co only or for both (LA and 60Co) along with dependant factors (Field Size, Depth, SSD)

S. No. Study Modality LA/ Both (LA and 60Co)/ 60Co Factor dependency (FS, Depth, SSD/Dist.)
1 Saffar MH et al. [2] LA Field Size, Depth, SSD
2 Ahmad M et al. [3] Field Size, Depth
3 Popescu A et al. [6] Field Size, Depth, SSD
4 Bar-Deroma RD and Bjärngard BE [7] Field Size, Depth
5 Podgorsak MB et al. [8] Field Size, Depth
6 Popple RA et al. [9] Field Size
7 Sewchand W et al. [10] Field Size, Depth
8 Palta JR et al. [11] Field Size
9 Wu A et al. [12] Field Size
10 McCullough EC et al. [13] Depth
11 Liu C et al. [14] Field Size
12 Zhu XR et al. [15] Field Size, Depth
13 Van Santvoort J [16] Not Available
14 Wichman BD [17] Field Size
15 Gibbons JP [18] Field Size
16 Cozzi FA et al. [19] Field Size, Depth
17 Dean EM and Davis JB [20] Field Size
18 Thomas J [21] Field Size
19 Birgani MJT [22] Field Size, Depth
20 Choi DR et al. [23] Field Size
21 Niroomand-Rad A et al. [24] Both (LA and 60Co) Field Size, Depth
22 Heukelom S et al. [25] Field Size and Depth
23 Kalend AM et al. [26] Field Size and Depth
24 Tailor RC et al. [27] Field Size, Depth
25 Haq M M et al. [4] 60Co Not Available
26 Safar MH et al. [5] Field Size, Depth, SSD
27 Kinhikar RA et al. [28] Field Size
28 Andrabi WH et al. [29] Not Available
29 Akinlade BI et al. [30] Not Available
30 Malik SR et al. [31] Not Available
31 Tagoe SNA et al. [32] SSD

Table 2. Wedge Factor of different wedge angles for different field sizes at 05 cm depth with their mean and standard deviation

Sr. No. Wedge Angle Wedge Identification Field Size cm × cm Wedge Factor 05 cm Mean Standard Deviation
1 15o W15 5 × 5 0.691011236 0.695123403 0.004542877
10 × 10 0.694358974
10 × 15 0.700000000
2 30o W30 5 × 5 0.573033708 0.576481321 0.003483690
10 × 10 0.576410256
10 × 15 0.580000000
3 45o W45 5 × 5 0.597752809 0.600601364 0.002467054
10 × 10 0.602051282
10 × 15 0.602000000
4 60o W60 5 × 5 0.440449438 0.448201095 0.008952596
10 × 10 0.446153846
10 × 15 0.458000000

Table 3. Wedge Factor of different wedge angles for different field sizes at 10 cm depth with their mean and standard deviation

Sr. No. Wedge Angle Wedge Identification Field Size cm × cm Wedge Factor 05 cm Mean Standard Deviation
1 15o W15 5 × 5 0.693251534 0.695602077 0.002179005
10 × 10 0.696000000
10 × 15 0.697554698
2 30o W30 5 × 5 0.582822086 0.582404445 0.000593885
10 × 10 0.582666667
10 × 15 0.581724582
3 45o W45 5 × 5 0.605828221 0.606653165 0.000818277
10 × 10 0.606666667
10 × 15 0.607464607
4 60o W60 5 × 5 0.447852761 0.453579406 0.004979142
10 × 10 0.456000000
10 × 15 0.456885457

Table 4. Wedge Factor from different researchers including current study with modality (for LA only, 60Co only or for both (LA and 60Co)

S. No. Study Modality LA/ Both (LA and 60Co)/ 60Co WF
1 Hajizadeh SM et al. [2] LA <2%
2 Ahmad M et al. [3] <10%
3 Popescu A et al. [6]] <±1.0%
4 Bar-Deroma RD and Bjärngard BE

[7]
<±1.5%
5 Podgorsak MB et al. [8] <25%
6 Popple RA et al. [9] <2%
7 Palta JR et al. [11] (3.5-7)%
8 McCullough EC et al. [13] (2-5)%
9 Liu C et al. [14] <1%
10 Van Santvoort J. [16] <3.5%
11 Wichman BD. [17] (1-3)%
12 Gibbons JP. [18] (1-4)%
13 Cozzi FA et al. [19] <1.5%
14 Birgani MJT [22] <5%
15 Choi DR et al. [23] Both (LA and 60Co) 5%
16 Heukelom S. et al. [25] <9%
17 Tailor RC et al. [27] (2-5)%
18 Haq MM et al. [4] 60Co <3.5%
19 Safar MH et al, [5] <1%
20 Kinhikar RA et al. [28] <2%
21 Andrabi WH. Et al. [29] <2%
22 Akinlade BI et al. [30] <5.5%
23 Malik SR et al. [31] <1%
24 Tagoe SNA et al. [32] <±0.50%
25 Current Study <±2.5%

Figure 3. Graphical representation of wedge factors for different wedges for different field sizes at 05 cm depth

Figure 4. Graphical representation of wedge factors for different wedges for different wedges for different field sizes at 10 cm depth

Figure 5. Graphical representation of mean Wedge Factors for different wedges at 05 and 10 cm depths

Figure 6. Graphical representation of Wedge Factors for different wedges for different field sizes at 05 and 10 cm depths

Acknowledgement

The authors wish to thank Mr. Wajid Hussain PT and Mr. Abdul Qadeer SSA for their assistance and helping in taking measurements on teletherapy machine, without their help the current study cannot be successfully completed


List of abbreviation

cc Cubic Centimeter
cm Centimeter
60Co Cobalt-60
dmax Dose at Maximum
d5 Dose at 5 cm
d10 Dose at 10 cm
Gy Gray
IAEA International Atomic Energy Association
ICRU International Commission on Radiation Units and Measurements
LA Linear Accelerator
MU Monitor Units
NACO Nordic Association of Clinical Physicists
NE Nuclear Enterprises
NIMRA Nuclear Institute of Medicine and Radiotherapy
NPIC Nuclear Power Institute of China
SSD Source to Surface Distance
TT Treatment Time
WF Wedge Factor

Conflict of Interests

None


Ethical approval

Ethical committee of NIMRA approved the current study.


Consent for publication from the study subjects

As there is no any data of patients/subjects has been used in study, only the teletherapy machine and dosimetry system is used, so no need of consent is required.

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How to Cite this Article
Pubmed Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. Behaviour of wedges for different field sizes and depths. Pak J Nucl Med. 2017; 7(1): 20-27. doi:10.24911/PJNMed.7.4


Web Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. Behaviour of wedges for different field sizes and depths. http://www.pjnmed.com/?mno=302234 [Access: November 17, 2018]. doi:10.24911/PJNMed.7.4


AMA (American Medical Association) Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. Behaviour of wedges for different field sizes and depths. Pak J Nucl Med. 2017; 7(1): 20-27. doi:10.24911/PJNMed.7.4



Vancouver/ICMJE Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. Behaviour of wedges for different field sizes and depths. Pak J Nucl Med. (2017), [cited November 17, 2018]; 7(1): 20-27. doi:10.24911/PJNMed.7.4



Harvard Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi (2017) Behaviour of wedges for different field sizes and depths. Pak J Nucl Med, 7 (1), 20-27. doi:10.24911/PJNMed.7.4



Turabian Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. 2017. Behaviour of wedges for different field sizes and depths. Pakistan Journal of Nuclear Medicine, 7 (1), 20-27. doi:10.24911/PJNMed.7.4



Chicago Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. "Behaviour of wedges for different field sizes and depths." Pakistan Journal of Nuclear Medicine 7 (2017), 20-27. doi:10.24911/PJNMed.7.4



MLA (The Modern Language Association) Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi. "Behaviour of wedges for different field sizes and depths." Pakistan Journal of Nuclear Medicine 7.1 (2017), 20-27. Print. doi:10.24911/PJNMed.7.4



APA (American Psychological Association) Style

Sajjad Ahmed Memon, Naeem Ahmed Laghari, Fayaz Hussain Mangi (2017) Behaviour of wedges for different field sizes and depths. Pakistan Journal of Nuclear Medicine, 7 (1), 20-27. doi:10.24911/PJNMed.7.4





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