Physical parameters of very small diameter 10 MV X-ray beams for linac-based stereotactic radiosurgery

Physical aspects of very small diameter X-ray beams used for a linac-based stereotactic radiosurgery are presented in this thesis. A 10 MV linac was used as the radiation source. Very small 10 MV photon fields with diameters of 1.5 mm, 3 mm, and 5 mm are produced by special collimators attached to the treatment head of the linac. The radiation beam data were measured with a small field diode detector as well as radiographic and radiochromic films. Measured beam parameters were compared with the same parameters calculated with Monte Carlo (MC) simulations. For very small photon fields with diameters on the order of the focal spot size, MC calculations show that both the percentage depth dose (PDD) distributions and dose profiles are sensitive to the focal spot size. A simple sliding slit technique was developed to measure the focal spot size and shape for accurate MC simulations of very small diameter beams. The measured focal spot of the 10 MV linac is elliptical in shape and fitted by a Gaussian distribution with full-widths-at-half-maximum (FWHMs) of 2.05 mm and 1.34 mm in the principal axes of the ellipse. A Gaussian circle equivalent in area to the experimentally determined focal spot ellipse was used in MC simulations. The resulting PDD and beam profile calculations are in good agreement with the measurements. Dynamic radiosurgery with very small diameter photon beams was carried out using the 10 MV linac. Radiosurgical isodose distributions were measured with radiographic films in a spherical head phantom and calculated with the MC technique. A good agreement between the measured and MC-calculated isodose distributions for very small diameter fields is achieved. The displacement of the center of the measured isodose distributions relative to the laser-defined isocenter was on the order of 0.7 mm. All these results show the potential of linac-based radiosurgery with very small diameter photon beams for clinical use.