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Zhu, T.C., Ahnesjö, A., Lam, K.L., Li, X.A., Ma, C.M., Palta, J.R., Sharpe, M.B., Thomadsen, B. and Tailor, R.C. (2009) In-Air Output Ratio, Sc, for Megavoltage Photon Beams. Report of the AAPM Radiation Therapy Committee Task Group No. 74. Medical Physics, 36, 5261-5291.
https://doi.org/10.1118/1.3227367

has been cited by the following article:

• TITLE: The Impact of Small Field’s Off-Set on Output Factor in Intensity Modulated Radiation Treatment

  AUTHORS: Hulya Ozdemir, Nina Tuncel, Adem Unal Kizildag

  KEYWORDS: Small Field, Off-Set Fields, Total Output Factor, In-Air Output Factor, Intensity Modulated Radiation Treatment

  JOURNAL NAME: International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, Vol.6 No.4, November 23, 2017

  ABSTRACT: In intensity modulated radiation treatment (IMRT) planning, the use of asymmetrically collimated fields that are placed on central axis or its off-set is mostly required. Output is the main topic discussed today for extremely small and/or severe irregularly shaped fields. The air scatter data are involved directly or indirectly in obtaining the output. Despite the fact that extensive data have been published in many studies to provide a guide on the magnitude of output factor for clinical accelerators, there are very few data reviewed about output factor in-air or phantom for off-set fields. This study was aimed to investigate the impact of these conditions for small fields. This study was conducted in Elekta Synergy linear accelerator which produces 6 MV X-ray energy. The in-air output factor (Sc) has been measured by CC04 ion chamber with brass-alloy “build-up” cap and Dose-1 electrometer, and the total output (Scp) measurements were carried on at dose maximum depth in phantom by the same chamber and Thermoluminescence dosimeter (TLD) for 1 - 10 cm2 fields. The all measurements at center of isocenter and off-set fields at three directions (X2, Y1, Diagonal) were done. By decreasing field size from 10 to 2 cm2 at isocenter, the Sc value using CC04 was decreased to 5.4% and Scp using CC04 and TLD to 14.5% and 11% respectively. By increasing off-set value, the Sc and Scp values were increased in all directions comparing to central fields. The maximum increase was obtained in Y1 direction for Sc and Scp. TLD results for Scp is slightly higher than CC04. The dosimetric properties of small fields and their off-set should be evaluated and modelled appropriately in the treatment planning system to ensure accurate dose calculation in Intensity Modulated Radiation Treatment.