Original Article

The Effect of Heterogeneity in Small Electron Fields: A Dosimetric Study

Abstract

Background: Small electron fields are used in radiotherapy for superficial tumors and areas close to the skin. However, the impact of tissue heterogeneity on dose distribution in these fields poses considerable challenges. To explore how the variability of cold foam affects dose distribution in small electron fields using Semiflex 3D and Advanced Markus dosimeters.

Methods: Dosimetric measurements were performed using an Elekta Vera-HD linear accelerator with 10 MeV and 12 MeV electron beams. Square field sizes of 2×2, 3×3, 4×4, 5×5, and 6×6 cm² were investigated. Dose distributions were assessed using Semiflex 3D and Advanced Markus ionization chambers. Percentage Depth Dose (PDD) curves were analyzed, revealing that at 10 MeV, the depth of maximum dose (d_max) was 2.2 cm, while at 12 MeV, it increased to 2.7 cm.

Results: The results confirm that the OF increases with both field size and beam energy. Larger field sizes enhance lateral electron scattering, and higher beam energy enables deeper penetration and broader dose distribution, further increasing the OF. A minimum field size of 3 cm × 3 cm is recommended, as differences between dosimeters were observed in 2 cm × 2 cm and 3 cm × 3 cm fields, but remained below 2% for larger fields. The study also found that increasing heterogeneity reduces the OF, with air-equivalent heterogeneities consistently decreasing the OF across all field sizes and energy levels.

Conclusion: Monte Carlo algorithms in treatment planning systems (TPS) model heterogeneities using CT images and Hounsfield Unit (HU) values. However, their accuracy depends on CT image quality and device calibration, and HU-to-parameter conversion may not fully account for tissue variability. Combining computational simulations with experimental validation is recommended to improve TPS accuracy, especially in electron mode and when dealing with heterogeneities.

1- Kesen ND, Cakir A, Okutan M, and Bilge H, "A comparison of TPS and different measurement techniques for small-field electron beams." Medical Dosimetry, Vol. 40 (No. 1), pp. 9-15, (2015).
2- Russo S et al., "Dosimetric Characterization of Small Radiotherapy Electron Beams Collimated by Circular Applicators with the New Microsilicon Detector." Applied Sciences, Vol. 12p. 600, (2022).
3- Ali I, Kendall E, Alsbou N, and Ahmad S, "Quantitative evaluation of the dosimetric uncertainties associated with small electron fields." Journal of Medical Imaging and Radiation Sciences, Vol. 53 (No. 2), pp. 273-82, (2022).
4- Van Eeden D, Sachse KN, and Du Plessis FC, "Practical Dosimetry Considerations for Small MLC-Shaped Electron Fields in a 60 cm SSD." Journal of Biomedical Physics and Engineering, Vol. 12 (No. 1), pp. 101-08, (2022).
5- Taylor ML, Kron T, and Franich RD, "A contemporary review of stereotactic radiotherapy: inherent dosimetric complexities and the potential for detriment." Acta Oncologica, Vol. 50 (No. 4), pp. 483-508, (2011).
6- Khan FM, "Electron Beam Therapy." in The Physics of Radiation Therapy, J. W. Pine, Ed. Philadelphia: Lippincott Williams & Wilkins, (2010), pp. 256-304.
7- Bagheri H, Soleimani A, Gharehaghaji N, Mesbahi A, Manouchehri F, and Shekarchi B, "An overview of small-field dosimetry in photon beam radiotherapy: Developments and challenges." Journal of Cancer Research and Therapeutics, Vol. 13 (No. 2), pp. 175-85, (2017).
8- Gerbi BJ, Antolak JA, Deibel FC, Followill DS, Herman MG, and Higgins PD, "Recommendations for clinical electron beam dosimetry: Supplementary to the recommendations of Task Group 25." Medical Physics, Vol. 36 (No. 7), pp. 3239-79, (2009).
9- International Atomic Energy Agency, "Absorbed Dose Determination in External Beam Radiotherapy." IAEA, Vienna, Austria, (2000).
10- Donmez Kesen N, Cakir A, Okutan M, and Bilge H, "Research of dosimetry parameters in small electron beams." Science and Technology of Nuclear Installations, Vol. 2014 (No. 1), p. 585219, (2014).
11- Wulandari C, Wibowo WE, and Pawiro SA, "The detector characteristics for output factor measurement of small field electron beams." Presented at the AIP Conference Proceedings, (2017).
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SectionOriginal Article(s)
Keywords
Tissue heterogeneity small electron fields radiotherapy Semiflex 3D Advanced Markus

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How to Cite
1.
Shomal-Nasab S, Sadeghi H, Seif F, Bayatiani MR. The Effect of Heterogeneity in Small Electron Fields: A Dosimetric Study. Frontiers Biomed Technol. 2026;.