Changes to dose in the build-up region when using multi-leaf collimators in place of lead blocks supported on an accessory tray

Doses in the build-up region have been compared for regular fields with and without a perspex accessory tray and for two irregular fields defined by either a Philips multi-leaf collimator (MLC) or lead blocks. The results show an increase in doses within the build-up region, by up to a factor of two, primarily due to the presence of the accessory tray. Fields shaped with the MLC exhibited build-up characteristics similar to those in unblocked fields and hence there will be systematic changes to the build-up dose when treatments are transferred from lead blocking techniques to those using an MLC mounted within the treatment head