SU-E-T-233: Modeling Linac Couch Effects On Attenuation and Skin Dose

Purpose: Treatment couch tops in medical LINAC rooms lead to attenuation to beams penetrating them, plus higher skin dose which can become a significant concern with the high fraction doses associated with Stereotactic Body Radiation Therapy. This work measures the attenuation and shallow depth dose due to a BrainLab couch, and studies the modeling of the couch top in our treatment planning system (TPS) as a uniform solid material with homogeneous density. Methods: LINAC photon beams of size 10×10 cm and nominal energy 6 MV were irradiated from different gantry angles on a stack of solid water. Depth dose were measured with two types of parallel plate chambers, MPPK and Markus. In the Philips Pinnacle TPS, the couch was modeled as a slab with varying thickness and density. A digital phantom of size 30×30×10 cm with density 1 g/cc was created to simulate the measurement setup. Both the attenuation and skin dose effects due to the couch were studied. Results: An orthogonal attenuation rate of 3.2% was observed with both chamber measurements. The attenuation can be modeled by couch models of varying thicknesses. Once the orthogonal attenuation was modeled well, the oblique beam attenuation in TPS agreed with measurement within 1.5%. The depth dose at shallow depth (0.5 cm) was also shown to be modeled correctly within 1.5% of the measurement using a 12 mm thick couch model with density of 0.9 g/cc. Agreement between calculation and measurement diverges at very shallow depths (≤1 mm) but remains acceptable (<5%) with the aforementioned couch model parameters. Conclusion: Modeling the couch top as a uniform solid in a treatment planning system can predict both the attenuation and surface dose simultaneously well within clinical tolerance in the same model