Impact of a flattening filter free linear accelerator on structural shielding design

Purpose: The present study aimed to assess the effects of a flattening filter free medical accelerator on structural shielding demands of a treatment vault of a medical linear accelerator. We tried to answer the question, to what extent the required thickness of the shielding barriers can be reduced if instead of the standard flattened photon beams unflattened ones are used. Material and Methods: We chose both an experimental as well as a theoretical approach. On the one hand we measured photon dose rates at protected places outside the treatment room and compared the obtained results for flattened and unflattened beams. On the other hand we complied with international guidelines for adequate treatment vault design and calculated the shielding barriers according to the therein given specifications. Measurements were performed with an Elekta Precise trademark linac providing nominal photon energies of 6 and 10 MV. This machine underwent already earlier some modifications in order to be able to operate both with and without a flattening filter. Photon dose rates were measured with a LB133-1 dose rate meter manufactured by Berthold. To calculate the thickness of shielding barriers we referred to the Austrian standard OeNORM S 5216 and to the US American NCRP Report No. 151. Results: We determined a substantial photon dose rate reduction for all measurement points and photon energies. For unflattened 6 MV beams a reduction factor ranging from 1.4 to 1.8 was identified. The corresponding values for unflattened 10 MV beams were 2.1 and 3.2. The performed shielding calculations indicated the same tendency: For all relevant radiation components we found a reduction in shielding thickness when unflattened beams were used. The required thickness of primary barriers was reduced up to 8.0%, the thickness of secondary barriers up to 11.4%, respectively. Conclusions: For an adequate dimensioning of treatment vault shielding barriers it is by no means irrelevant if the accommodated linac operates with or without a flattening filter. The lower consumption of shielding space and material for new treatment vaults housing a FFF machine may reduce building costs, whereas for existing vaults one might benefit in terms of increased weekly workload. Also a more frequent use of monitor unit intense treatment techniques as well as aiming at reduced occupational exposure for staff is conceivable. (orig.)