Electrons as the cause of the observed dmax shift with field size in high energy photon beams

For megavoltage x-ray beams, it is well known that the percent depth-dose increases considerably with field size in the buildup region, resulting in a significant shift in the apparent position of maximum dose, dmax. The nature of this increase has been investigated using a sweeping magnet placed just below the treatment head of a 25-MV linac. Measurements show that for increasing magnetic fields the dose in the buildup region is continually reduced, until a point is reached beyond which no additional reduction is observed. Here the buildup curve is essentially field size independent. These results clearly show that electrons are the primary cause of dose increase with field size in the buildup region, in contrast to a recent publication claiming that scattered photons are the cause. Further measurements were made by blocking out the primary beam at the level of the jaws and measuring the depth dose of the scattered electrons originating from the jaws. The results show that a thickness of approximately 1 gcm-2, of either polystyrene or lead, reduces the dose by a factor of two, providing further evidence that the scattered component of the beam consists of low energy electrons.