Monte Carlo commissioning of clinical electron beams using large field measurements

Monte Carlo simulation can accurately calculate electron fluence at the patient surface and the resultant dose deposition if the initial source electron beam and linear accelerator treatment head geometry parameters are well characterized. A recent approach used large electron fields to extract these simulation parameters. This method took advantage of the absence of lower energy, widely scattered electrons from the applicator resulting in more accurate data. It is important to validate these simulation parameters for clinically relevant fields. In the current study, these simulation parameters are applied to fields collimated by applicators and inserts to perform a comprehensive validation. Measurements were performed on a Siemens Oncor linear accelerator for 6 MeV, 9 MeV, 12 MeV, 15 MeV, 18 MeV and 21 MeV electron beams and collimators ranging from an open 25 x 25 cm(2) applicator to a 10 x 10 cm(2) applicator with a 1 cm diameter cerrobend insert. Data were collected for inserts placed in four square applicators. Monte Carlo simulations were performed using EGSnrc/BEAMnrc. Source and geometry parameters were obtained from previous measurements and simulations with the maximum field size (40 x 40 cm(2)). The applicators were modelled using manufacturer specifications, confirmed by direct measurements. Cerrobend inserts were modelled based on calliper measurements. Monte Carlo-calculated percentage depth dose and off-axis profiles agreed with measurements to within the least restrictive of 2%/1 mm in most cases. For the largest applicator (25 x 25 cm(2)), and 18 MeV and 21 MeV beams, differences in dose profiles of 3% were observed. Calculated relative output factors were within 2% of those measured with an electron diode for fields 1.5 cm in diameter or larger. The disagreement for 1 cm diameter fields was up to 5%. For open applicators, simulations agreed with parallel plate chamber-measured relative output factors to 1%. This work has validated a recent methodology used to extract data on the electron source and treatment head from large electron fields, resulting in a reduction in the number of unknown parameters in treatment head simulation. Applicator and insert collimated electron fields were accurately simulated without adjusting these parameters. Results demonstrate that commissioning of electron beams based on large electron field measurements is a viable option.