Evaluating and modeling of photon beam attenuation by a standard treatment couch

The purpose of this study was to evaluate beam attenuation by treatment couch and build a treatment couch model in TPS to check for beam-couch intersection at the planning stage and deal with beam attenuation by treatment couch in dose calculation. In this study, a standard treatment couch, Siemens ZXT couch, has been incorporated into Pinnacle3 8.0 TPS, based on an existing TPS tool, model-based segmentation (MBS). This was done by generating the couch's model from contours of the couch, together with the density information. Both the geometric and dosimetric accuracy of the couch model were evaluated. The test of beam-couch intersection prediction showed good agreement between predicted and measured results, and the differences were within 1° gantry rotation. For individual posterior oblique beams, the attenuation by metallic frames and PMMA couch top could reach nearly as high as 60% and 10%, respectively. For several posterior oblique beams (180°, 220°, 235°) that attenuated by the PMMA couch top, the calculated and measured dose distributions were compared. The dose differences at central axis were within 1%, and almost all points agreed with the calculations when the DD and DTA criteria of 3%/3 mm were adopted. The difference between calculated and measured attenuation factors were within 0.5%. This study demonstrates that the couch model created by MBS, which contains geometric and density information of the couch, can be used to detect the beam-couch intersection, and also is able to provide an accurate representation of the couch top attenuation properties in patient dose calculation.