Improving precision and safety in the use of beam modifying devices in radiation therapy

Reliable and safe implementation of beam modifying devices such as wedges and block trays requires careful design and construction. Inappropriate design may pose problems ranging from user-hostile operation to hard-to-track, but significant variations in actual position in a beam. This may cause variation in actual wedge output factors, or variation in the position of a block tray. In case of simple mechanical failure or personnel mistake, design related mechanical conditions may result in injury to either a patient or a staff member. This paper is based on experience with linear accelerators from one manufacturer, but similar conditions are likely to exist with other radiation machines. A simple technical modification is offered which improves both accuracy and reproducibility in the placement of wedge-type filters. For our machines the solution also provides improved safety in the use of both wedge trays and block trays.