Two-argument total scatter factor for small fields simultaneously collimated by MLC and jaws: application to...

Direct use of the total scatter factor (S _tot) for independent monitor unit (MU) calculations can be a good alternative approach to the traditional separate treatment of head/collimator scatter (S _c) and phantom scatter (S _p), especially for stereotactic small fields under the simultaneous collimation of secondary jaws and tertiary multileaf collimators (MLC). We have carried out the measurement of S _tot in water for field sizes down to 0.5  ×  0.5 cm² on a Varian TrueBeam STx medical linear accelerator (linac) equipped with high definition MLCs. Both the jaw field size (c) and MLC field size (s) significantly impact the linac output factors, especially when c [Formula: see text] s and s is small (e.g. s  <  5 cm). The combined influence of MLC and jaws gives rise to a two-argument dependence of the total scatter factor, S _tot(c,s), which is difficult to functionally decouple. The (c,s) dependence can be conceived as a set of s-dependent functions ('branches') defined on domain [s _min, s _max  =  c] for a given jaw size of c. We have also developed a heuristic model of S _tot to assist the clinical implementation of the measured S _tot data for small field dosimetry. The model has two components: (i) empirical fit formula for the s-dependent branches and (ii) interpolation scheme between the branches. The interpolation scheme preserves the characteristic shape of the measured branches and effectively transforms the measured trapezoidal domain in (c,s) plane to a rectangular domain to facilitate easier two-dimensional interpolation to determine S _tot for arbitrary (c,s) combinations. Both the empirical fit and interpolation showed good agreement with experimental validation data.