Computer aided design and verification of megavoltage tissue compensators for oblique beams

A computer based radiotherapy dose compensator system is presented. A plane of uniform dose (pud) is chosen which passes through the central axis at a reference depth in the patient. The pud is oriented at an arbitrary angle. Tissues thicknesses are the ray line distances from the patient surface to the pud. Relative dose estimates on the pud are derived from tissue-air ratio, tissue-maximum ratio, or tissue-phantom ratio tables interpolated for field size and tissue thickness. An inverse square law correction is also applied. Compensator thicknesses are calculated from measured effective attenuation coefficients to attenuate the beam by a factor proportional to the estimated dose on the pud. Water phantom measurements for 60Co for both oblique incidence and wedge geometries demonstrate dose uniformity to better than +/- 4%. Dose measurement with radiographic films sandwiched between the two halves of a wax phantom verify adequate compensation for neck irradiation by 60Co opposed lateral beams and 6-MV x-ray inferiorly angled lateral beams. Compensator factors used for absolute dose determination are accurate to better than +/- 3%. The dose modeling routine, QCBEAM, is found to be sufficiently accurate for routine compensator verification for these geometries.