Beam collimation and filtration optimization for a novel orthovoltage radiotherapy system

The inaccessibility of clinical linear accelerators in low- and middle-income countries creates a need for low-cost alternatives. Kilovoltage (kV) x-ray tubes have shown promise as a source that could meet this need. However, performing radiotherapy with a kV x-ray tube has numerous difficulties, including high skin dose, rapid dose fall-off, and low dose rates. These limitations create a need for highly effective beam collimation and filtration.

To improve the treatment potential of a novel kV x-ray system by optimizing an iris collimator and beam filtration using Bayesian techniques and Monte Carlo (MC) simulations.

The Kilovoltage Optimized AcceLerated Adaptive therapy system's current beam configuration consists of a 225 kVp x-ray tube, a 12-leaflet tungsten iris collimator, and a 0.1 mm copper filter. A Bayesian optimization was performed for the large and small focal spot sizes of the kV x-ray tube source at 220 kVp using TopasOpt, an open-source library for optimization in TOPAS. Collimator thickness, copper filter thickness, source-to-collimator distance (SCD), and source-to-surface distance (SSD) were the variables considered in the optimization. The objective function was designed to maximize the dose rate and the dose at a depth of 5 cm while minimizing the beam penumbra width and the out-of-field dose (OFD), all evaluated in a water phantom. Post-optimization, the optimal beam configuration was simulated and compared to the existing configuration.

The optimal collimation setup consisted of 2.5 mm thick tungsten leaflets for the iris collimator and a 350 mm SSD for both focal spot sizes. The optimal copper filtration was 0.22 mm for the large focal spot and 0.15 mm for the small focal spot, with a SCD of 148.5 mm for the large focal spot and 125.8 mm for the small focal spot. For the large focal spot, the surface dose rate decreased by 9.4%, while the PDD at 5cm depth ( ${\text{PDD}}_{5cm}$ ) increased by 7.7% compared to the existing iris collimator. Additionally, the surface beam penumbra width was reduced by 31.3%, and no significant changes in the OFD were observed. For the small focal spot, the surface dose rate for the new collimator increased by 3.7% and the ${\text{PDD}}_{5cm}$ increased by 5.3%, with no statistically significant changes in the beam penumbra width or OFD.

The optimal beam collimation and filtration for both x-ray tube focal spot sizes of a kV radiotherapy system was determined using Bayesian optimization and MC simulations and resulted in improved dose distributions.