Lateral electron disequilibrium in radiation therapy

The radiation dose in radiation therapy is mainly measured by ion chamber. The ion chamber measurement will not be accurate if there is not enough phantom material surrounding the ion chamber to provide the electron equilibrium condition. The lack of electron equilibrium will cause a reduction of dose. This may introduce problems in treatment planning. Because some planning algorithms cannot predict the reduction, they over estimate the dose in the region. Electron disequilibrium will happen when the radiation field size is too small or the density of irradiated material is too low to provide sufficient electrons going into the dose volume. The amount of tissue required to provide electron equilibrium in a 6MV photon beam by three methods: direct calculation from Klein-Nisina equation, measurement in low density material phantom and a Monte Carlo simulation is done to compare with the measurement, an indirect method from a planning algorithm which does not provide an accurate result under lateral electron disequilibrium. When the error starts to happen in such planning algorithm, we know that the electron equilibrium conditions does not exist. Only the 6MV photon beam is investigated. This is because in most cases, a 6MV small fields are used for head and neck (larynx cavity) and 6MV fields are commonly used for lung to minimise uncertainity due to lateral electron at higher energies