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Charity Rogstad

2017 Spring Semester

Attenuation Project

60 Degree Wedge Transmission Factor Calculation

Objective: To determine the transmission factor for a 60 degree wedge, and use this factor in a
patient monitor unit calculation.

Purpose: The most commonly used beam modifying filter is a wedge shaped piece of dense
material, usually lead, which attenuates the beam progressively across the field. 1 The angle of
the wedge is defined as the tilt of isodose curve not the angle of the actual wedge. When this
wedge is placed in the path of the beam, whether it be a hard physical wedge or a universal
wedge built in to the head of the gantry, the attenuation needs to be accounted for.

The formula for a wedge factor is defined by the following equation:2

WF = Dose rate at point of calculation for a wedge field

Dose rate without wedge modifier

Methods and Materials: The data was measured on an Elekta Synergy linear accelerator using a
universal wedge in the in position which is equivalent to a 60 degree wedge for the entire field.
Readings were taken using 6 megavoltage (MV), 10 MV, and 15 MV photon energies, at each
energy three readings were taken at each of the following: Open field or no wedge, wedge with
180 degree collimator and wedge with 0 degree collimator. Solid water was placed on the
treatment table at an SAD of 100 cm, depth 10cm, 10 by 10 field size. A Farmers thimble
ionization chamber was placed in a precut 10 cm depth hole in the solid water phantom. The
thimble chamber was connected to a Max 4000 electrometer to measure the charge. The machine
was set in service mode with 100 MU s set for each reading, a total of 9 readings were done for
each energy wedge out and wedge in at 2 collimator angles; 180 and 0. The purpose of checking
the reading at both 180 and 0 degree collimator is to ensure that the center of the universal wedge
is at the central axis and that the chamber is set accurately in the solid water.
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Image 1: setup of Solid water with thimble chamber in place.

Results:

Table 1: Reading taken at collimator 180 and 0

Readings at 0 Readings at 180 Average

degree degree of both
collimator collimator readings
Energy (nC) (nC) (nC)
6MV 1 3.98 4 3.99
2 3.98 4 3.99
3 3.98 4 3.99
10MV 1 4.55 4.57 4.56
2 4.55 4.58 4.57
3 4.55 4.58 4.57
15MV 1 4.68 4.75 4.72
2 4.68 4.71 4.70
3 4.68 4.72 4.70
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Table 2: Average 60 degree wedge readings and wedge out readings, including average of the
three readings for each energy and wedge position.

Calculated
reading with Reading with
wedge wedge out
Energy (nC) (nC)
6MV 1 3.99 14.6
2 3.99 14.61
3 3.99 14.62
Average 3.99 14.61
10MV 1 4.56 15.94
2 4.57 15.95
3 4.57 15.95
Average 4.57 15.95
15MV 1 4.72 16.71
2 4.70 16.72
3 4.70 16.73
Average 4.71 16.72

Table 3: Calculating the wedge transmission factor using the averages obtained from the
readings with and without the wedge for all three energies.

Reading with wedge

Reading without Wedge
Energy wedge Factor
6MV 3.99
14.61 = 0.273
10MV 4.57
15.95 = 0.287
15MV 4.71
16.72 = 0.282
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Discussion: The Wedge Factor for the 6MV photon beam is 0.273, 10 MV photon beam is
0.287, and 15 MV photon beam is 0.282. The information shows that the 60 degree wedge
attenuates 73% of the 6MV beam, 71% of the 10 MV beam, and 72% of the 15 MV beam. The
data is consistent with previously measured data on the same machine.

Clinical Application: Palliative 3D conformal lung treatment. The daily prescribed dose is
300cGy for three fields Anterior (Ant), Posterior (Post), and Left Posterior Oblique (Lpo). The
Ant beam is weighted 23% with no wedge, the Post beam is weighted 41% with a 60 degree
wedge, and the Lpo is weighted 36% with a 55 degree wedge. The MU hand calculations are
demonstrated in Image 2. The effective wedge angle equation was needed for calculation of the
55 degree wedge on the Lpo field.

Image 2: Hand calculations of three treatment fields and formulas that were used for each field.
When comparing the hand calculation for each field to the computer generated plan in Image 3
the there is a 0.2% MU calculation difference for the Ant field, 3.4% MU calculation difference
for the Post field, and 0.01% difference for the open portion of the field and a 2.1% difference
for the wedge portion of the field.
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Image 3: Pinnacle planning system report of patients actual treatment parameters and MU that
were used for treatment
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Image 4: Image of isodose lines and how the wedge assists in getting the lines to cover the
treatment volume adequately. The Post field wedge draws the dose more inferiorly on the medial
part of the tumor and the Lpo field wedge draws the dose more lateral. The heels of the wedges
are towards each other for this treatment.

Conclusion: A universal wedge is a wedge of a given angle that is fixed in the beam and serves
all beam widths up to a designated limit.1 With the advancement in technology and linear
accelerators going from a physical hard wedge to universal wedge has defiantly changed the
workflow for Radiation Therapist and also Dosimetrist. This project demonstrates the importance
and technicality of treatment planning with a wedge and the extra considerations that need to be
taken when doing a hand calculation for a field with a wedge. Even though the wedge factor
varies with energy there is at least a 70% increase in MU when using a wedge versus a field
without a wedge.
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References

1. Bentel GC. Dose determination for external beams: Radiation Therapy Planning.
2nd ed. New York, NY: McGraw-Hill; 1996
2. Gibbons JP, Antolak JA, Followill DS, etal. Monitor unit calculations for external
photon and electron beams: Report of the AAPM therapy physics committee taks
group No. 71. Med Phy. 2014;41(3). http://dx.doi.org/10.1118/1.4864244