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Lauren T Edwards
Attenuation Project
DOS 522- 501
Radiation Dose Calculations
March 26, 2019

Wedge Transmission Factor Calculation

Objective: The purpose of this project is to conduct calculation for the transmission factor of a
45- degree physical wedge. This data will show the impact a wedge has on the attenuation of a
radiation photon beam, and how the wedge factor is used in monitor unit calculations.

Purpose:
In recent studies, wedge factors have been used to study the advancement on radiotherapy and
the numerous components that are in a wedge factor. A wedge is considered a beam modifying
device that is made from a piece of dense material which can be steel or lead that can be placed
internally or externally.1 It’s main purpose is to constrict the radiation beam, by altering its
intensity and decreasing the dose distributed. So, when the wedge is used, the output of the
machine is decreased. 2 The wedge transmission factor (WF) represents the amount of dose
transmitted through the wedge, it is measured by on the central axis and is found by the ratio of
the dose with and without the wedge in the path of the beam. 1 The formula for the wedge
transmission factor is as follows:

Figure 1. Formula for calculating a wedge factor.

𝐃𝐨𝐬𝐞 𝐰𝐢𝐭𝐡 𝐰𝐞𝐝𝐠𝐞
WF= 𝐃𝐨𝐬𝐞 𝐰𝐢𝐭𝐡𝐨𝐮𝐭 𝐰𝐞𝐝𝐠𝐞

Methods and Materials: With the aid of a physicist, the necessary data for the WF was
obtained, data was collected on a Varian Clinic 2100 SC Linear 4 accelerator at my facility.
Measurements of the transmission factor for a 45-degree physical wedge were performed on a
solid water phantom with a pre-cut hole at 5cm depth, a PTW chamber was inserted and
connected into an electrometer which measured the charges in nanocoulombs (nC). Lastly, a 9cm
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build up was added to the bottom below the ion chamber to account for backscatter. The
measurements were taken with 0-degree gantry angle and the collimator rotation of 90 degrees ,
at a 100 cm (SAD) distance, at the console a 10x10cm field was programmed with 200 MU
delivered with a 45 degree OUT physical wedge delivered to the ion chamber using a 6MV and
15MV photon energy 600Mu/ min dose. Each energy was repeated twice, charge reading was
logged for five sequential measurements for both 6MV and 15 MV for an open field and a wedge
field. The readings were then averaged and for the five measurements used to perform the wedge
factor calculation.

Figure 2.. 45° physical wedge (Lead)

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Figure 3. Farmer ionization chamber placed at a depth of 5cm in Solid water Phantom.
Measurement setup, setup conditions and ion chamber.
SAD (cm)- 100
Depth (cm)- 5cm
Field Size (cm)- 10x 10
MU- 200
Dose Rate (Mu/min)- 600
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Figure 6. PTW Electrometer

Figure 7. Set up
Results:

Table 1. Readings for 6 MV and 15MV with and without a 45° physical wedge.

6MV OPEN PHYSICAL 45-

OUT
Reading 1 (nC) -1.272 -0.619
Reading 2 (nC) -1.276 -0.619
Reading 3 (nC) -1.275 -0.618
Reading 4 (nC) -1.273 -0.619
Reading 5 (nC) -1.275 -0.619
Average (nC) -1.275 -0.618
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15 MV OPEN PHYSICAL 45
OUT
Reading 1 (nC) -1.398 -0.739
Reading 2 (nC) -1.397 -0.742
Reading 3 (nC) -1.397 -0.739
Reading 4 (nC) -1.398 -0.738
Reading 5 (nC) -1.398 -0.739
Average (nC) -1.397 -0.739

Figure 3. 45° Physical Wedge factor calculation for 6MV and 15MV

WF (6MV, 45° physical wedge) = -0.618nC = 0.484

-1.275 nC

WF (15MV, 45° physical wedge) = -0.739nC = 0.529

-1.3976

Discussion: The wedge factors measured for the 45-degree physical wedge for a 6MV photon
energy is 0.484 and for 15 MV 0.529. The data indicates that the wedge is placed in the path of
the beam approximately 52% of the radiation beam will be weakened by the 45-degree wedge
and approximately 48% will be transmitted through the wedge for 6MV. However, when a
15MV is used approximately 48% of the radiation will be weakened and 53% will be transmitted
through the wedge for a 15MV. Therefore, when a wedge is added to the path of the beam, the
wedge “hardens the beam” which reduces the overall intensity of the beam while increasing the
average energy of the photons.
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Clinical Application:
The applicability of a 45-degree physical wedge is seen in treatment experiment with use of a
right breast that has a 6MV and 15MV photon of energy. The treatment plan implemented two
tangential fields with 45degree physical wedges and without and was used on medial and lateral
fields with the collimator at 90 degrees. The treatment was prescribed to the isocenter. 200cgy at
1 fraction was used to make the calculation easier, but total prescription dose was 5000cgy. The
medial field had a beam weighting of 46.4 and lateral field 53.6 without the wedge. Image 1 and
2 show the similarities of the plan with and without the wedge. Also, further explained is MU
calculations that also shows with and without the involvement of the factor and the percentile
difference between them.

Image 1: Right Breast treatment plan without 45° Wedge

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Image 2: Right Breast treatment plan with 45° Wedge

Figure 8. Formula for Calculating treatment MU

*MU may be slightly off due to use of a different machine for treatment planning.

Monitor Unit Calculation with a 6MV 45-degree physical wedge

MU= Prescribed Dose

Dcal X Scp x IDL x TMR x ISF x WF

MU = 92.7
(1.0) (1.0)(1.0)(0.88)(1.03)(0.484)

MU=. 92.7
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0.425

MU= 218

226- (treatment plan MU)-=3.5%

218

Monitor Unit Calculation with a 15 MV 45- degree physical wedge

MU= Prescribed Dose

Dcal X Scp x IDL x TMR x ISF x WF

MU= 107.0
(1.0)(1.0)(1.0)(0.943)(1.03)(0.529)

MU= 107
0.498

MU= 215

225 (treatment plan MU)= 4.6%

215

Monitor Unit Calculation with a 6MV NO WEDGE

MU= Prescribed Dose

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Dcal X Scp x IDL x TMR x ISF

MU= 93.1
(1.0)(1.0)(1.0)(0.88)(1.03)

MU=93.1
0.88

MU=106

108- treatment plan MU= 2.1%

106

Monitor Unit Calculation with a 15MV NO WEDGE

MU= Prescribed Dose

Dcal X Scp x IDL x TMR x ISF

MU=. 107.6
(1.0)(1.0)(1.0)(0.94)(1.03)

MU=114

1 MU= Prescribed Dose

Dcal X Scp x IDL x TMR x ISF x WF
119 (treatment plan MU)
114= 4%
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Figure 11. Treatment Planning System measurements and MU calculations

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Conclusion: The overall takeaway from this experiment is measuring wedge factor it is the key
component that plays a vital role on the monitor calculations and dose response. If the data on
the wedge factor is flawed the implications on patients can lead to adverse effects, toxicity or
under -over dose within the treatment plans. Therefore, in clinical settings, once therapists and
dosimetrists use wedges it is imperative to use correct form during various treatment plans.
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References

1. Khan FM. Treatment Planning I: Isodose Distributions. In: Khan FM, Gibbons JP, eds.
The Physics of Radiation Therapy. 5th ed. Philadelphia, PA: Lippincott Williams &
Wilkins; 2014:170-194.

2. Akasaka, H., Mukumoto, N., Nakayama, M., Wang, T., Yada, R., Shimizu, Y., Osuga, S.,
Wakahara, Y. and Sasaki, R. (2019). A Comparison of Physical vs. Nonphysical Wedge
Modalities in Radiotherapy. https://www.intechopen.com/books/radiotherapy/a-
comparison-of-physical-vs-nonphysical-wedge-modalities-in-radiotherapy