KV Machines, Cobalt Units and Beam Quality: James Beck

KV machines, Cobalt units
and beam quality
James Beck
General design
50cm
Steel container
filled with lead
Co60 source
Isocentre
at 80cm
Controlling exposure
- Moving shutter
Shutters must have some
overlap to minimise risk
Beam on Beam off
- Moving shutter
Rotating design
- Moving source
Beam off Beam on
 Timer starts when

source begins to
move
 Exposure starts
when source is in
position
Difference = timer error

 must be measured regularly
 affects patient dose
 is needed to calculate exposure time
Radiation energy spectrum
Intensity
1 2
Energy (MeV)
 1.17MeV and 1.33MeV, emitted with almost equal

intensity
 Similar to the average energy from a 4MV x-ray
spectrum
Rate of decay
 Half life = 5.27 years

 = about 1% per month
 Treatment times get longer as the
source decays
 Source needs replacing at roughly 5
year intervals
Safety
 The source is always emitting radiation
- you can’t turn it off
 The treatment room is never at
background radiation levels
 Regular wipe tests are needed to
check that source remains totally
sealed.
Cost
 Installation cost is less than for a linac
…but…….
 Replacement source is expensive

 You have to pay for safe disposal of the
source on decommissioning
Penumbra
The larger size of the source means that the geometric

penumbra is much wider than for an x-ray machine or
linac.
source
collimators
patient
penumbra
Summary
• Advantages:
– Reliable
– Low maintenance costs
– Long half life
• Disadvantages:
– Storage /disposal of radioactive sources
• safety and cost implications
– Lower dose rates compared to linacs
– Energy restricted
– Large penumbra due to source size
– Ongoing cost of source replacement
Kilovoltage Machines
X-rays are produced whenever electrons are brought

suddenly to rest.
Key features of an X-ray tube
• Electrons produced by heated filament (the
cathode).
• Potential difference applied (in kilovolts or kV).
• Electrons accelerated towards target (the

anode) made of tungsten.
• Evacuated glass tube (old design) or metal

ceramic tube (smaller, lighter and less
breakable.)
Therapy X-ray tube
What happens in the target?
X-rays are produced by the interaction of

the electrons from the filament (cathode)
with the material of the target.
Bremmstrahlung
(braking radiation)
X-ray photon
Electrons passing
close to the nucleus lose
electron
some of their energy as they
slow down. This energy is
carried away as an X-ray nucleus
photon.
Occasionally an electron is stopped,

producing an X-ray photon of maximum
energy equal to the total energy of the
electron (kVp).
Characteristic Radiation
Electrons from the
cathode interact
with individual
electron
electrons in the
atom
An electron from the photo-

atom’s shells is electron
knocked out leaving
the atom ionised deflected
electron
X-ray
Electron from
L-shell drops
down to K- The vacancy in the
shell shell is quickly filled
by an electron from
another shell and an
X-ray is produced
X-ray Spectrum
The continuous
Characteristic spectrum contains all
radiation
energies from a
certain maximum
(kVp) downwards
whereas the
Continuous characteristic
Spectrum
spectrum is specific
to the atoms making
up the target.
Spatial distribution of X-rays
For 50-150kVp, X-rays are produced in all directions, but at higher energies emission is
concentrated more in a forward direction.
In practice, electrons undergo many collisions, changing direction many times before
coming to rest and penetrate beneath the surface of the target. X-rays produced at depth
in the target suffer attenuation as they emerge and this affects the uniformity of the
beam.
Heel Effect
X-rays produced along
θ
ray “c” will pass through
Electron
stream target more of the target than
“a” and “b” and so
undergoes greater
attenuation. This is
a particularly evident in
c
b diagnostic therapy to
produce a small focal
spot.
X-ray emission can be described in terms of:
Quantity
• the intensity of the X-rays
Quantity
• the intensity of the X-rays
Quality
• a measure of the penetration of the beam
• depends upon the energy spectrum
• a “hard” beam has more energetic photons
than a “soft” beam.
Effect of Target Material
Effect of Target Material
Continuous spectrum
Intensity α z
but shape of spectrum
is independent of
target material.
Line spectrum:
lines are characteristic
of target material.
At 80-150kV they
contribute approx. 10% of
the dose.
Effect of Applied Voltage
Effect of Applied Voltage
For the continuous spectrum, applied voltage affects:

• Maximum energy
• Position of peak intensity
• Total intensity (I) α kV2
Effect of tube current
Effect of tube current
Intensity α mA
Spectrum remains the same shape but the

greater the current the greater the number of
electrons released from the filament and
therefore the more radiation produced.
Effect of Voltage Waveform
Effect of Voltage Waveform
This can affect the intensity of the beam and the position of
the peak intensity.
Factor Effect on Effect on
Quality Quantity
Target material Continuous x Iαz
Characteristic 
Applied  I α kV2
Voltage
Tube Current x I α mA
Voltage  
Waveform
Added filtration  
Efficiency of X-ray production
• Increases with atomic number of target
• Increases with kV
Operating Percentage of Percentage of

Voltage Energy to Heat Energy to X-
rays
60kV 99.5% 0.5%
200kV 99% 1.0%
4MV 60% 40%
20MV 30% 70%
More about therapy tubes:
• Typical length – roughly twice as long as a diagnostic tube because
the higher kV. This is to avoid sparking between the electrodes.
• Cooling – the tube current is ~1/10 of that of a diagnostic tube but is

run for a much longer time (in order to deliver a useful dose in a few
minutes). The target is embedded in Cu (a good conductor of heat)
which can then be further cooled by the circulation of oil.
• Focal spot size – much bigger than diagnostic focal spot which must
be small to give good image definition.
• Target angle – chosen to give the most uniform beam.
• Typical SSD - usually around 50cm which is a compromise

between adequate output (better at short SSD) and sufficient
penetration (better at longer SSD).
Desirable effect of filtration
Beam Filtration
Effects of filtration:
• Beam hardening
• Reduced intensity
Requirements of a filter
• Greater attenuation of lower energy radiation
• Acceptable balance between beam hardening
and reduced intensity
• No absorption edge in the useful range
Essential requirements of a suitable filter
In the energy range to be filtered, the linear attenuation coefficient*
decreases with increasing energy. This means that, of the three
attenuation processes, the photoelectric effect dominates.
*The linear attenuation coefficient represents the probability per unit

thickness that any one photon will interact.
Another way of looking at this…
Of the 3 attenuation processes: 1
3
Attenuation due to PE is proportional to  E 
1
CE is proportional to  
E
While PP only occurs above 1.02MeV
So the photoelectric effect must dominate.

Photoelectric effect also varies with z3 and so filter
material should have a high atomic number.
Desirable effect of Effect achieved in
filtration: practice:
• The filter must not be too thin as the thickness
must be uniform, with no possible pinhole.
However, a filter that is too thick may reduce the
intensity of the beam excessively – this problem
must be balanced against the beam hardening
achieved.
• In the useful energy range, an “absorption edge”

should be avoided. It could have an undesirable
effect.
• Absorption edges exist because bound electrons have
discrete energies.
• As photon energy
increases, attenuation
by P.E. decreases
according to
 Z3

E3
until the binding energy (Ek) of the electron shell is
reached. At this energy the P.E. absorption leaps to a
higher value and then decreases again as the energy is
increased.
The effect of an absorption edge in the useful
energy range
Composite filters
Another problem involving the photo-electric effect
is the production of characteristic radiation.
When this is significant, the filter can be backed
with another material to absorb it.
E.g. Tin produces characteristic radiation at 29keV. A copper backing

will absorb this but produces its own characteristic radiation at 9keV. A
further backing of Aluminium will remove this – it’s own
characteristic radiation is of such a low energy that it is removed by air.
Composite filters contd.
• E.g.
Summary of Suitable Filters
30 – 120kV Aluminium
100 – 250kV Copper + backing
200 – 600kV Tin + backing
600kV – 2MV Lead + backing
Above 2MV none

Added filtration
Name kV Treatment Filtration
Depth
Orthovoltage 150-400 A few cm Cu+Al
X-rays or Sn, Cu
+Al
Superficial 50-150 ~5mm Al
X-rays (perhaps Cu)
Grenz Rays 10-20 very plastic

superficial
Specifying beam quality
Why?
• To be able to predict the penetrative
characteristics of the beam.
• For dosimetry purposes. Dosimetry protocols
and data from standard laboratories are
specified in terms of energy.
• For machine purchasing
• Use with QC checks
• Intercomparisons / clinical studies between
different centres.
• The radiation quality cannot be solely described
by the KV used to generate the electrons. It is
standard practice to define it instead in terms of
the Half Value Layer (or thickness) HVL i.e. the
thickness of a specified absorber which reduces
the beam intensity to half its original value.
• This parameter describes the ability of the beam

to penetrate a material and hence is linked to a
clinically significant parameter.
shielding
treatment beam
detector
x-ray
source
sheets of
absorber
Intensity Log (Intensity)
100
50
HVL Thickness Thickness

The HVL is obtained by measurement of an
absorption curve using the specified material.
The ratio of the first to second HVL is termed the

homogeneity index and is 1 for a mono-energetic
beam and less than 1 for heterogeneous beams.
i.e. for mono-energetic beams

second HVL= first HVL
for a spectrum of energies
second HVL > first HVL
An important consideration when measuring HVL is the use of good
geometry and the reduction of scattered radiation. When a broad beam
is incident on sheets of attenuating material there will be additional
scattered radiation as well as the primary radiation.
Narrow beam geometry Broad beam geometry
absorbing
material
shielding
absorbing
material
detector only measures transmitted scatter radiation from the metal

radiation and hence correct HVL reaches detector and affects HVL
measurement
The use of broad beam as opposed to narrow beam geometry falsely
results in a more penetrating beam, the amount of which depends on
the field size.
Intensity
100
50
broad beam
narrow beam
HVL Thickness of material
Thus the use of broad beam geometry will result in an incorrect

measurement of HVL.
HVL is related to the attenuation coefficient of the beam by:
I  I 0 e  t
0.693

HVL
NB 1 HVL reduce intensity by a factor of (2)1 = 2
2 HVLs reduce intensity by a factor of (2)2 = 4
10 HVLs reduce intensity by a factor of (2)10 = 1024
• Care must be taken in choice of the purity of the attenuating sheets

especially at low energies due to photoelectric absorption.
• Also need scatter free environment (away from walls etc.)
• Beams are thus specified in terms of their HVL and kV.

30kV and below
Instead of HVL we use Half Value Depth (HVD).
HVD = depth in water at which absorbed dose rate
falls to half of its value at the surface.
Fixed
SSD
detector
water

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KV machines, Cobalt units

and beam quality

 Timer starts when

Difference = timer error

 1.17MeV and 1.33MeV, emitted with almost equal

 Half life = 5.27 years

 Replacement source is expensive

The larger size of the source means that the geometric

X-rays are produced whenever electrons are brought

• Potential difference applied (in kilovolts or kV).

• Electrons accelerated towards target (the

• Evacuated glass tube (old design) or metal

X-rays are produced by the interaction of

Occasionally an electron is stopped,

An electron from the photo-

For the continuous spectrum, applied voltage affects:

Spectrum remains the same shape but the

Operating Percentage of Percentage of

• Cooling – the tube current is ~1/10 of that of a diagnostic tube but is

• Target angle – chosen to give the most uniform beam.

• Typical SSD - usually around 50cm which is a compromise

*The linear attenuation coefficient represents the probability per unit

Attenuation due to PE is proportional to  E 

While PP only occurs above 1.02MeV

So the photoelectric effect must dominate.

• In the useful energy range, an “absorption edge”

E.g. Tin produces characteristic radiation at 29keV. A copper backing

100 – 250kV Copper + backing

200 – 600kV Tin + backing

600kV – 2MV Lead + backing

Above 2MV none

Grenz Rays 10-20 very plastic

• This parameter describes the ability of the beam

Intensity Log (Intensity)

HVL Thickness Thickness

The ratio of the first to second HVL is termed the

i.e. for mono-energetic beams

Narrow beam geometry Broad beam geometry

detector only measures transmitted scatter radiation from the metal

HVL Thickness of material

Thus the use of broad beam geometry will result in an incorrect

• Care must be taken in choice of the purity of the attenuating sheets

• Also need scatter free environment (away from walls etc.)

• Beams are thus specified in terms of their HVL and kV.

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