Electron Beam

Treatment Planning

Dr John McLellan
Background
Electrons suffer frequent collisions with target atoms.
An electron will interact approximately 105 times.
Energy loss is nearly continuous so electrons have a well defined range.
A definite range gives electrons an advantage for shallow tumours.
But, frequent interactions complicate the calculation of the dose
distribution.
Background
Electron beams are better suited to certain clinical situations than
photon beams.

120

9MeV Electron Beam

100
6MV Photon Beam

80
Relative Dose (%)

60

40

20

0
0 20 40 60 80 100 120 140 160
Depth (mm)
Characteristics of Depth Dose
Curves
Depth dose curves
100.0 are characterised
using various
80.0
parameters.
Dose (%)

60.0

40.0

20.0

0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Characteristics of Depth Dose
Curves
Surface dose ranges
100.0 from80% to 95%.

80.0
Dose (%)

60.0

40.0

20.0

0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Characteristics of Depth Dose
Curves
Depth of maximum
100.0 dose depends on
energy and linac
80.0 design.
Dose (%)

60.0

40.0

20.0

0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Characteristics of Depth Dose
Curves

100.0 Depth of 80% is

80.0 usually considered
the clinically useful
Dose (%)

60.0 depth of
penetration.
40.0

20.0

0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Characteristics of Depth Dose
Curves

100.0

80.0
Dose (%)

Depth of 50% is
60.0 often used as an
40.0 indicator of beam
energy.
20.0

0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Characteristics of Depth Dose
Curves

100.0

80.0
Dose (%)

60.0

40.0 Bremsstrahlung
photons create a
20.0 “tail”.
0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Characteristics of Depth Dose
Curves

100.0

80.0
Dose (%)

60.0

40.0

20.0 Practical Range

0.0
0.0 2.0 4.0 6.0 8.0
Depth (cm)
Depth Dose Curves: Dose Build-up
Dose build-up is NOT due to secondary electron build-up.
Dose build-up is NOT due to a Bragg peak as for heavy ions.
Dose build-up is due to increasing obliquity of the electron paths with
increasing depth…
Depth Dose Curves: Dose Build-up
Electrons increase their average angle of travel as they scatter in a
medium.

Incident
Electrons

Water
Depth Dose Curves: Dose Build-up
Electrons travelling obliquely deposit more energy in a given layer of
material.

Normal Oblique
Incidence Incidence

Slab of Water Slab of Water

Short Path Long Path

Depth Dose Curves: Energy
Dependence
The shape of the depth dose curve varies with energy.

120

4 MeV
100 6 MeV
9 MeV
80 12 MeV
16 MeV
Dose (%)

60

40

20

0
0 2 4 6 8 10
Depth (cm)
Depth Dose Curves: Energy
Dependence
The depth of 80% is very roughly 1/3 the beam energy.

120

4 MeV
100 6 MeV
9 MeV
80 12 MeV
16 MeV
Dose (%)

60

40

20

0
0 2 4 6 8 10
Depth (cm)
Depth Dose Curves: Energy
Dependence
Practical range is roughly half the beam energy.

120

4 MeV
100 6 MeV
9 MeV
80 12 MeV
16 MeV
Dose (%)

60

40

20

0
0 2 4 6 8 10
Depth (cm)
Depth Dose Curves: Field Size
Dependence
For fields sizes smaller than Rp, the depth of dose maximum shifts
towards the surface and the dose fall-off becomes less steep as the field
size is reduced.
Depth Dose Curves: Field Size
Dependence
120

15x15 Field
100
4x4 Field

80
Relative Dose (%)

60

40

20

0
0 2 4 6 8 10 12
Depth (cm)
Beam Penumbra
Electron scattering leads to larger penumbra than for photon beams.
The penumbra increases nearly linearly with depth.
The penumbra width depends on the linac design.
Typically, the electron field size must be 2 cm greater than the width of
the target volume.
Beam Penumbra
Electron beams have broader penumbra than photon beams.

120

100
Relative Dose (%)

80

60

6MeV Electrons
40
6MV Photons

20

0
-100 -50 0 50 100
Off-axis Distance (mm)
Calculation of Dose Distributions
Surface obliquity, surface irregularities and internal inhomogeneities are
problematical.
Ray-line methods of dose calculations don’t work since electrons don’t
travel in straight lines.
“Pencil beam” methods of dose calculation are widely used (though,
Monte Carlo is becoming increasingly used for electron beams).
The pencil beam model is useful for explaining various phenomena.
Calculation of Dose Distributions
A broad electron beam is a superposition of many narrow “pencil
beams”.
Effect of Surface Obliquity
Increasing the angle of incidence increases the apparent depth of
penetration and shifts dmax towards the surface.

>0 deg

0 deg Angle
Dose on Central Axis (%)

Depth
 Effect of Surface Obliquity
The effect may be explained using the pencil beam concept.

Normal Incidence Oblique Incidence

Surface

Surface

Pencil
Beams
Effect of Inhomogeneities
Pencil beam method uses slab approximation
Inhomogeneity lying on the central axis of a pencil beam is assumed to
extend infinitely in the lateral direction
If the central axis of the pencil beam does not pass through the
inhomogeneity, the pencil beam is assumed to lie entirely in a
homogeneous medium.
Effect of Inhomogeneities
Can estimate the dose near inhomogeneities using pencil beams and
the “infinite slab” approximation.
 Effect of Inhomogeneities
Inhomogeneities in a medium can cause “hot” and “cold” spots in the
dose distribution.

Edge of Dense
Material
Dense
Material

Hot Spot
Relative Dose

Water

Cold Spot

x
Effect of Inhomogeneities
Higher density creates broader pencil beams.
Overlap / “underlap” causes hot / cold spots.

Dense
Material

Fewer More
electrons electrons
arrive arrive
here here
Monitor Unit Calculations
The amount of dose delivered by the linac is controlled by specifying
the number of “monitor units”.
The dose per monitor unit depends on:
◦ the depth of the point (percent depth dose),
◦ the size of the beam defining “cone” (cone factor),
◦ the size of the aperture defined by the “cut-out” (cut-out factor),
◦ the source-to-surface distance (inverse square law).
Monitor Unit Calculations
The linac gives 1 cGy/MU for a reference situation.
The output for other field sizes is determined using cone and cut-out
factors.

Dref D

D/Dref = Cone Factor × Cut-out factor

Monitor Unit Calculations
The “output” (dose per monitor unit) is given by:

PDD
OP   Cone Factor  Cutout Factor  ISL
100%

• The number of monitor units required for a given

prescribed dose is:

Dose
MU 
OP
Correction for Source-to-Surface
Distance
Virtual
Electrons are spread into a Source
broad beam by the scattering
Scattering Incident
foils. Foils Electrons
They have no well defined
source.
Model electrons as though they
emanate from a single point:
the “virtual source”.
Electron
Use the virtual source distance Cone
for inverse square calculations.
Clinical Applications
Boost dose to tumour bed in breast irradiation
Irradiation of skin lesions -- especially skin lying over bone or calcified
cartilage as for the hand, nose, ear, etc...
Total skin electron irradiation
Tumours of the lip and cheek (internal shields are used to spare gums
and teeth)
Whole neck irradiation for treatment of (e.g.) larynx and nasopharynx
tumours with nodal involvement (lymph nodes may be irradiated
without over-dosing the underlying spinal cord)
Irradiation of the parotid gland with a direct lateral field