Monte Carlo dosimetry study of a 6 MV stereotactic radiosurgery unit

Small-field and stereotactic radiosurgery (SRS) dosimetry with radiation detectors, used for clinical practice, have often been questioned due to the lack of lateral electron equilibrium and uncertainty in beam energy. A dosimetry study was performed for a dedicated 6 MV SRS unit, capable of generating circular radiation fields with diameters of 1.25-5 cm at isocentre using the BEAM/EGS4 Monte Carlo code. With this code the accelerator was modelled for radiation fields with a diameter as small as 0.5 cm. The radiation fields and dosimetric characteristics (photon spectra, depth doses, lateral dose profiles and cone factors) in a water phantom were evaluated. The cone factor (S(t)) for a specific cone c at depth d is defined as St(d, c) = D(d, c)/D(d, c(ref)), where c(ref) is the reference cone. To verify the Monte Carlo calculations, measurements were performed with detectors commonly used in SRS such as small-volume ion chambers, a diamond detector, TLDs and films. Results show that beam energies vary with cone diameter. For a 6 MV beam, the mean energies in water at the point of maximum dose for a 0.5 cm cone and a 5 cm cone are 2.05 MeV and 1.65 MeV respectively. The values of S(t) obtained by the simulations are in good agreement with the results of the measurements for most detectors. When the lateral resolution of the detectors is taken into account, the results agree within a few per cent for most fields and detectors. The calculations showed a variation of S(t) with depth in the water. Based on calculated electron spectra in water, the validity of the assumption that measured dose ratios are equal to measured detector readings was verified.