Spatial distribution of bremsstrahlung in a dual electron beam used in total skin electron treatments: Errors due to ionization chamber cable irradiation

The spatial distribution of the bremsstrahlung dose in total skin electron therapy and large electron fields has been assumed to be symmetric along the match line; however, the measured data in the entire plane have not been available. Das et al [“Spatial distribution of bremsstrahlung in total skin electron irradiation,” Med. Phys. 19, 810 (1992)] reported the ion-chamber measured bremsstrahlung data in the Stanford six-field technique and found that the bremsstrahlung dose profile was 2.5 times greater in the caudal plane (beam facing toward floor) as compared to the cephalic plane. This observation was recently quoted by Klevenhagen [Physics and Dosimetry of Therapy Electron Beams (Medical Physics, Madison, WI, 1993)]. Further study using thermoluminescent dosimeters and careful measurements using ion chambers showed that the bremsstrahlung radiation was indeed symmetric at the match line as theoretically predicted and was not a function of the beam angle or the type of floor. The earlier observations of Das et al. were found to be due to cable effects. Ionization chamber cable response in a large electron field and the associated errors in the bremsstrahlung distribution are presented. It is suggested that a cable-free dosimeter should be used for measuring low levels of bremsstrahlung radiation in large electron fields and at extended distances.