BEAM MODIFICATION DEVICES
Faja kassim
4th year BMRT
●Beam modification defined as desirable
modification in the spatial distribution of
radiation - within the patient - by insertion of
any material in the beam path.
Types of Beam modification
● Shielding: To eliminate radiation dose to some special parts of zone at which
the beam is directed.
● Compensation: To allow normal dose distribution data to be applied to
treated zone, when the beam enters obliquely through the body or where
different types of tissues are present.
● Wedge filtration: Where a special tilt in isodose curves is obtained.
● Flattening: Where the spatial distribution of natural beam is altered by
reducing central exposure rate relative to peripheral.
SHEILDING BLOCKS
●Aims of Shielding:
● Protect critical organs
● Avoid unnecessary radiation to surrounding normal tissue
● Matching adjacent fields
●An ideal shielding material should have the following characteristics:
● High atomic number.
● High-density.
● Easily available.
● Inexpensive.
● Most commonly used shielding material for photons is Lead (Pb).
● Thickness of shielding block used depends upon
energy of radiation.
● Shielding material which reduces beam transmission
to 5% of its original is considered acceptable.
CUSTOM BLOCK
●Material used for custom blocking is known as the Lipowitz metal or
Cerrobend.
●This material consist of 50% Bismath
● 26.7%Lead
● 13.3%Tin
● 10%Cadmium
●The main advantage of cerrobend over lead is that it melt at about 70
°C and easily cast into any shape.
●At room temperature it is harder than lead.
●Custom block can be of 2 type
● Positive block: Central area blocked
● Negative block: Peripheral area blocked
INDEPENDENT JAWS/
ASYMMETRICAL JAWS
● Used when we want to block a part of the field without changing the
position of isocenter.
● Independently movable jaws, allows to shield a part of the field, and this
can be used for beam splitting.
● Here beam is blocked off at the cental axis to remove the divergence.
● Use of independent jaws and other beam blocking devices results in the
shift of the isodose curves.
● This is due to elimination of photon and electrons scatter from the blocked
part of field.
MULTILEAF COLLIMATOR
● Multileaf collimators are a bank of large number of collimating blocks or leaves that can be
moved automatically independent of each other to generate a field of any shape.
● Typically MLC consist of 60- 80 pairs
● Thickness = 6 – 7.5 cm
● The individual leaf has a width of 1cm
● Made of a tungsten alloy.
● Density -17 - 18.5 g/cm3.
● Primary x-ray transmission:
● Through the leaves < 2%.
● Interleaf transmission < 3%.
● MLC’s can be used as dynamic wedge, electronic compensator
COMPENSATORS
● A beam modifying device which evens out the skin surface
contours, while retaining the skin-sparing advantage.
● It allows normal depth dose data to be used for such irregular
surfaces.
● Compensators can also be used-
● To compensate for tissue heterogeneity.
● To compensate for dose irregularities arising
due to reduced scatter near the field edges
● thickness ratio depends on:
● Compensator to surface distance.
● Thickness of the missing tissue.
● Field size.
● Depth.
● Beam quality.
●2 types of compensator
●2D compensator- Thickness varies, along a single
dimension only. It can be constructed using thin
sheets of lead, lucite or aluminum.
●3D compensator-designed to measure tissue deficits
in both transverse and longitudinal cross sections.
WEDGE FILTERS
● It causes a progressive decrease in intensity across the beam,
resulting in tilting the isodose curves from their normal positions.
Degree of the tilt depends upon the slope of the wedge filter.
Material: tungsten, brass, lead or steel.
● Usually wedges are mounted at a distance of 15 centimeters from the skin surface.
● The sloping surface is made either straight or sigmoid in shape.
● A sigmoid shape produces a straight isodose curve.
● Mounted on trays which are mounted on to the head of the gantry.
● All systems have 15°, 30°, 45°, 60° angle.
Types of wedge filter
●Physical wedge and Dynamic wedge
●Physical wedge further divided into Manual
wedge & Automatic wedge (motorized wedge).
Manual wedges further divided into
Individualized wedge & universal wedge
● Individual wedges requires a separate wedges for each beam width and
it is suitable for Cobalt beams
● Universal wedges are designed so that the same wedge can be used
with all field sizes, used mostly with linac photon beams.
● Automatic wedge is steep wedge shaped filter. It is mounted inside the
head and automatically moved into the beam infront of the flattening
filter during treatment.
● Dynamic wedge is created automatically by dynamic motion of
an independent jaw from open to closed position while the beam is
on.
●Wedge angle refers to the angle through which the isodose
curve is tilted at the central ray of a beam at a depth of
10cm.
●To obtain an uniform dose distribution
● pair of wedges are used. θ
●The angle between the central axis of the 2
●wedge angle is called Hinge angle.
FLATTENING FILTERS
● A beam flattening filter reduces the central exposure rate
relative to that near the edge of the beam.
● Used for Linear accelerators.
● Isodose curves are exhibit forward peaking.
● The filter is designed so that the thickest part is in the
centre.
● Flattening filters makes field intensity uniform.
● Material: copper or brass.
BOLUS
● A tissue equivalent material used to reduce the depth of the maximum dose (Dmax).
● Better called a “build-up bolus”.
● A bolus can be used in place of a compensator for kilovoltage radiation to even out
the skin surface contours.
● In megavoltage radiation bolus is primarily used to bring up the buildup zone near
the skin in treating superficial lesions.
● The thickness of the bolus used varies according to the energy of the radiation.
● Co60 : 2 - 3 mm ; 6 MV : 7- 8 mm
● 10 MV : 12 - 14 mm ; 25 MV: 18 - 20 mm
● Properties of an ideal bolus:
● Same electron density and atomic number.
● Pliable to conform to surface.
● Commonly used materials are:
● Cotton soaked with water.
● Paraffin wax.
● Other materials that have been used:
● Mix- D (wax, polyethylene, mag oxide)
● Temex rubber (rubber)
● Spiers Bolus (rice flour and soda bicarbonate)
● Commercial materials:
● Superflab: Thick and doesn't undergo elastic deformation. Made of synthetic oil gel.
● Superstuff: Add water to powder to get a pliable gelatin like material.
● Bolx Sheets: Gel enclosed in plastic sheet.
BREAST CONE
● A beam modifying and directing device used for a
tangential field therapy.
● Directs beam to the central axis of the area of interest,
where a tangential beam is applied to a curved surface.
● Helps position, the patient with an accurate SSD.
● End plate provides compensation, enhances surface dose
and presses down the tissue.
● Effective shielding of lungs.
PENUMBRA TRIMMERS
● Region at the edge of the beam where the dose-rate
changes rapidly as a function of distance from the
beam axis is known as penumbra.
● Penumbra trimmer consists of extensible heavy metal
bars to attenuate the beam in the penumbra region
ELECTRON BEAMS
● Electron field shaping is done using lead cutouts.
● For a low-energy electrons (<10 MeV), sheets of lead, less than 6 mm
thickness are used.
● The lead sheet can be placed directly on the skin surface.
● Shields can also be supported at the end of the treatment cone if too heavy at
the cost of greater inaccuracies.
● Design is easier, because the size is same as that of the field on the patients
skin.
● To avoid variation in output and electron scatter, jaws cannot be used to
collimate electron beams.
● An electron beam cone is therefore used to provide the collimation.
● A primary collimator is provided close to source – defines the maximum field
size.
● A secondary collimator, near the patient defines the treatment field.
SCATTERING FOIL
●Scattering foils are used when electron beam
therapy is applied.
●Pencil beam of electron are made to fall on the
scattering foil to widen the electron
●beam to be used for treatment.
●Tin, lead or aluminium are used.
BEAM SPOILERS
● Special beam modification device where shadow
trays made from Lucite are kept at a certain distance
from the skin.
● Based on the principle that relative surface dose
increases when the surface to tray distance is
reduced.
● Used in TBI to bring the surface dose to
● at least 90% of the prescribed TBI dose.
THANK YOU
