Investigation of physical penumbra definition in treatment planning

Background: Due to the small size of the beamlets in IMRT (intensity modulated radiotherapy), physical penumbra is one of the important dosimetric parameters and small changes in the penumbra have a notable impact on the results. The physical penumbra width is defined as the lateral distance between two specified isodose curves at a specified depth of phantom. In this study, after demonstrating the inconsistency of conventional physical penumbra definition for non-uniform MLC (multileaf collimator) fields, two new dosimetric parameters proposed that are suitable for MLC fields. Materials and Methods: Physical penumbra evaluation was obtained using IAEA (international atomic energy agency) phase space data for a Varian IX and EGS (electron gamma shower)nrc Monte Carlo code package. These measurements have been performed in water phantom at an SSD of 100 cm and a depth of 5 cm. Results: With conventional definition, physical penumbra width for all MLC setups on right and left sides of isodose curves (parallel to X and Y axes) are not equal. With a novel beam penumbra parametrization, the effect of MLC setup is taken into consideration. Conclusion: The conventional definition of physical penumbra for non-uniform MLC setups is not comprehensive. For such cases, surface penumbra and uniformity index parameters are demonstrated to be more suitable and indicative of the field non-uniformity. It is also shown that for an idle treatment planning system, the uniformity index approaches unity.