X-Ray Beam Segment Size and Entrance Location Effects on the Integral Quality Monitor (IQM®) Signal and Usefulness in Predicting Complex Segment Output Signals

Background: The Integral Quality Monitor (IQM®) is an independent online dosimetry device attached to the treatment machine to monitor the accuracy of radiation delivery. Objective: This study investigates the influence of beam segment size and displacement as projected onto the IQM chamber on the signals and determine how individual signals can be added to get a combined segment signal made up of smaller segments. Material and Methods: This is an experimental original research type of study. IQM response maps were generated by irradiating the IQM sensitive area with small elementary segments and measuring their corresponding signals per monitor unit (MU). The output signal/MU was measured for regular and irregular fields and compared with the predicted signal/MU obtained from decomposing the open segment into a set of smaller regular segments and summing their signals from their respective response maps. The dependence of signals on segment size, shape, location and combination was investigated. Results: Predicted signals were calculated within 95-98 % accuracy for regular fields and 90-98% for irregular fields. More uniform fluence contain distribution for larger segments was observed. Response maps were consistent with the geometrical symmetry in the chamber’s wedge shape and the symmetry in the linac fluence. Conclusion: The field decomposition method allows the pre-calculation of known segment output signals per MU within 2% error, although the accuracy drops significantly for smaller, irregular fields. A method of correcting predicted signals in smaller segments needs to be laid down to get a better match with measured signals.