Physica Medica (2013) 29, 388e396

Available online at www.sciencedirect.com

journal homepage: http:// www.physicamedica.com

ORIGINAL PAPER

Monte Carlo simulation and measurement

of radiation leakage from applicators used
in external electron radiotherapy
Tomohiro Shimozato a,*, Kuniyasu Okudaira b, Hiraku Fuse c,
Katsuyoshi Tabushi d

a
Department of Radiation Oncology, Iwata City Hospital, 512-3 Ohkubo, Iwata, Shizuoka 4388550,
Japan
b
Department of Radiotherapy, Nagoya University Hospital, 65 Tsuruma-chou, Shouwa-ku,
Nagoya, Aichi 4668560, Japan
c
Proton Medical Research Center, University of Tsukuba, 2-2-1 Amakudo, Tsukuba,
Ibaraki 3058576, Japan
d
Department of Radiological Technology, Nagoya University School of Health Science,
1-1-20 Daikoh-minami,Higashi-ku, Nagoya, Aichi 4618673, Japan

Received 23 January 2012; received in revised form 27 May 2012; accepted 9 June 2012
Available online 7 July 2012

KEYWORDS Abstract External electron radiotherapy is performed using a cone or applicator to collimate
External electron the beam. However, because of a trade-off between collimation and scattering/bremsstrah-
radiotherapy; lung X-ray production, applicators generate a small amount of secondary radiation (leakage).
Peripheral dose; We investigate the peripheral dose outside the radiation field of a Varian-type applicator. The
Monte Carlo dose and fluence outside the radiation field were analyzed in a detailed Monte Carlo simula-
simulation tion. The differences between the calculation results and data measured in a water phantom
in an ionization chamber were less than
1% in regions more than 3 mm below the surface of
the phantom and at the depth of dose maximum. The calculated fluence was analyzed inside
and outside the radiation field on a plane just above the water phantom surface. Changing the
electron energy affected the off-axis fluence distribution outside the radiation field; however,
the size of the applicator had little effect on this distribution. For each energy, the distribu-
tions outside the radiation field were similar to the dose distribution at shallow depths in the
water phantom. The effect of secondary electrons generation by photon transmission through
the alloy making up the lowest scraper was largest in the region from the field edge to directly
below the cutout and at higher beam energies. The results of the Monte Carlo simulation

* Corresponding author.
E-mail addresses: [email protected], [email protected] (T. Shimozato).

1120-1797/$ - see front matter ª 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.ejmp.2012.06.006
Monte Carlo simulation and measurement of radiation leakage 389

confirm that the peripheral dose outside the field is significantly affected by radiation scat-
tered or transmitted from the applicator, and the effect increases with the electron energy.
ª 2012 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Introduction dose by improving the applicator design. However, the appli-

cator developed by Varian has many gaps and open sidewalls, so
In external electron radiotherapy, irradiation is generally it is possible that radiation generated by this type of applicator
performed using an applicator to collimate the beam and cannot be reduced sufficiently. Chow and Grigorov [6] later
reduce radiation leakage to tissue outside the field. confirmed the presence of peripheral doses outside of Varian-
However, special irradiation methods such as total skin type applicators by measurements using films. They reported
electron irradiation [1] are exceptions to this practice. a peripheral dose of about 1.5% for a 4-MeV electron beam.
Applicators are designed to absorb most incident electrons; In this investigation, we analyze the contributions of
however, X-ray photons are transmitted and generate radiation scattered and transmitted by the applicator to
secondary electrons, which in turn increase the absorbed the dose outside the radiation field of a Varian-type appli-
dose. Many papers [2e15] have been published on radiation cator. We compare the results of an MC simulation with
leakage outside the radiation field. Measurements using those of measurements in a water phantom in an ionization
films [2e7] and ionization chambers [2,3,5,7e12] have chamber.
been performed outside the field collimated by electron
applicators. Previous papers [8,10e14] analyzed the scat-
Material and methods
tered radiation inside the radiation field by analyzing dose
distributions in a water phantom by using Monte Carlo (MC)
simulations. For example, Ebert et al. [15] analyzed the Measurements
scattered and transmitted radiation outside the radiation
field of the Siemens KD2 linear accelerator using the MC To acquire the percentage depth ionization (PDI) and dose
method. In 1990, Perec and Kubo [4] reduced the peripheral profiles in a water phantom, the medical linear accelerator
Clinac 2100CD (Varian Medical Systems, Palo Alto, CA, USA)
and the 3D water phantom mp3 (PTW Freiburg, Freiburg,
Germany) were set up as shown in Fig. 1. The Clinac 2100CD
allows a choice of five electron energies (4, 6, 9, 12, and
16 MeV) and a set of five applicators (6  6, 10  10, 15  15,
20  20, and 25  25 cm2). Table 1 [16] lists the secondary jaw
settings for each applicator and each energy as defined by
the manufacturer. The multi-leaf collimator is normally
retracted and is not supposed to affect the beam in electron
mode. Varian-type applicators have open sidewalls and three
scrapers made of a zinc alloy. The lowest scraper, called the
standard insert, is made of zinc alloy and another alloy (58%
Bi, 42% Sn); it is provided by the manufacturer and is used
during measurement or treatment to form the radiation field
[16]. The side of the collimator nearest the patient is 95 cm
from the source. The design drawing of the electron appli-
cators does not describe the width of each scraper in detail,
although the thickness of each scraper is given. We measured
the data that did not appear in the design drawing by using
a micrometer caliper. The source-to-surface distance (SSD)
was 100 cm.

Table 1 Secondary jaw sizes (in centimeters) with elec-

tron beam applicator size and nominal electron energy. All
field sizes are defined at the isocenter distance (100 cm)
and X  Y as defined by the manufacturer [16].
Energy Applicator field size at isocenter (cm  cm)
(MeV) 66 10  10 15  15 20  20 25  25
4 20  20 20  20 20  20 25  25 30  30
Figure 1 Experimental set up for depth profile and off-axis 6 20  20 20  20 20  20 25  25 30  30
profile measurement using the ionization chamber and the 3D 9 20  20 20  20 20  20 25  25 30  30
water phantom. The parallel plane ionization chamber was 12 11  11 14  14 17  17 25  25 30  30
used to measure the depth dose profile, and the thimble 16 11  11 14  14 17  17 23  23 28  28
ionization chamber was used to measure the off-axis profile.
390 T. Shimozato et al.

Table 3 Differences (calculated minus measured) in

percentage depth dose values for 10  10 cm2 applicator at
each energy.
Depth Energy (MeV)
(cm) 4 6 9 12 16
0.50 0.98% 1.00% 0.98% 0.97% 0.88%
0.75 0.00% e e e e
1.00 1.00% 0.84% 0.89% 0.98% 0.93%
1.40 e 0.00% e e e
1.50 0.80% 0.21% 0.61% 0.47% 0.39%
2.00 0.17% 0.76% 0.36% 0.05% 0.97%
2.20 e e 0.00% e e
2.50 0.00% 0.15% 0.57% 0.16% 0.73%
2.80 e e e 0.00% e
3.00 0.01% 0.69% 0.93% 0.04% 0.18%
3.50 0.01% 0.03% 0.92% 0.20% 0.00%
4.00 0.00% 0.01% 0.47% 0.26% 0.15%
4.50 e 0.02% 0.15% 0.12% 0.27%
5.00 e e 0.05% 0.36% 0.42%
5.50 e e 0.03% 0.74% 0.12%
6.00 e e e 0.59% 0.01%
6.50 e e e e 0.21%

Figure 2 Schematic geometry of the linear accelerator’s treatment head configuration consisted of a primary colli-
gantry head for MC simulation using BEAMnrc code. All mator, exit window, primary scattering foil, secondary
dimensions are in centimeters. scattering foil, monitor chamber, mirror, upper and lower
jaws, Mylar screen, and applicator, as shown in Fig. 2. The
A TM34045 (PTW Freiburg) parallel plane ionization chamber manufacturer provided detailed information about the
was used to measure the PDI in the water phantom. The PDI was geometry, material composition, and dimensions of each
converted to the percentage depth dose (PDD) according to component under a confidential agreement. The boundary
AAPM TG51 [17] using the dose analysis software MEPHYSTO Ver. crossing algorithm was set to EXACT, and spin effects were
7.42 (PTW Freiburg). Next, the off-axis ratios (OARs) on the turned on. The electron step algorithm was PRESTA-II, and
cross-line (transverse direction) dose profiles were measured at
a depth of 5 mm (Rs), the depth of dose maximum (R100), the
depth of a 90% dose (R90), the depth of a 50% dose (R50), and the Table 4 Differences (calculated minus measured) in off-
practical range (Rp) as defined by AAPM TG25 [18] using axis ratios for 10  10 cm2 applicator at 5-mm depth (Rs)
a TM31010 (PTW Freiburg) thimble ionization chamber with an for each energy.
effective volume of 0.125 cm3. The doses measured at off-axis Distance Energy (MeV)
points of interest were normalized to the dose at the central from 4 6 9 12 16
beam axis in a water phantom for the given electron energy. central
axis (cm)
Monte Carlo simulation 0.00 0.00% 0.00% 0.00% 0.00% 0.00%
1.00 0.50% 0.89% 0.75% 0.41% 1.00%
Establishment of linear accelerator gantry head 2.00 0.39% 0.75% 0.26% 0.75% 0.98%
configuration 3.00 0.14% 0.32% 1.00% 0.13% 0.64%
The MC simulation was performed using EGSnrc [19]. The 4.00 1.31% 1.19% 0.59% 1.43% 1.78%
treatment head was modeled using BEAMnrc [20]. The 5.00 1.71% 3.33% 3.89% 3.90% 0.51%
6.00 1.86% 0.73% 0.45% 0.79% 1.22%
Table 2 Parameters of incident electrons in MC 7.00 0.08% 0.06% 0.06% 0.19% 0.34%
simulation. 8.00 0.02% 0.00% 0.14% 0.21% 0.35%
9.00 0.01% 0.01% 0.00% 0.12% 0.15%
Energy Spot size Mean energy eFWHM 10.00 0.00% 0.05% 0.06% 0.02% 0.10%
(MeV) (cm) (MeV) (%) 11.00 0.03% 0.04% 0.04% 0.05% 0.03%
4 0.20 4.27 3.0 12.00 0.01% 0.08% 0.10% 0.10% 0.09%
6 0.15 6.90 3.0 13.00 0.12% 0.18% 0.19% 0.20% 0.15%
9 0.17 9.90 3.0 14.00 0.23% 0.15% 0.15% 0.16% 0.17%
12 0.15 13.40 3.0 15.00 0.22% 0.14% 0.09% 0.11% 0.18%
16 0.17 17.40 3.0 16.00 0.11% 0.19% 0.17% 0.16% 0.12%
Monte Carlo simulation and measurement of radiation leakage 391

Figure 3 Dose distributions in the cross-line (transverse) direction as measured by the ionization chamber (solid lines) and
calculated using the MC simulation (circles) at 5-mm depth (Rs) in the water phantom at beam energies of (a) 4 MeV, (b) 6 MeV, (c)
9 MeV, (d) 12 MeV, and (e) 16 MeV for the 10  10 cm2 applicator. Each data point was normalized by the depth of dose maximum for
each energy. Insets show magnified graphs outside the field edge. Error bars indicate one standard deviation results calculated
using the MC simulation.

the maximum fractional energy loss per step (ESTEPE) was electron beam were adjusted iteratively until the measured
set to 0.25. In BEAMnrc, transport parameters of and simulated PDD and OAR values agreed to within
1%.
AP Z PCUT Z 0.01 MeV and AE Z ECUT Z 0.521 MeV were Table 2 lists the parameters of the incident electrons for
selected. Phase space data were scored at 100 cm SSD. The each energy: the spatial spread (spot size, shown as full
secondary jaws for each applicator were set to the positions width at half maximum [FWHM]), mean energy, and eFWHM
specified by the manufacturer (Table 1). The source was (FWHM of energy spread). The number of particle histories
simulated with a Gaussian energy distribution using ISO- was determined such that the statistical uncertainty would
URC Z 19 in BEAMnrc, which represents a parallel circular be within
1% for each PDD in the region from R100 to Rp
beam with a Gaussian radial distribution [21]. and for the OARs inside the radiation field at R100. The
Phase space data were used as input to compute the number of primary electrons ranged from 200 million to 400
dose distribution in a heterogeneous water phantom million for the BEAMnrc simulation, depending on the
using the EGSnrc/DOSXYZnrc code [22]. In DOSXYZnrc, electron energy. For the DOSXYZnrc simulation, the number
transport parameters of AP Z PCUT Z 0.01 MeV and of histories was 5000 million. The material library PEGS4
AE Z ECUT Z 0.521 MeV were selected. The mean ener- (Preprocessor for EGS4) data file was used, and materials
gies, energy spread, and spatial spread of the incident that did not appear by default in PEGS4 were added and
392 T. Shimozato et al.

Figure 4 Fluence distribution inside the radiation field for (a) 4 MeV, (b) 6 MeV, (c) 9 MeV, (d) 12 MeV, and (e) 16 MeV electron
beams for the 10  10 cm2 applicator.

calculated by EGSnrcMP (EGSnrc multi-platform) [23]. The Analysis of scattered and transmitted radiation from
computation times ranged from 216 to 729 h for BEAMnrc applicator
simulation and from 92 to 221 h for the DOSXYZnrc simu- BEAMDP [26] was used to analyze the phase space data
lation, depending on the incident electron energy. The acquired in BEAMnrc. The 2D distributions were analyzed,
simulation was performed in Microsoft Windows XP SP2 with and the spectral fluence distributions were generated for
the g77 compiler installed on an Intel Core2 Duo E6850 the selected component using the LATCH option to identify
3.0 GHz processor with 2.0 GB of RAM. the type and position of scattered radiation. Consequently,
The calculation grid size was 0.1  0.1  0.1 cm3. the dose distribution and fluence generated by scattered
STATDOSE [24] was used to extract the PDDs and OARs from radiation from various components could be analyzed.
the DOSXYZnrc water phantom dose distributions. The size The spectral fluence inside and outside the radiation
of the geometrical field was defined as 100 cm SSD. The size field for each applicator was obtained using BEAMDP to
of the radiation field was defined as the FWHM when the investigate the differences in the fluence distribution due
OAR value was normalized on the central beam axis at to variations in the applicator size or electron energy. The
100 cm SSD. The difference between the geometrical and purpose was to investigate the contributions of transmitted
radiation fields was maintained at less than 2 mm or
1%, in and scattered radiation to the dose distribution in the
accordance with AAPM TG40 [25]. water phantom.
Monte Carlo simulation and measurement of radiation leakage 393

Figure 5 Fluence distribution outside the radiation field for (a) 4 MeV, (b) 6 MeV, (c) 9 MeV, (d) 12 MeV, and (e) 16 MeV electron
beams for the 10  10 cm2 applicator.

Results and discussion OARs differed from the measurements by less than 0.5%.
Table 4 lists the differences between the measured and
Comparison of calculated and measured data calculated OARs at Rs for each energy for the 10  10 cm2
applicator.
The dose distributions measured outside the 10  10 cm2
The differences between the calculated and measured PDD
applicator at Rs in the water phantom for the 4- and 6-MeV
values were less than
1% for each energy in the region
electron beams exhibited a local peak and a peripheral
from R100 (depth of dose maximum) to Rp. The disagree-
dose, as shown in Fig. 3. These peaks were located about
ment was larger (a maximum of 13%) close to the phantom
12 cm from the central beam axis for 4- and 6-MeV electron
surface. This difference is due to the waterproof enclosure
energies. The local peaks for the other energies were
of the parallel plane chamber, which affects the depth
discrete. Because the radiation transmitted through the
profile at the surface of the phantom. Table 3 lists the
standard insert alloy increased as the electron energy
differences between the measured and calculated PDD
increased, a distinct difference appeared between the dose
values for each energy using the 10  10 cm2 applicator.
below the standard insert alloy and that outside the
The calculated OARs for each energy agreed with the
applicator. The differences between the measured and
measurement to within
1% inside the radiation field at
calculated OAR data were less than
0.5% at both Rs
both Rs and Rp. Outside the radiation field, the calculated
394 T. Shimozato et al.

outside the radiation field. However, they became larger at electron fluence generated by the secondary jaws and
greater distances from the central beam axis. These applicator inside the radiation field at 100 cm SSD changed
differences occurred because the electronic components very little with the electron energy. A number of electron
and the lead blocks shielding the target, the monitor fluence components existed on the periphery of the
chamber, and the jaw inside the treatment head could not maximum energy. The lower-energy photon component and
be simulated accurately and were not included in the the photon fluence per energy bin increased as the accel-
design drawing. Because the design drawing did not include erating energy increased. Figure 5 shows the peripheral
an accurate thickness for each scraper in the applicator, fluence distributions on a plane at 100 cm SSD for each
the error in the thickness measured using the caliper energy outside of the radiation field for the 10  10 cm2
affected the results calculated outside the applicator. applicator. All of the fluence outside the applicator was
generated by radiation transmitted or scattered by the
secondary jaws and applicator, and a small fluence due to
Fluence of scattered and transmitted radiation scattered electrons contributed to the total fluence. The
from the applicator fluence contributions from electrons and photons gener-
ated by the applicator exhibited similar trends for each
The fluence distributions for each energy inside the radia- energy. The electron fluence peripheral to the maximum
tion field at 100 cm SSD for the 10  10 cm2 applicator are energy increased at low accelerating energies. The fact
shown in Fig. 4. The shape of the distribution of the that the angle of radiation scattered by the Compton effect

Figure 6 Fluence values in the cross-line (transverse) direction for applicator sizes of (a) 6  6 cm2, (b) 10  10 cm2,
(c) 15  15 cm2, (d) 20  20 cm2, and (e) 25  25 cm2 for the 4-MeV electron beam.
Monte Carlo simulation and measurement of radiation leakage 395

is large for lower accelerating energies seemed to account Figure 7 shows the fluence distribution for each electron
for the increases in electron fluence outside the applicator. energy in the cross-line direction for the 10  10 cm2
Figure 6 shows the fluence distributions for various applicator. At each energy, the fluence outside the appli-
applicator sizes in the cross-line (transverse) direction for cator was produced by photons and electrons (including
the 4-MeV electron beam at 100 cm SSD. The distance from positrons) generated by interactions with the applicator.
the edge of the radiation field to the local peak was about The fluence of photons below the “standard insert” corre-
7 cm regardless of the applicator size. Thus, the scattering sponding to the field size determined at the lowest scraper
angle of radiation scattered from the applicator changed increased as the accelerating energy increased. The
very little despite variations in the applicator size. The increase in the dose between the edge of the radiation field
maximum fluence intensity at the local peak was 1.5% for and the local peak (Fig. 3) is attributed to enhancement by
the 25  25 cm2 applicator. Although the photon fluence secondary electrons generated by photons impacting this
outside the applicator for the 4-MeV electron beam also region and passing through the lowest scraper.
showed a local peak, the dose delivered by the photon According to our MC analysis, the fluence entered the
fluence did not strongly affect the dose profile in the water water phantom; we investigated which components of the
phantom, as shown in Fig. 3. This result shows that the scattered and transmitted radiation affected the absorbed
contribution to the dose from secondary electrons gener- dose inside the phantom. Although the Varian-type appli-
ated by photons was low for the 4-MeV electron beam. cator is an improvement over older applicators, its shape
These results agree with the data measured by Chow and has many gaps and open sidewalls; however, there was very
Grigorov [6] using films. little radiation leakage, and it proved to be an excellent

Figure 7 Fluence values in the cross-line (transverse) directions for beam energies of (a) 4 MeV, (b) 6 MeV, (c) 9 MeV, (d) 12 MeV,
and (e) 16 MeV electron beams for the 10  10 cm2 applicator.
396 T. Shimozato et al.

unit. Possible methods of reducing the radiation leakage [8] Kassaee A, Altschuler MD, Ayyalsomayajula S, Bloch P. Influ-
outside the applicator include increasing the scraper ence of cone design on the electron beam characteristics on
thickness or using a denser material for the scraper. clinical accelerators. Med Phys 1994;21(11):1671e6.
However, these changes may reduce the flat region in the [9] Yeboah C, Karotki A, Hunt D, Holly R. Quantification and
reduction of peripheral dose from leakage radiation on
radiation field. In addition, although increasing the scraper
siemens primus accelerators in electron therapy mode. J Appl
thickness is expected to reduce the transmitted radiation Clin Med Phys 2010;11(3):154e72.
below the scrapers, it may also increase the scattered [10] Edimo P, Clermont C, Kwato MG, Vynckier S. Evaluation
radiation outside the applicator. of a commercial VMCþþ Monte Carlo based treatment
planning system for electron beams using EGSnrc/-
BEAMnrc simulations and measurements. Phys Med 2009;
Conclusions 25:111e21.
[11] O’Shea TP, Sawkey DL, Foley MJ, Faddegon BA. Monte Carlo
Radiation in the peripheral regions of the defined appli- commissioning of clinical electron beams using large field
cator fields in a Varian linac was investigated in this study. measurements. Phys Med Biol 2010;55:4083e105.
The applicator we examined was superior to the older types [12] Battum LJ, Zee W, Huizenga H. Scattered radiation from
applicators in clinical electron beams. Phys Med Biol 2003;48:
of applicators reported in the literature [4] and reduced the
2493e507.
scattered radiation. The results of our study were similar to [13] Zhang GG, Rogers DWO, Cygler JE, Mackie TR. Monte Carlo
those of a previous study [6], which reported that the investigation of electron beam output factors versus size of
peripheral dose outside the applicator was about 1.5%. We square cutout. Med Phys 1999;26(5):743e50.
conducted a detailed analysis of the peripheral dose by [14] Ebert MA, Hoban PW. A model for electron-beam applicator
measurements and an MC simulation. It is necessary to scatter. Med Phys 1995;22(9):1419e29.
analyze each linear accelerator in detail because the [15] Ebert MA, Hoban PW. A Monte Carlo investigation of electron-
configuration inside the accelerator head and the shape of beam applicator scatter. Med Phys 1995;22(9):1431e5.
the applicator vary depending on the type of accelerator [16] Monte Carlo data package. Varian medical systems. DWO
and the manufacturer. Investigating the peripheral dose is No.100040466e100040501 rev.1.
[17] Almond PR, Biggs PJ, Coursey BM, Hanson WF, Huq MS, Nath R,
prudent because it is usually not fully accounted for by
et al. AAPM’s TG-51 protocol for clinical reference dosimetry
commercial treatment planning systems. of high-energy photon and electron beams. Med Phys 1999;
This study analyzed only the square fields formed by the 26(9):1847e70.
alloy used for the standard insert during beam data measure- [18] Khan FM, Doppke KP, Hogstrom KR, Kutcher GJ, Nath R,
ment and not the complex fields formed by low-melting lead Prasad SC, et al. Clinical electron-beam dosimetry: report of
alloy. Such research will be conducted in the future. AAPM radiation therapy committee task group no. 25. Med
Phys 1991;18(1):73e109.
[19] Kawrakow I, Mainegra-Hing E, Rogers DWO, Tessier F,
References Walters BRB. The EGSnrc code system: Monte Carlo simulation
of electron and photon transport. NRCC report PIRS-701;
[1] Khan FM. The physics of radiation therapy. 3rd ed. Phila- 2011.
delphia, PA: Lippincott Williams & Wilkins; 2003. p. 340e8. [20] Rogers DWO, Faddegon BA, Ding GX, Ma CM, We J, Mackie TR.
[2] Richard A, Keys MA, Purdy JA. Radiation leakage from linac BEAM: a Monte Carlo code to simulate radiotherapy treatment
electron applicator assembly. Int J Radiat Oncol Biol Phys units. Med Phys 1995;22(5):503e24.
1984;10(5):713e21. [21] Rogers DWO, Walters B, Kawrakow I. BEAMnrc users manual.
[3] Das KR, Cramb JA, Millar M, Kenny MB, Patterson WR, NRCC report PIRS-0509(A)revL; 2011.
Ackerly TL, et al. Levels of leakage radiation from electron [22] Walters B, Kawrakow I, Rogers DWO. DOSXYZnrc users manual.
collimators of a linear accelerator. Med Phys 1990;17(6): NRCC report PIRS-794revB; 2011.
1058e63. [23] Kawrakow I, Mainegra-Hing E, Rogers DWO. EGSnrcMP: the
[4] Perec A, Kubo H. Radiation leakage through electron applica- multi-platform environment for EGSnrc. NRCC report PIRS-
tors on clinac-1800 accelerators. Med Phys 1990;17(4):715e9. 877; 2006.
[5] Pennington EC, Jani SK, Wen BC. Leakage radiation from [24] McGowan HCE, Faddegon BA, Ma CM. STATDOSE for 3D dose
electron applicators on a medical accelerator. Med Phys 1988; distributions. NRCC report PIRS-0509(F); 2007.
15(5):763e5. [25] Kutcher GJ, Coia L, Gillin M, Leibel S, Morton RJ, Palta JR,
[6] Chow JCL, Grigorov GN. Peripheral dose outside applicators in et al. Comprehensive QA for radiation oncology: report of
electron beams. Phys Med Biol 2006;51:N231e40. AAPM radiation therapy committee task group 40. Med Phys
[7] Wen BC, Pennington EC, Hussey DH, Jani SK. Alopecia asso- 1994;21(4):581e618.
ciated with unexpected leakage from electron cone. Int J [26] Ma CM, Rogers DWO. BEAMDP users manual. NRCC report PIRS-
Radiat Oncol Biol Phys 1989;16(6):1637e41. 0509(C)revA; 2009.