{'fraction_non_alphanumeric': 0.0324141267537494, 'fraction_numerical': 0.02370585389453314, 'mean_word_length': 5.100294985250738, 'pattern_counts': {'":': 0, '<': 1, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
SU-F-T-551: Beam Hardening and Attenuation of Photon Beams Using Integral Quality Monitor in Radiotherapy.

PURPOSE
Aim of the multi-centre study was to analyse beam hardening effect of the Integral Quality Monitor (IQM) for high energy photon beams used in radiotherapy with linear accelerators. Generic values for attenuation coefficient k(IQM) of IQM system were additionally investigated.


METHODS
Beam hardening effect of the IQM system was studied for a set of standard nominal photon energies (6 MV-18 MV) and two flattening filter free (FFF) energies (6 MV FFF and 10 MV FFF). PDD curves were measured and analysed for various square radiation fields, with and without IQM in place. Differences between PDD curves were statistically analysed through comparison of respective PDD_20,10 values. Attenuation coefficients k(IQM) were determined for the same range of photon energies.


RESULTS
Statistically significant differences in beam qualities for all evaluated high energy photon beams were found, comparing PDD_20,10 values derived from PDD curves with and without IQM in place. Significance of beam hardening effect was statistically proven with high confidence (p < 0,01) for all analysed photon beams except for 15 MV (p = 0,078), although relative differences in beam qualities were minimal, ranging from 0,1 % to 0,5 %. Attenuation of the IQM system showed negligible dependence on radiation field size. However, clinically important dependence of kIQM versus TPRs20,10 was found: 0,941 for 6 MV photon beams, to 0,959 for 18 MV photon beams, with highest uncertainty below 0,006. k(IQM) versus TPRs were tabulated and polynomial equation for the determination of k(IQM) is suggested for clinical use.


CONCLUSION
There was no clinically relevant beam hardening, when IQM system was on linear accelerators. Consequently, no additional commissioning is needed for the IQM system regarding the determination of beam qualities. Generic values for k(IQM) are proposed and can be used as tray factors for complete range of examined photon beam energies.