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Two other important effects on dose distribution are the patient contour and patient inhomogeneity, which
are considered separately.
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distance is lower, the attenuation of the beam is reduced due to the slower fall off in intensity at greater
distance.
For an increased SSD:
Zmax and percent depth dose increase
The geometric penumbra increases with increasing distance
Reduced SSD shows the opposite effect.
Beam Quality
The most commonly used beams are kilovoltage (under 200 keV), 60Co (between 1.1 and 1.37 MeV), 6 MV
(under 6 MeV photons, median of 1.5 MeV) and 18 MV (under 18 MeV photons, median of 4 6 MeV).
In general, as beam energy increases:
Zmax increases due to increased range of scattered electrons
Percent depth dose increases
Penumbra initially reduces in size (from kilovoltage to low megavoltage) before slightly increasing with
high megavoltage energies (18 MV). This increase in penumbra at higher energies is due to
increased lateral range of electrons generated by the higher energy photons.
Kilovoltage beams generally show bulging isodose curves due to increased lateral scatter of photons,
unlike megavoltage beams which have much less lateral scatter of photons. Zmax is usually located on the
surface.
Beam Output
Beam output has no effect on dose distribution, but has implications for treatment time.
http://ozradonc.wikidot.com/factors-effecting-dose-distribution-photons
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