Shielding requirements in helical tomotherapy

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IOP PUBLISHING PHYSICS IN MEDICINE AND BIOLOGY
Phys. Med. Biol. 52 (2007) 50575067 doi:10.1088/0031-9155/52/16/023
Shielding requirements in helical tomotherapy
S Baechler
1
, F O Bochud
1
, D Verellen
2
and R Moeckli
1
1
University Institute for Radiation Physics, Lausanne, Switzerland
2
Department of Radiotherapy, Oncology Center, Academic Hospital,
Vrije Universiteit Brussel (AZ-VUB), Belgium
E-mail: sebastien.baechler@chuv.ch
Received 16 March 2007, in nal form 7 June 2007
Published 1 August 2007
Online at stacks.iop.org/PMB/52/5057
Abstract
Helical tomotherapy is a relatively new intensity-modulated radiation therapy
(IMRT) treatment for which room shielding has to be reassessed for the
following reasons. The beam-on-time needed to deliver a given target dose is
increased and leads to a weekly workload of typically one order of magnitude
higher than that for conventional radiation therapy. The special conguration
of tomotherapy units does not allow the use of standard shielding calculation
methods. A conventional linear accelerator must be shielded for primary,
leakage and scatter photon radiations. For tomotherapy, primary radiation is
no longer the main shielding issue since a beam stop is mounted on the gantry
directly opposite the source. On the other hand, due to the longer irradiation
time, the accelerator head leakage becomes a major concern. An analytical
model based on geometric considerations has been developed to determine
leakage radiation levels throughout the room for continuous gantry rotation.
Compared to leakage radiation, scatter radiation is a minor contribution. Since
tomotherapy units operate at a nominal energy of 6 MV, neutron production
is negligible. This work proposes a synthetic and conservative model for
calculating shielding requirements for the Hi-Art II TomoTherapy unit. Finally,
the required concrete shielding thickness is given for different positions of
interest.
1. Introduction
Helical tomotherapy is an innovative radiation therapy technique. In a way similar to diagnostic
computed tomography (CT), the patient is treated in slices by a very narrow photon beam.
Unlike conventional radiation therapy, the beamsource rotates continuously around the patient.
Since the beams enter the patient from many different angles, the tumor is potentially more
precisely targeted and the normal tissue surrounding the tumor is less irradiated (Mackie
et al 1993, Beavis 2004). This technique presents new radiation protection challenges related
0031-9155/07/165057+11$30.00 2007 IOP Publishing Ltd Printed in the UK 5057
5058 S Baechler et al
to the shielding design of the unit. The increased beam-on-time requires a reconsideration of
shielding evaluation methods, particularly against leakage radiation.
Recommendations and technical information for the design of structural shielding of
radiotherapy facilities using x-rays up to 10 MeV are fully described in Report no. 49 of the
National Council on Radiation Protection and Measurements (NCRP) (National Council on
Radiation Protection and Measurements 1976). This report proposes shielding calculation
methods for primary, leakage and scatter radiations, and describes concepts of workload,
use factor as well as occupancy factor. In 2005, the NCRP released Report no. 151 (National
Council on Radiation Protection and Measurements 2005) superseded the NCRPReport no. 49.
This new report includes information for facilities operating at higher voltages than the
10 MV maximum covered previously. In addition to conventional radiotherapy, the NCRP
Report no. 151 addresses special procedures, especially intensity-modulated radiation therapy
(IMRT). Concerning shielding requirements for tomotherapy, the report briey summarizes
the conclusions of the work performed by Robinson et al (2000) and points out that these results
are not likely to apply to helical tomotherapy because they assessed serial tomotherapy that
consists in intensity-modulated arc therapy using a conventional accelerator. This technique
differs greatly from helical tomotherapy that is built with much more inherent accelerator
shielding and uses the rotating beam more efciently. The IAEA Safety Report no. 47
(International Atomic Energy Agency 2006) published in 2006 also gives succinct guidance
on the structural shielding of IMRT facilities, but fails to address tomotherapy.
Shielding considerations for helical tomotherapy were rst discussed by Balog et al
(2005) based on measurements performed around the Hi-ART II TomoTherapy accelerator
and reported in the Site Planning guide of Tomotherapy Inc. (TomoTherapy Hi-Art System
2004). In that work, they quantied primary, leakage and scatter radiation contributions.
Ramsey et al (2006) performed similar measurements and obtained comparable results. Using
data provided by TomoTherapy Inc. (TomoTherapy Hi-Art System 2004), Wu et al (2006)
proposed shielding calculations for the setting of a tomotherapy unit in an existing LINAC
treatment room.
This paper presents shielding calculation formulae for the Hi-Art II TomoTherapy unit
according to the Swiss ordinance on medical accelerators (Swiss Ordinance on medical
accelerators 2004) as well as the German Industrial Norm DIN 6847-2 (Deutsches Institut
f ur Normung 2003), from which the Swiss regulation has been derived. The methodology of
these two guidelines for calculating the thickness of the primary and secondary barriers up to
6 MeV photons is mainly based on the NCRP Report no. 49 (National Council on Radiation
Protection and Measurements 1976) and complies with applicable international radiation safety
levels. The method developed in this study uses experimental data obtained by Balog et al
(2005), as well as complementary information provided by Tomotherapy Inc. (TomoTherapy
Hi-Art System 2004). This work has been conducted to prepare the upcoming installation of
the Hi-Art II TomoTherapy unit at the Lausanne University Hospital in Switzerland.
2. Materials and methods
2.1. Shielding calculation methodology
The protection thickness at the place to protect against each radiation component is calculated
using the following formula (Swiss Ordinance on medical accelerators 2004):
s
i
= z
i
n
i
Shielding requirements in helical tomotherapy 5059
with
n
i
= log
10
_
1
B
_
= log
10
_
W T
H
U
i
R
i
q
i
_
, (1)
where i is the radiation component index, s is the required shielding thickness, z is the tenth
value layer (TVL), n is the number of TVLs required for the shield, Bis the required attenuation
of the shield, W is the weekly workload, U is the use (or direction) factor, T is the occupancy
factor, H is the allowable ambient dose, R is the reduction factor and q is the equivalent dose
factor. These different factors are described in the following sections. The nomenclature used
in expression (1) and in the following sections is consistent with the Swiss ordinance (Swiss
Ordinance on medical accelerators 2004).
2.2. Non-radiation-component-dependant parameters
The minimal weekly workload W for conventional linear accelerators is 10
5
monitor units
(MU), i.e. about 1000 Gy per week at the isocenter (National Council on Radiation Protection
and Measurements 1976). This value corresponds to 100 patients per day over ve days
with a dose of 2 Gy. For a tomotherapy unit, unlike conventional radiotherapy facilities,
the dose delivered at the isocenter is not directly tied to the number of MUs. Balog et al
(2005) propose a weekly workload of 7 10
5
MU. This corresponds to a weekly irradiation
time of 700 min (5 min/patient 3.5 patients/h 40 h) with a reference dose rate of about
10 Gy min
1
at the isocenter. The clinical practice at the Radiotherapy Department of the AZ-
VUBin Brussels suggests a weekly beam-on-time of 960 min (8 min/patient 3 patients/h
40 h). Considering an average beam-on-time per treatment of 7.5 min and 32 patients/day,
Wu et al also assume a weekly irradiation of 1200 min (Ramsey et al 2006). For the present
work, a weekly irradiation time of 1000 min was adopted, giving a workload of 10
6
MU/week
or about 10 000 Gy/week at the isocenter.
The occupancy factor T for an area is the fraction of time during which the maximally
exposed individual is present while the beam is on. According to the Swiss ordinance (Swiss
Ordinance on medical accelerators 2004), the occupancy factor T is set to 0 for unoccupied
areas, 0.2 for partially occupied areas and 1 for occupied areas. The NCRP reports (National
Council on Radiation Protection and Measurements 1976, 2005) and DIN norm (Deutsches
Institut f ur Normung 2003) propose similar values, but go down to 0.05 and 0.1, mainly for
toilets, bathrooms and stairways. As stated by the NCRP Report no. 151 (National Council
on Radiation Protection and Measurements 2005) as well as the Swiss ordinance (Swiss
Ordinance on medical accelerators 2004), the allowable ambient dose H is 0.02 mSv per week
for uncontrolled areas and 0.1 mSv in controlled areas. These shielding design goals in dose
equivalent ensure that the annual effective doses for workers and for members of the public
do not exceed 5 mSv and 1 mSv, respectively.
2.3. Radiation-component-dependant parameters
Shielding calculations in the design of radiotherapy facilities have to be performed for primary,
leakage and scatter radiations. TVLs for primary and leakage radiation z
p
and scatter radiation
z
s
for 6 MeV incident x-rays are given in table 1, according to different national and
international recommendations. There is a very good matching between the different data
sets.
The use factor U is the maximum fraction of time during which the beam is directed
toward the place to protect. In the case of tomotherapy, this factor has to be evaluated for a
continuously rotating gantry, which is always the case during patient tomotherapy treatments.
5060 S Baechler et al
Table 1. Approximate TVLs (in cm) based on large attenuation of 6 MeV x-rays in materials.
DIN/Swiss NCRP no. 151 IAEA no. 47
Primary/
Shield material leakage Scatter Primary Scatter
a
Primary Scatter
a
Concrete (2.3 g cm
3
) 34 17 33 17 34 17
Steel (7.8 g cm
3
) 9.8 5 10 9.8
Lead (11.3 g cm
3
) 5.3 1.5 5.7 1.5 5.5
a
For patient-scattered radiation at an angle of 90

.
For primary radiation, the factor U will be considered when determining the reduction factor.
For leakage and scatter radiations, the use factor is set to 1 as for conventional radiotherapy
units.
The equivalent dose factor q is equal to 1 mSv mGy
1
in any case since neutron
contribution is totally negligible with a photon energy of 6 MeV.
The reduction factor R gives the ratio of the dose rate for a specic radiation component at
a given distance to the dose rate at the reference point. It should be noted that the electron beam
mode is not available for the tomotherapy unit, and thus shielding against electron components
is kept out. The reduction factor for the four radiation components of interest is determined
hereafter for tomotherapy units, starting from conventional formulae given in the DIN norm
(Deutsches Institut f ur Normung 2003) and the Swiss ordinance (Swiss Ordinance on medical
accelerators 2004).
2.4. Primary radiation
The reduction factor for primary radiation follows the inverse square law of the distance and
is calculated by the following expression:
R
p
=
a
2
0
a
2
n
. (2)
For a conventional radiotherapy unit, the reference distance a
0
is usually located at 1 m from
the source. For tomotherapy, it is more relevant to place the reference point at the isocenter,
i.e. on the rotation axis of the gantry, 0.85 m from the source. The parameter a
n
is the
distance between the place to protect and the source. For the Hi-Art II tomotherapy system, a
beam stop consisting of 13 cm thick lead slabs is mounted on the gantry directly opposite the
source. Using TVLs from table 1, the beam stop transmission for the primary ranges between
1/190 and 1/285. Measuring the transmission with an ion chamber, a factor of 1/250 was
found (Balog et al 2005). Considering a transmission correction of 1/250 and introducing the
distance a
p
between the place to protect and the isocenter, equation (2) becomes
R
p
=
a
2
0
(a
0
+ a
p
)
2

1
250
. (3)
Since the gantry continuously rotates during treatments, a simple estimate of the use factor U
consists in taking the ratio of the maximal beam opening angle to the full angle. The maximal
surface of the primary beam at the isocenter is (40 5) cm
2
, corresponding to an opening
angle of 27

in the transverse direction. Adding a 5

margin to each side due to high-energy

scattered radiation at small angles, the use factor U is then evaluated to 0.10. Wu et al (2006)
propose an analytical expression that depends on the distance between the place to protect
and the isocenter to calculate the use factor. Considering room dimension requirements for
the TomoTherapy Hi-Art II system, distances of interest for shielding evaluation are typically
Shielding requirements in helical tomotherapy 5061
Figure 1. Schematic top view of the tomotherapy facility that indicates the conguration to
evaluate leakage radiation in the isocenter (I) plane.
between 2.5 m and more than 10 m. Using Wus formula (Wu et al 2006), the use factor U
ranges from 0.10 at 2.5 m to 0.08 at 10 m. Thus, our simple approach giving a value of 0.10
is conservative and appropriate in the present context, especially, as we will see below, that
primary radiation is not the major contribution.
2.5. Leakage radiation
Tomotherapy Inc. (TomoTherapy Hi-Art System 2004) and Balog et al (2005) published
measurements concerning leakage radiation surrounding a helical tomotherapy unit. They
measured in-air doses at the horizontal plane (xz) at the height of the isocenter for several
angles at radial distances from 1 to 4 m (see gure 1). The gantry continuously rotated, and all
leaves were closed during these measurements. They obtained leakage fractions, or reduction
factors, ranging between 0.18% and 0.0006% of the dose at the isocenter. Recently, Ramsey
et al (2006) obtained comparable results using a similar approach.
Extrapolating reduction factors measured between 1 m and 4 m to larger radial distances
involved in shielding consideration, up to 10 m, is not straightforward. For conventional
radiotherapy, the leakage reduction factor R
l
follows the inverse square law of the distance as
shown in the following expression:
R
l
=

D
l

D
p

a
2
0
a
2
n
, (4)
where the maximal ratio of the leakage radiation dose rate

D
l
to the radiation dose rate at
the reference point

D
p
is generally used. In the case of tomotherapy, the source continuously
rotates around the isocenter and the dose rate does not decrease with the square of the distance
between the place to protect and the source. In such a geometric system, a reformulated
distance correction is necessary for the leakage radiation component. In the transverse plane
(xy in gure 2), the rotating source generates the same mean contribution at any equal distance
from the isocenter. Without lack of generality, our calculation will be then restricted to the
dose distribution in the horizontal plane (xz in gure 1). Two coordinates are thus relevant:
the distance from the isocenter a
p
and the angle relative to the rotation axis . Therefore,
5062 S Baechler et al
Figure 2. Schematic view of the tomotherapy unit for leakage radiation consideration: the source
S rotates around the isocenter I and generates leakage (and scatter radiation) at the place P.
we introduce a mean distance a(a
p
, ) for which the dose decreases with the square of the
distance, as given in the following equation:
1
a
2
(a
p
, )
=
1
2a
0
2
_
0
1
a
2
n
(a
p
, )
a
0
d. (5)
Then, the analytical solution of equation (5) that enables us to calculate the mean distance
when a
p
> a
0
is expressed as follows:
a
n
(a
p
, ) =
4
_
_
a
2
0
+ a
2
p
_
2
(2a
p
a
0
sin )
2
. (6)
For instance, for a distance a
p
of 2 m, the mean distance ranges between 1.8 and 2.2 m, at
respectively 90

and 0

. The larger the distance from the gantry, the closer the mean distance
and the distance from the isocenter. Indeed, in this situation, the rotating accelerator can be
considered as a punctual source; above 6.5 m, the difference is less than 1% for any angle.
Distances a
0
and a
n
given in expression (4) are then replaced by mean distances. Leakage
doses surrounding a tomotherapy system depend not only on purely geometric considerations,
but also on the head shielding and other interactions within the gantry. Therefore, in our
model, the reduction factor is normalized to experimental dose rate ratios measured at 3 m
from the isocenter. For this purpose, a factor named K() which is the ratio of the leakage
radiation dose rate at a mean distance of 1 m to the radiation dose rate at the isocenter, i.e. the
reduction factor at a mean distance of 1 m, has been introduced and is calculated according to
the following equation:
K() =
_

D
l

D
p
_
exp,a
p
=3m
a
n
(3, )
2
. (7)
In expression (7), K() is calculated taking advantage that the leakage dose rate decreases
with the square of the mean distance. Experimental dose rate ratios at a distance a
p
of 3 m
were chosen for normalization since shorter distances are less relevant for structural shielding
design of the Hi-Art II TomoTherapy unit. These numerical data are available from the Site
Planning guide of TomoTherapy Inc (TomoTherapy Hi-Art System 2004), and are given in
table 2. Then, substituting equation (6) into equation (7) enables us to determine the K()
normalization factors that are given in table 2 for different angles. Finally, the reduction factor
for leakage radiation is determined as follows:
R
l
= K()
1
a
n
(a
p
, )
2
. (8)
Shielding requirements in helical tomotherapy 5063
Figure 3. Isocurves of reduction factors for leakage radiation in the isocenter (I) plane using
analytical data (solid lines) and experimental data (dashed lines).
Table 2. Experimental

D
l
/

D
p
at 3 m from the isocenter and K() normalization factors used to
calculate the reduction factor for leakage radiation.
Angle (

)

D
l
_

D
p
(10
4
) for a
p
= 3 m
a
K() (10
4
)
0 0.097 0.95
15 0.24 2.31
30 0.39 3.66
45 0.49 4.42
60 0.72 6.24
75 0.65 5.45
90 0.82 6.79
105 0.95 7.96
120 0.50 4.33
135 0.25 2.26
150 0.25 2.35
165 0.16 1.54
180 0.097 0.95
a
Data given by the Site Planning guide of TomoTherapy Inc (TomoTherapy Hi-Art System
2004).
Reduction factors were calculated for different distances and angles of interest, and then
compared to experimental values available from the Site Planning guide of TomoTherapy
Inc. (TomoTherapy Hi-Art System 2004) as well as from gure 6 in Balog et al (2005).
Figure 3 shows the good agreement between our model and the experiment. Deviations larger
than 50% are observed at short radial distances, between 1 and 2 m, probably due to the
complex scattering behavior of photons in the vicinity of the gantry. However, this region is
not of interest for structural shielding evaluation.
2.6. Scatter radiation
The reduction factor for scatter radiation is calculated using the following expression in
accordance with the Swiss ordinance (Swiss Ordinance on medical accelerators 2004):
5064 S Baechler et al
Table 3. Reduction factor R
s
for scatter radiation and scatter fraction dened at the isocenter.
Angle (

) R
s
for a
s
= 2 m
a
R
s
for a
s
= 1 m f
s
(%)
0 5.10 10
5
2.04 10
4
1.02
15 5.70 10
5
2.28 10
4
1.14
30 5.90 10
5
2.36 10
4
1.18
45 7.10 10
5
2.84 10
4
1.42
60 8.40 10
5
3.36 10
4
1.68
75 1.00 10
4
4.00 10
4
2.00
90 3.00 10
5
1.20 10
4
0.60
105 0 0 0
120 0 0 0
135 4.40 10
5
1.76 10
4
0.88
150 3.80 10
5
1.52 10
4
0.76
165 3.70 10
5
1.48 10
4
0.74
a
Calculated using measurements given in table 2 of Balogs paper (Balog et al 2005).
R
s
= f
s
F
n

1
a
2
s
. (9)
The distance a
s
is the distance (in m) between the place to protect and the patient, or the
scattering object, and F
n
is the maximumradiation eld area incident on the patient (in m
2
). The
parameter f
s
is the scatter radiation fraction at 1 m from the patient. The DIN norm (Deutsches
Institut f ur Normung 2003) and the Swiss ordinance (Swiss Ordinance on medical accelerators
2004) propose a constant scatter fraction of 1% for conventional accelerators. According to
the NCRP report no. 151 (National Council on Radiation Protection and Measurements 2005),
the maximal scatter fraction from 6 MV x-rays is 1.04% for a eld size of 400 cm
2
at small
scatter angles (10

). For the Hi-Art II TomoTherapy unit, Balog et al estimate the scatter-only

contribution by measuring the sum of the leakage and scatter contributions at 2 m from the
isocenter, and then subtracting the leakage-only contribution at 2 m. The combined scatter
and leakage contribution was measured with all leaves open and with a water phantom placed
at the isocenter. Since scatter radiation is produced at the isocenter, the inverse square law of
the distance is applicable to determine the scatter reduction factor at 1 m. Using expression
(9), the scatter radiation fraction f
s
is easily determined using experimental data for R
s
, the
maximal radiation eld area F
n
of (40 5) cm
2
at the isocenter and a distance a
s
of 1 m.
In table 3, scatter fractions f
s
range from 0% to 2% depending on room angles . The
scatter contribution is slightly higher on the side of the patient couch with a maximal value
at 75

, and smaller between 105

and 120

due to the presence of the gantry itself. For the

present model, we propose to adopt a conservative f
s
of 2% for any room angle, especially
as scatter radiation is not the major contribution. Since all leaves are not open during helical
tomotherapy treatments, the effective scatter contribution will be smaller in clinical use.
2.7. Second scatter and scattered leakage radiation
The DIN norm (Deutsches Institut f ur Normung 2003) and the Swiss ordinance (Swiss
Ordinance on medical accelerators 2004) specically address second scatter and scattered
leakage radiation, commonly named tertiary radiation. The reduction factor R
t
is determined
similar to scatter radiation:
R
t
=
_
f
s

D
d

D
r
+ f
t
_
F
t

1
a
2
t
. (10)
Shielding requirements in helical tomotherapy 5065
Table 4. Formulae to be used to determine the required shielding thickness for the different
radiation components in helical tomotherapy.
Radiation component Shielding thickness Reduction factor
Primary s
p
= z
p
log
10
_
WT
H
R
p
_
R
p
=
a
2
0
(a
0
+ap)
2
1
250
Leakage s
l
= z
p
log
10
_
WT
H
R
l
_
R
l
= K()
1
_
(a
2
0
+a
2
p
)
2
(2apa
0
sin )
2
Scatter s
s
= z
s
log
10
_
WT
H
R
s
_
R
s
= 0.02 F
n
1
a
2
s
Second scatter and s
t
= z
s
log
10
_
WT
H
R
t
_
R
t
= 1.3 10
5
F
t
1
a
2
t
scattered leakage
Table 5. Shielding thickness of concrete (2.3 g cm
3
) required for different situations of interest.
H = 0.1 mSv week
1
(T = 1) H = 0.02 mSv week
1
(T = 1)
(

) a
p
/a
s
(m) s
p
(cm) s
l
(cm) s
s
(cm) s
p+l
(cm) s
p
(cm) s
l
(cm) s
s
(cm) s
p+l
(cm)
0 4 93 55 117 67
0 6 81 50 105 61
0 8 73 45 97 57
90 4 104 123 55 128 128 147 67 151
90 6 94 111 50 116 118 135 61 140
90 8 87 102 45 107 110 126 57 131
105 4 126 55 150 67
105 6 113 50 137 61
105 8 105 45 128 57
The rst term in expression (10) corresponds to the scattered leakage, and thus f
s
is set to 1%
for a conventional accelerator. The second term represents the second scatter fraction f
t
that
is estimated to be 10
6
, taking into account both the scatter fraction f
s
and an approximate
wall-reection coefcient (Swiss Ordinance on medical accelerators 2004). The maximal
beam area F
t
is equal to the rst scattering surface and a
t
is the distance from the beam center
at the rst reection to the place to protect. For a tomotherapy unit, the rst term is determined
by the maximal product value between scatter fractions f
s
() given in table 3 and factors K()
given in table 2. A maximal value of 1.1 10
5
is then obtained when the angle is of
75

, besides corresponding to the maximal rst scatter fraction of 2%. For the second scatter
contribution, the fraction f
t
is simply doubled by analogy with the rst scatter fraction and is
therefore 2 10
6
. Thus, the reduction factor for tertiary radiation is the following:
R
t
= 1.3 10
5
F
t

1
a
2
t
. (11)
3. Results and discussion
Table 4 summarizes the calculation formulae of the different radiation components to be
considered for shielding design and evaluation of helical tomotherapy units. Table 5 lists
shielding thicknesses of concrete required against primary, leakage and scatter radiation
components for several points of interest and typical conditions. Obviously, shielding against
primary radiation is relevant only for an angle of 90

or 270

. For all cases, leakage radiation

yields the main contribution. However, although the contribution of the primary beam is
clearly less restrictive than leakage radiation, the former should not be neglected to determine
5066 S Baechler et al
the shielding thickness effectively required. Since TVLs for primary and leakage radiations
were conservatively assumed identical, the following expression is applicable to evaluate the
effective thickness s
p+l
taking into account both radiation components:
s
p+l
= z
p
log
_
10
sp
z
+ 10
s
l
z
_
. (12)
The shielding required for both primary and leakage radiations s
p+l
is increased by about 3%
to 5% compared to the leakage-only shielding. The relative contribution of the primary beam
to leakage radiation becomes more signicant as the distance from the isocenter increases.
Barrier thicknesses as shown in table 5 are in good agreement with shielding requirements
calculated by Wu et al (2006) for the setting of a tomotherapy unit in a conventional treatment
room. They found that the largest thickness required is of 143 cm at 4.4 m and 90

when
the allowable ambient dose H is 0.02 mSv/week, and 85 cm at 7.9 m and 0

when H =
0.1 mSv/week. It should be noted that Wu et al assume a workload of 12 000 Gy/week.
Balog et al (2005) give a worst-case estimate of only 100 cm of concrete at 4 m from the
isocenter for an allowable occupational exposure of 0.1 mSv/week. However, they assume a
smaller weekly workload of 7000 Gy week
1
and a less conservative TVL for 6 MV leakage
radiation of 28 cm. The workload largely depends on how the machine will be used and more
conservative workload values that are not discussed in the present study may be possible.
Scatter, second scatter and scattered leakage radiations can be ignored in most cases since
they are insignicant in comparison to leakage radiation. Furthermore, the effective scatter
contribution would be less than the model estimate because beams are modulated during
treatment delivery, and then not all leaves would be open. Nevertheless, some situations may
require shielding calculations where scatter components are the major radiation sources, for
instance at the entrance of an existing conventional radiotherapy room where a tomotherapy
unit is going to be installed.
The shielding calculation method proposed in this study has taken advantage of
dose measurements performed previously by Balog et al (2005) and TomoTherapy Inc.
(TomoTherapy Hi-Art System 2004) in order to address in detail the different radiation
contributions surrounding a helical tomotherapy unit. Compared to the method described
by Wu et al (2006), the present work includes an analytical formula to estimate shielding
requirements against leakage radiation at large distances from the isocenter (>4 m), as well
as a formula to assess second scatter and scattered leakage radiation contribution.
The upcoming use of the TomoTherapy Hi-Art II unit in a topotherapy mode to deliver
breast treatments in a manner of conventional tangents (Gonzalez et al 2006) will require a
reconsideration of the present shielding model. In such a conguration, the gantry remains
stationary during IMRT treatment delivery while the couch is moving. This new application is
still under investigation and cannot be assessed at the time of writing, particularly with respect
to workload.
4. Conclusions
Tomotherapy treatment delivery requires about ten times longer beam-on-time than required
for conventional radiotherapy. Because of the beam stopper mounted on the opposite side
of the source, shielding requirements against primary radiation are of second importance.
Consequently, leakage radiation remains the major shielding issue in tomotherapy although the
accelerator head was designed to minimize this radiation component. Therefore, a geometrical
and analytical model has been developed to estimate leakage radiation contribution as a
function of the angle relative to the rotation axis and the distance from the isocenter. Primary
and scatter radiation components are also considered in the model, but give minor contributions
Shielding requirements in helical tomotherapy 5067
compared to leakage radiation. The conservative model proposed in this work is synthetic,
comprehensive, compatible with international guidelines and appropriate for any structural
shielding design and evaluation for helical tomotherapy. Implementing these formulae in a
spreadsheet application enables us to simply determine shielding thicknesses required for each
specic wall, ceiling and oor of adjacent areas, especially if the available space is limited and
has to be optimized. Although calculated shielding is largely dependent on projected weekly
workload and conservativeness of factors selection, a good agreement was observed between
our shielding requirements and those proposed in the literature.
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