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Attenuation Project
Beverly Meyer

Wedge Transmission Factor Calculation

Objective: To determine the transmission factor for a wedge as it applies to monitor unit
calculation.

Purpose: Radiation therapy involves a dose of radiation written as a prescription by the

radiation oncologist to a specific target. This target is a tumor inside the patients body which
will receive the specific dose prescribed by the doctor. The dosimetrist and physicist ensure that
the correct prescribed dose is delivered to that spot.
The linear accelerator is calibrated to a standard by the physicist using an ion chamber and
electrometer. These have been calibrated to a specific protocol, TG-51 at a national laboratory to
ensure all are calibrated equally.1 The output is calibrated to a reference field of 10 x 10 cm, at a
distance of 100 SSD, and a depth of 10 cm in a water phantom. Frequently beam-modifiers are
placed in the path of the beam. One such beam-modifier is a wedge. A wedge is made of metal
and attenuates the beam.2 Wedges are usually lead and wedge-shaped and attenuate the beam
progressively across the beam path. The thin edge attenuates less and the thick edge attenuates
more, which is useful when more dose is desired on one side of the field than the other. The
wedge affects the dose on the central axis and requires a wedge factor in calculations. The factor
is measured through the center of the wedge.
The formula to find the general Transmission factor is:3

TF = Dose with the object in the beam path

Dose without the object in the beam path

The general formula to calculate MU is:

MU = Dose / wedge factor
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Methods and Materials: A Varian 2100 IX linear accelerator was used using 18 megavoltage
photon energy with 5 x 5 cm, 10 x 10 cm, and 20 x 20 field sizes. Different field sizes were
used to find an average since the ratio changes with field size. Solid water was utilized as the
phantom material along with an ion chamber which was connected to an electrometer measuring
the charge. Two trials each with 100 MU were conducted at each open field size, as well as one
each with a 30 degree wedge inserted both right and left. The 30 degree wedge was chosen since
it is the most severe.
Image 1: Solid water with ion chamber

Image 2: Wedge in beam path

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Results:
Table 1: Readings taken with open fields, then wedge left and right, and attenuation factor.

Discussion:
The measurements were taken with the wedge oriented both right and left along long axis of the
ion chamber which results in the shortest distance across the wedge length. As expected, the
wedge decreases the output, so the effective MUs would increase. The wedge has three main
effects on the beam: the wedge hardens the beam, the skin dose increases due to scatter from the
wedge, and it changes the profile of the field by pushing dose to one side of the field. The
attenuation factor for the open 10 x 10 is 0.627 and 20 x 20 is 0.646; thus the average is 0.637
and is used for the patients treatment fields to show the clinical application of the wedge.

Clinical Application:
The patient was to receive palliative radiation treatment to the spine. By using the wedge factor
of 0.637, one can easily see how the MUs are higher for the wedge field. As seen by the
calculations performed on the machine with the wedge and output, the attenuation factor
essentially raises the MUs necessary to give the dose to the target by approximately 60%. This is
easily understood from the fact that the wedge attenuates the beam during the output experiment
discussed previously (see Table 1). RadCalc is used to perform secondary checks on treatment
plan MUs.
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Table 2: The table below depicts the wedge factor introduced to the spine treatment.

If the wedge factor had not been placed into the calculation, then the MUs would not be
sufficient to deliver the dose through the wedge to the spine and it would be underdosed by
approximately 60%. In addition, if a wedge were placed and not needed (assuming the machine
would not give an accessory fault) then the effect would be the same: severe underdosing. On
the other hand, if a wedge were needed and not placed in the beam path, then the patient would
receive an overdose to the spine of 60% possibly leading to permanent damage.

Conclusion: Machines are calibrated to specific standards. When a patients treatment calls for
the deviation from said standard, then MU calculations must be performed taking into account
these changes. One such change to the calculation includes the introduction of a wedge to the
beams path. Wedges are used to push dose to one side of the patients treatment field. They
also attenuate the beam and increase skin dose. By performing this experiment, one can
calculate the wedge factor necessary to use in the MU calculation. It also evidenced the fact that
the wedge factor also changes with the field size.
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References
1. Smith, J. Medical Dosimetry Concepts-Calibration and Calculations. [SoftChalk]. La Crosse,
WI: UW-L Medical Dosimetry Program; 2017.
2. Bentel GC. Dose determination for external beams. In: Radiation Therapy Planning. 2nd ed.
New York, NY: McGraw-Hill; 1996:49-52.
3. Stanton R, Stinson D. Photon beam dosimetry. In: Applied Physics for Radiation Oncology.
Revised ed. Madison, WI: Medical Physics Publishing; 2009.