Monte Carlo simulations of electron beams collimated with a dual electron multileaf collimator: a feasibility study.

Electron applicators and cut-outs have been used for some time in the delivery of electron beam therapy. A dual electron multileaf collimator (eMLC) consisting of upper and lower eMLCs was designed, and dose distributions of electron beams delivered by it were evaluated by Monte Carlo simulations by use of the EGSnrc Monte Carlo code. The percentage depth dose (PDD), dose profiles, dose gradient falloff (G), depth of maximum dose (R(100)), surface dose, bremsstrahlung background, beam flatness, and penumbra of the dual eMLC were evaluated and compared with those simulated and measured with the standard applicators inserted into the treatment head of the medical linear accelerator (linac). The results showed good agreement in most cases. Specifically, the flatness and penumbra obtained with the dual eMLC were better than those obtained with standard applicators. It is therefore possible to use the proposed dual eMLC in the delivery of electron beam therapy without the need for applicators and cut-outs. This will minimize the inconvenience of placing cut-outs on the patients; also, changes in the required field can be effected without the therapist going into the accelerator room when the dual eMLC is finally automated. The absence of a helium bag between the upper and lower eMLCs did not offer significant changes in the dosimetry parameters compared to the eMLC fitted with the helium bag.