Computer-controlled direct TMR measurement.

It is common practice to derive tissue maximum ratios (TMRs) indirectly by calculation from percent depth dose (PDD) data which are more convenient to measure using currently available automated scanners. A system has been developed, however, for the completely automatic direct measurement of TMR, using an ionization chamber which is rigidly supported at the isocenter of a teletherapy machine. The chamber is immersed in a water phantom which is moved up and down by computer control of the motorized treatment couch. Ionization current is sampled by the computer which simultaneously regulates both the radiation field size and chamber depth. This system provides a means of rapidly measuring and processing complete sets of TMR and output factor values for both square and elongated field shapes. The results of such measurements performed on the Clinac 18 accelerator are described in this paper.