X-ray sources of medical linear accelerators: focal and extra-focal radiation.

A computerized tomography (CT) reconstruction technique has been used to make quantitative measurements of the size and shape of the focal spot in medical linear accelerators. Using this technique, we have measured the focal spots in a total of nine accelerators, including (i) two Varian Clinac 2100c's, (ii) two Atomic Energy of Canada Ltd. (AECL) Therac-25's, (iii) two AECL Therac 6's, (iv) a Siemens KD-2, (v) a Varian Clinac 600c (4 MV), and (vi) an AECL Therac-20. Some of these focal spots were monitored for changes over a 2-yr period. It has been found that (i) the size and shape of the source spot varies greatly between accelerators of different design ranging from 0.5 to 3.4 mm in full width at half maximum (FWHM); and (ii) for accelerators of the same design, the focal spots are very similar. In addition to the measurements of the focal spot, a new technique for measuring the magnitude and distribution of extra-focal radiation originating from the linear accelerator head (flattening filter, primary collimator) has also been developed. The extra-focal radiation produced by a Varian Clinac 2100c accelerator was measured using this technique and it was found that the extra-focal radiation accounts for as much as 8% of the total photon fluence reaching the isocenter. The majority (75%) of this extra-focal radiation originates from within a circle 6 cm in diameter at the target plane. The source MTFs for each of the measured focal spots have been calculated in order to assess their influence on the spatial resolution of verification images. The limiting spatial resolution (i.e., 10% modulation) for all the source MTFs is 1.8 mm-1 or greater when used for transmission radiography at a magnification of 1.2. The extra-focal radiation, which produces a low-frequency drop in the source MTFs of up to 8%, changes with field size. As a result, the source MTFs of linear accelerators depend not only on the design of individual accelerators and image magnification, but also on the field size used when forming an image.