Percentage depth dose distributions in inhomogeneous phantoms with lung and bone equivalent media for small fields of CyberKnife

Abstract: The percentage depth dose distributions in inhomogeneous phantoms with lung and bone equivalent media are studied. For lung equivalent media a Balsa wood is used, and for a soft bone equivalent media a compound material with epoxy resin, hardener and calcium carbonate is used. Polystyrene slabs put together with these materials are used as an inhomogeneous phantom. Dose measurements are performed with Gafchromic EBT film by using photon beams from 6MV CyberKnife at the Seoul Uridul Hospital. The cone sizes of the photon beams are varied from 5, 10 to 30 mm. As a simulation tool GEANT4 Monte Carlo code v9.4.p02 is used. When the Balsa wood is inserted in the phantom, the dose measured with EBT film is found to be significantly different from the dose without the EBT film in and beyond the Balsa wood region, particularly for small field sizes. On the other hand, when the soft bone equivalent material is inserted in the phantom, discrepancy between the dose measured with EBT film and the dose without EBT film can be seen only in the region of bone equivalent material. GEANT4 simulations are done with and without the EBT film to compare the simulation results with measurements. We find that the simulations including EBT film agree with the measurements for all the cases within an error of $2.2\%$. Also, we find the "doses to phantom" without the EBT film differ from the "doses to film" up to $29\%$, which shows that for accurate dose estimations for inhomogeneous phantoms with EBT film the presence of the EBT film needs to be taken into account properly in particular for small fields.