A comparison of phantom scatter from flattened and flattening filter free high-energy photon beams

Flattening filter free (FFF) photon beams have different dosimetric properties from those of flattened beams. The aim of this work was to characterize the collimator scatter (Sc) and total scatter (Scp) from 3 FFF beams of differing quality indices and use the resulting mathematical fits to generate phantom scatter (Sp) data. The similarities and differences between Sp of flattened and FFF beams are described. Sc and Scp data were measured for 3 flattened and 3 FFF high-energy photon beams (Varian 6 and 10 MV and Elekta 6 MV). These data were fitted to logarithmic power law functions with 4 numerical coefficients. The agreement between our experimentally determined flattened beam Sp and published data was within ± 1.2% for all 3 beams investigated and all field sizes from 4 × 4 to 40 × 40 cm2. For the FFF beams, Sp was only within 1% of the same flattened beam published data for field sizes between 6 × 6 and 14 × 14 cm2. Outside this range, the differences were much greater, reaching − 3.2%, − 4.5%, and − 4.3% for the fields of 40 × 40 cm2 for the Varian 6-MV, Varian 10-MV, and Elekta 6-MV FFF beams, respectively. The FFF beam Sp increased more slowly with increasing field size than that of the published and measured flattened beam of a similar reference field size quality index, i.e., there is less Phantom Scatter than that found with flattened beams for a given field size. This difference can be explained when the fluence profiles of the flattened and FFF beams are considered. The FFF beam has greatly reduced fluence off axis, especially as field size increases, compared with the flattened beam profile; hence, less scatter is generated in the phantom reaching the central axis.