FIELD MATCHING
RAJALAKSHMI.R
20.05.2022
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SEPARATION OF ADJACENT FIELDS:
In certain cases there is a need for treatment involving
adjacent fields
1. Hodgkins disease(lymphoma)
2. Craniospinal fields in treatment of medulloblastoma
3. some head and neck treatment fields
PROBLEM:
When photon fields are placed next to one another the
divergence causes hot spots at depths and cold areas near
the surface.
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SEPARATION OF ADJACENT FIELDS :
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SEPARATION OF ADJACENT FIELDS :
A- Angling the beams away from each other so that the two
beams abut and are aligned vertically.
B: Fields separated at the skin surface. The junction point is at a
depth where dose is uniform across the junction.
C: Isocentric split-beam technique for head and neck tumors.
D: Craniospinal irradiation using penumbra generators
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METHODS OF FIELD SEPARATION:
Two basic approaches : geometric and dosimetric
In geometric approach, field is defined by 50% decrement line
(line joining points at depth where the dose is 50% of central axis
value at the same depth), producing 100% at the junction point
The lateral dose distribution at the junction depth, can be more
or less uniform , depending on the inter-field scatter
contribution and penumbra characterstic of beam.
In dosimetric approach, the goal is to produce a composite
isodose distribution which is uniform at a desired depth
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GEOMETRIC METHOD ( 2 ADJACENT BEAMS) :
S = S1 + S2
Geometry of two adjacent beams, separated
by a distance S1 + S2 on the surface and
junctioning at depth d.
SSD, source to surface distance. 8
GEOMETRIC METHOD ( 2 PAIRS OF PARALLEL OPPOSED BEAMS)
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DIVERGENCE IN TREATING BREAST CARCINOMAS
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HALF BEAM BLOCK:
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SSD = 80 cm in cobalt
SSD = 100 cm in linac
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FIELD MATCHING IN CRANIO-SPINAL IRRADIATION
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Fixed or calculated gap
• Use of fixed gap ranging 5 mm to 10mm between fields OR
• Customized gap for each patient depending on the field length &
depth of prescription - more appropriate
• Spinal fields are simulated after gap calculation
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Gap calculation
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AAPM, Paediatric treatment planning
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Matching of cranial and spinal fields
The collimator and couch must be rotated
during delivery of cranial fields in order to
account for beam divergence.
• Couch rotation (~ 6°) to match divergence of
cranial field with the spinal field
• Collimator rotation (7 - 10°) to match
divergence of spinal field with the cranial field
• Half beam block
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Junction shift
• Feathering after every 5 to 7 fraction smooths out any
overdose or under-dose over a longer segment of cord
• 5mm overlap at 4 MV photons -> 30 to 40% overdose(14Gy
for 36Gy prescribed dose) which may exceed cord tolerance.
• Systematic error during radiotherapy delivery could further
lead to an overlap or gap.
• Accepted systematic error for CSI – 2mm
Hopulka et al, 1993, IJRO
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Done every 5-7 fractions.
Cranial field moved superiorly by approx. 5mm. Spinal field moved by approx.
40 1cm.
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GUIDELINES FOR FIELD MATCHING:
1. The site of field matching should be chosen, over an area that
does not contain tumor or a critically sensitive organ.
2. If the tumor is superficial at the junction site, the fields
should not be separated because a cold spot on the tumor
will risk recurrence. However, if the diverging fields abut on
the skin surface, they will overlap at depth. In some cases,
this may be clinically acceptable, provided the excessive
dosage delivered to the underlying tissues does not exceed
their tolerance.
3. In the case of a superficial tumor with a critical organ located
at depth, one may abut the fields at the surface but eliminate
beam divergence using a beam splitter or by tilting the
beams.
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GUIDELINES FOR FIELD MATCHING:
4. Fordeep-seated tumors, the fields may be separated on the skin
surface so that the junction point lies at the midline. Again, care
must be taken in regard to a critical structure near the junction
region
5. The line of field matching must be drawn at each treatment
session on the basis of the first field treated. It is not necessary
anatomically to reproduce this line every day because variation in
its location will only smear the junction point, which is desirable.
For the same reason some advocate moving the junction site two
or three times during a treatment course.
6. A field-matching technique must be verified by actual isodose
distributions before it is adopted for general clinical use.
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REFERENCES:
Clinical applications of geometrical field matching in radiotherapy based on a
new analytical solution victor hernandez, [Link]., Meritxell arenas, ph.D., Ferran
pons, [Link]., and josep sempau, ph.d.
Dosimetry and field matching for radiotherapy to the breast and supraclavicular
fossa Elizabeth A. Miles a,*, Karen Venables b , Peter J. Hoskin c , Edwin G.A.
Aird b , On Behalf of the START Trial Management Group 1
The Matching of Adiacent Fields in Radiotherapyl David I. Armstrong, [Link]., and Jack J.
Tait, [Link].
Field matching in breast irradiation: An exact solution to a geometrical problem Joos V.
Lebesque* The Netherlands Cancer Institute, Antoni van Leeuwenhoek Ziekenhuis,
Plesmanlaan 121, 1106 CX Amsterdam
A three-field monoisocentric inverse breast treatment planning technique without half-
beam blocking Tiezhi Zhang,1a Joshua T. Dilworth,2 Ovidiu Marina,2 Peter Chen,2 Lisa
Benedetti,2 Qiang Liu2 Department of Radiation Oncology,1 Washington University, St.
Louis, MO; Department of Radiation Oncology,2 William Beaumont Hospitals, Royal Oak,
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MI, USA tzhang@[Link] Received 4 December, 2014; accepted 12 April, 2015
THANK YOU
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