Practice Problems Week 3

The following questions are thought of as SAD-only setups

1. If the cGy/MU is 1.000 at 100cm SAD at 1.5cm depth, what is the cGy/MU at 200cm SAD at
1.5cm depth?
2. If the cGy/MU is 1.000 at 100cm SAD (dmax-1.5cm), how far do I have to be from the
source to achieve a dose rate of 10cGy/MU?
3. What is the dose at Dmax for a 6MV beam with an SAD of 100cm, delivering 180cGy to a
depth of 10cm (TMR=0.77)?
4. What is the total output at a depth of 5cm (TMR=0.85) if the total output is 1.027 cGy/MU at
Dmax?
5. The effective TAR for a blocked field set-up isocentrically at 80 cm SAD for a 60Co beam
unit is 0.565. The dose rate in air at the axis for the collimator setting used is 125.6 cGy/min.
The blocking tray factor is 0.98. The timer setting to deliver 180 cGy to the isocenter is
________? (Normally you would need an area factor if there was a field size factor needed
but for this problem you dont need one).
a. 0.83
b. 2.54
c. 2.59
d. 3.86
e. 3.92
6. For an isocentric treatment with 6MV x-ray beam, the mu setting for a tumor dose of 180
cGy at 10 cm depth with a 15 x 15 cm field is (TMR = .803, RFF = 1.028, IF = 1.03, TF =
.98): (RFF is reference field size factor same as Sc and Sp or area factor just different
terminology; IF = iso factor or SAD factor again different terminology).
a. 248
b. 226
c. 216
d. 200
e. 196
7. The dose rate at the patients midplane is found to be 250 cGy/min at 100 cm SAD. A
protocol requires that the dose rate be no more than 100cGy/min. Therefore, the patient must
be treated at ________ cm SAD. (SAD can be different with different manufacturers or
different machines. You can also change the SAD for specialty treatments such as TBI or
TSI. This would be a situation where you would need to change SAD distances)

8. 100 SAD treatment. 180 cGy to depth of 10 cm. Dmax = 1.6cm. Sc = 1.000, Sp = 1.003.
TMR = .789 @10cm. Machine calibrated at dmax (use 101.6).
Calculate the SAD factor = (101.6/ ?)2 =
Calculate the MU setting =
9. The TMR for a 10 x 10 cm 4MV photon field at 100 cm SAD is .730 at 10 cm depth. If the
SSD were changed from 90 cm to 95 cm (but the depth remains the same), the expected
change in the TMR would be:
a. Increase of 5%
b. Increase of 7.5%
c. Decrease of 5%
d. Decrease of 7.5%
e. Zero
1. Use the following information to answer questions 10 through 14:
2. A 21EX machine is calibrated to deliver 1cGy = 1MU at 100cm SAD for a 10x10cm field
size at Dmax = 1.5cm.
10. What is the inverse square correction factor when your calculation point is at:
a. Isocenter
b. 5cm deeper than isocenter
c. 5cm shallower than isocenter
11. We are prescribing 3000cGy in 10 fractions to the isocenter for whole brain irradiation using
RLAT and LLAT field orientations. What are the MU per beam if we treat equally weighted
beams, SSD = 93cm, depth = 7cm. TMR(7) = 0.825, Sc = 1.026, Sp = 1.032.
12. If my values of Sc=Sp=1.000 for a 10x10cm field size and the TMR for 10x10=0.770:
a. Are Sc and Sp for a 5x5 field higher or lower than 10x10?
b. Is the TMR for a 5x5 field (greater/less/equal) to the TMR for a 10x10?
13. How many MU are needed to treat a single spine posterior field with a prescription dose of
300cGy. The SSD=100cm, the depth of treatment (and calculation!) is 5cm and the field size
is 5x15cm. (Scp=1.05, TMR=0.85hintdo you need an ISF?)
14. How many MU are needed to treat the spine field from question 13 if we set SSD=95cm and
calculation point is at 5cm depth. (instead of 100cm SSD)?