Beam generation and planar imaging at energies below 2.40 MeV with carbon and aluminum linear accelerator targets

Purpose: Recent work has demonstrated improvement of image quality with low-Z linear accelerator targets and energies as low as 3.5 MV. In this paper, the authors lower the incident electron beam energy between 1.90 and 2.35 MeV and assess the improvement of megavoltage planar image quality with the use of carbon and aluminum linear accelerator targets. Methods: The bending magnet shunt current was adjusted in a Varian linear accelerator to allow selection of mean electron energy between 1.90 and 2.35 MeV. Linac set points were altered to increase beam current to allow experimental imaging in a practical time frame. Electron energy was determined through comparison of measured and Monte Carlo modeled depth dose curves. Planar image CNR and spatial resolution measurements were performed to quantify the improvement of image quality. Magnitudes of improvement are explained with reference to Monte Carlo generated energy spectra. Results: After modifications to the linac, beam current was increased by a factor greater than four and incident electron energy was determined to have an adjustable range from 1.90 MeV to 2.35 MeV. CNR of cortical bone was increased by a factor ranging from 6.2 to 7.4 and 3.7 to 4.3 for thin and thick phantoms, respectively, compared to a 6 MV therapeutic beam for both aluminum and carbon targets. Spatial resolution was degraded slightly, with a relative change of 3 and 10 at 0.20 lpmm and 0.40 lpmm, respectively, when reducing energy from 2.35 to 1.90 MV. The percentage of diagnostic x-rays for the beams examined here, ranges from 46 to 54. Conclusion: It is possible to produce a large fraction of diagnostic energy x-rays by lowering the beam energy below 2.35 MV. By lowering the beam energy to 1.90 MV or 2.35 MV, CNR improves by factors ranging from 3.7 to 7.4 compared to a 6 MV therapy beam, with only a slight degradation of spatial resolution when lowering the energy from 2.35 MV to 1.90 MV.