The British Journal of Radiology, 80 (2007), 469–475

Neutron contamination of 10 MV X-rays: its relevance to

treatment room door and maze design
1 2
P J RUDD, PhD, D PRIOR, MSc and 1S AUSTIN-SMITH, MSc

1
Medical Physics Department, Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, London SE1 7EH and
2
Medical Physics Department, Royal Sussex County Hospital, Brighton, East Sussex BN2 5BE, UK

ABSTRACT. 10 MV X-rays produced by linear accelerators are commonly used in

radiotherapy. This paper demonstrates that neutron leakage cannot be neglected at 10
MV when direct access doors are used or when short mazes, typically less than 7 m in
length, are employed. Measurements and calculations were made in terms of the
operational quantities and personal and ambient dose equivalents, and the use of
neutron fluence or contentious issues, such as effective dose and radiation weighting
factors, were avoided. Neutron leakage from the head of an Elekta Precise linear
Received 22 February 2005
accelerator was measured and compared with published data. The neutron protection Revised 17 August 2006
afforded by a direct access door was considered and the use of borated polyethylene to Accepted 4 September
remove thermal neutrons was found to be unnecessary. Extensive measurements were 2006
made in two treatment room mazes using survey meters of the Andersson-Braun and
DOI: 10.1259/bjr/17350806
Leake type. Acceptable agreement was found between the individual instrument
readings and calculations. However, one meter unexpectedly appeared to both ’ 2007 The British Institute of
respond to photons and over-respond at high neutron dose rates. Radiology

Neutron dosimetry
The impression given by many publications [1] is that
the production of neutrons by clinical linear accelerators is
only relevant for machines producing X-rays of energy
above 10 MV.
This can lead to the false conclusion that neutrons are
unimportant at 10 MV, so much so that at a recent
installation at St Thomas’ Hospital, London using a direct
access door with no maze, the door supplier initially
suggested that no neutron protection would be necessary.
Neutron dosimetry for radiation protection is difficult.
Terms and quantities relevant to radiation safety are set out
in the UK in the Approved Code of Practice of the Ionising
Radiation Regulations (IRR) [2] and incorporate changes
recommended by the International Commission on
Radiological Protection (ICRP) in 1991 in Publication 60 [3].
Changes to radiation factors present a particular problem
when comparing past measurements or using and adapt-
ing old methods of calculation. Changes to neutron quality
factors introduced by ICRP Publication 60 were not large
and a neutron survey meter calibrated, say, 20 years ago
could retain the same calibration factor if calibration is
performed to an accuracy of +/2 30% (Private commu-
nication, Thomas DJ, National Physical Laboratory (NPL)
2004). Even the calibration factor supplied by the NPL for
the St Thomas’ meter used in this publication has not
changed significantly with the introduction of IRR 1999.
The impression that neutron effective dose has increased
substantially is given when calculations utilize radiation
weighting factors recommended by ICRP 60. However,
errors were made in estimating the new factors and ICRP
Address correspondence to: Dr Peter Rudd, Medical Physics
Department, Guy’s and St Thomas’ NHS Foundation Trust, St
Thomas’ Hospital, Lambeth Palace Road, London SE1 7EH, UK.
E-mail: peter.rudd@gstt.sthames.nhs.uk
admits that ‘‘insufficient account was taken of the large
photon component that results in the human body when
exposed to neutrons below 1 MeV’’ [4]. The resulting
difficulties have still not been fully resolved.
We deliberately avoid the use of radiation weighting
factors as employed in the maze calculations of Institute of
Physics and Engineering in Medicine (IPEM) 75 [5].
Whenever possible in this publication we quote neutron
doses and perform calculations in terms of operational
quantities. Ambient dose equivalents H*(10) are relevant
to survey meter measurements and personal dose equiva-
lents Hp(10,0) to personal dosimeter badge measurements.
The numerical relationship of H*(10) and Hp(10,0) is, to a
good approximation, unity [6] and we use this simplifica-
tion. IRR 1999 accepts that such measurements can be used
to demonstrate legal compliance with effective dose limits.
Another area of complexity is the traditional use of
neutron fluence for head leakage and room scatter calcula-
tions as in IPEM 75 and NCRP 79 [7]. To convert fluence to
ambient or personal dose equivalent [8] knowledge of the
neutron spectrum is required. We do not have this knowl-
edge and have attempted to convert fluence calculations to
dose equivalent calculations using information in NCRP 79.
Using the dosimetric approach outlined above, this
paper investigates neutron leakage when a Precise linear
accelerator (Elekta Ltd, Crawley, UK) is generating
10 MV X-rays and quantifies the effect for bunkers with
direct access doors and short mazes.
Materials – neutron dosimeters
Neutron personal dosimeter badges
Neutron monitoring badges were used in high dose
rate situations and to confirm doses estimated from
survey meter readings in low dose rate areas [9].

The British Journal of Radiology, June 2007 469


The two types of badges employed were of the CR-39
type. One difficulty in choosing a suitable badge is
determining the consequences of its energy response [6,
10]. In order to determine the leakage rate from the X-ray
head polyallyldiglycol carbonate (PADC) badges were
obtained from the NRPB, Chilton, UK. The NRPB, now
the Radiation Protection Division of the Health
Protection Agency, performed calculations to correct
the badge response for intrinsic sheet sensitivity, the
angle of incidence and the neutron spectrum. Luxel dose
monitoring badges containing a Neutrak 144 neutron
detector were obtained from Landauer Inc., Oxford, UK
for measuring photon and neutron doses within and
external to a treatment room as discussed below.
Landauer reported the doses from these badges in their
normal manner. The energy range of these badges is
quoted as ‘‘Thermal neutrons below 0.5 eV and fast
neutrons from 40 keV to 35 MeV’’. Badges have inherent
limitations when measuring low doses outside treatment
rooms. The minimum reported dose for fast neutrons for
each of the two badges used in this study is quoted as
0.2 mSv and for Neutrak 144, for thermal neutrons,
0.1 mSv.
Neutron survey meters
Two NM2B survey meters (Thermo Electron Corpo-
ration, Beenham, UK) of the generic Andersson-Braun
type were used. Meter A was owned by St Thomas’
Hospital and meter B was loaned by Elekta Ltd.
These meters have high discrimination against
photons but can be affected by large photon pulses
produced by linear accelerators. NM2B meters are fitted
with a circuit that monitors the presence of a high photon
pulse and then switches off the neutron detection circuit
while the X-ray pulse subsides. The slower neutrons then
arrive at the monitor to be detected. This photon
response was partly investigated in this study.
The dead-time of the survey instruments may result in
neutrons not being detected in pulse fields [5]. For a
Precise accelerator operating at 10 MV with a pulse
repetition rate of 200 s21, NM2B meter readings above
65 mSv h21 should underestimate the true reading. Meter
A is regularly calibrated using a 252 Cf source at the NPL
and the meter response is quoted in terms of ambient
dose equivalent H*(10). Meter B had been calibrated by
the NRPB to an accuracy of +/2 30%.
The NPL also conducted measurements on our behalf
using Harwell Model 0949 survey meters (Harwell
Instruments Ltd., Winfrith, UK) of the generic Leake
type.
Both types of meter essentially count the number of
neutrons arriving at the detecting element. The different
designs, e.g. the materials used to absorb neutrons on
their way to the detector, attempt to ensure that the
efficiency of neutron detection mimics the ambient dose
equivalent to fluence correction curve. If this were
perfectly achieved, no correction for the neutron energy
spectrum would need to be applied. The orientation of
the meters relative to the neutron beam can significantly
alter their response. In consequence the NM2B meters
were used in the 90 degree (side-on) orientation and
Harwell meters in the 0 degree (straight-on) orientation.
470
P J Rudd, D Prior and S Austin-Smith
As demonstrated by recent Monte Carlo calculations [11]
these meters can under-respond or over-respond by
almost an order of magnitude at certain energies and
beam directions. In their normal orientations H*(10) can
be overestimated by about a factor of 5 at approximately
5 keV and underestimated by a factor of 2.5 at 0.025 eV
for neutrons in thermal equilibrium with their surround-
ings. However, corrections for NM2 meters in practical
spectra in the nuclear industry can be only of the order of
15% [12]. Due to the paucity of relevant published
spectra no correction has been applied in this paper.
Neutron head leakage
Measurements
PADC badges were placed at varying distances and
positions in the isocentric plane and around the head of
Elekta 1 (serial number 105635) at St Thomas’ Hospital.
The collimation system was closed. The photon dose that
would otherwise have been delivered to the isocentre
was 100 Gy.
Results
The values of Hp(10,0) reported by the NRPB were
fitted to a (1/r2) relationship. Ignoring the constant term
(attributed to room scatter), the leakage due to direct
neutrons at 1 m from the target (identified as L(1) below)
was of the order of 0.0045% Sv Gy21, i.e. 0.000045
neutron Sv per photon Gy at the isocentre.
Neutron leakage and a direct access door
At St Thomas’, Elekta 3 (serial number 105742) was
placed in a bunker constructed of LediteH blocks (Atomic
International Ltd, Frederick, USA). A direct access door
of welded steel plates was to be provided with 20 cm of
lead and calculations were performed to determine the
neutron shielding required.
Theoretical calculations
Unattenuated dose at the door due to epithermal
neutrons
We have converted Equation (13) of NCRP 79 to one in
terms of H*(10).
L(p)~L(1)
r12
(Eave =Edir )0:735
(1=r2 z4pW =S) ð1Þ
where
L(p) is the H*(10) leakage at a position p per photon Gy
(Sv Gy21)
L(1) is the Hp(10,0) leakage due to direct neutrons at
1 m (Sv Gy21)
r1 is the distance, at which L(1) was determined (1 m)
Eave is the average energy of both direct and scattered
neutrons (MeV)
The British Journal of Radiology, June 2007
Neutrons at 10 MV, treatment room door and maze design
Edir is the average energy of the direct neutrons after
passing through the head shielding (MeV)
r is the distance from the X-ray target (m)
S is the internal surface area of the treatment room
(m2)
W is a dimensionless constant
W normally has a value of 5.4. But when we consider
an opening, we have assumed only half the room
scattered neutrons are travelling in the direction out of
the treatment room; in such a case we have used a value
of 2.7. This simple assumption possibly leads to an
overestimation by a factor of 2 or p in the scattered
neutron contribution to the dose [13, 14]. The term
involving the ratio Eave/Edir is needed to convert from a
fluence based equation.
The power factor 0.735 results from Figure 31a of
NCRP 79 and is applicable to spectra with average
neutron energies below 1.0 MeV. No account is taken
here of the effects of ICRP 60 on the accuracy of Figure
31a.
Eave/Edir is derived from Equation (2) which is a
reformulation of Equation (14) of NCRP 79 to amplify the
effect of selecting different values of W.
Eave =Edir ~(Sz0:24
W
4pr2 )=(SzW
4pr2 )
We have used the following information. The distance, r,
to the centre of the door opening is approximately 4 m
and the internal surface area, S, of the room is
approximately 182 m2. A value of Edir of 0.65 MeV for
10 MV X-rays as suggested by NCRP 79 was used. To
calculate instantaneous H*(10) rates and annual H*(10) at
the treatment room door we need further information.
The Elekta 3 bunker design assumes a high tension (ht)
on time at 10 MV of 167 hours per annum at 500 monitor
units per minute. This ht on time results from the
delivery of traditional treatments at St Thomas’ using a
motorized wedge. The photon dose consistent with our
definition of head leakage becomes effectively 50 kGy
per annum.
Table 1 provides the results of two sets of calculations,
on the inside of the closed door and at the open door.
The closed door calculation is simply provided to give an
estimate of the dose that would be received by a
monitoring badge on the inside surface of the door.
The open door calculation allows us to estimate the
amount of neutron shielding required in the treatment
door.
Table 1. Neutron dose calculations applicable to in-room
dose monitoring and door protection for the Elekta 3 bunker
at St Thomas’ Hospital
Parameter Inside closed door At open door
Average energy of 0.23 0.28
neutrons (MeV)
26 26
Neutron (Sv. photon 9.1 * 10 6.0 * 10
Gy21)
Annual H*(10) (mSv) 455 300
Instantaneous 2724 1796
H*(10) rate (mSv h21)
The British Journal of Radiology, June 2007
Neutron shielding in the door
From NCRP 79 the dose equivalent tenth value layer
(TVL) for polyethylene is expected to be 7.15 cm for Eave
equal to 0.28 MeV. Unlike photons, it is not clear what
oblique incidence correction is necessary; therefore, no
attempt has been made to make such a correction. In
order to reduce the transmitted H*(10) to 0.5 mSv per
annum, 19.9 cm of polyethylene would be required.
Atomic International actually installed 22.5 cm of poly-
ethylene to fully fill the void in the door. Calculation
therefore suggests that the transmitted H*(10) should be
0.21 mSv per annum and the instantaneous H*(10) rate,
1.25 mSv h21. The attenuation of the steel facing of the
door can be ignored and that of 20 cm of lead is minimal;
if we used a TVL of 80 cm [15] the instantaneous H*(10)
rate would be reduced to 0.7 mSv h21.
Unattenuated dose at the door due to thermal
neutrons
Thermal neutrons scattered in the room are considered
separately in NCRP 79. McGinley et al [16] provide an
estimate of the thermal neutron fluence. We derive
Equation (3).
ð2Þ TR~L(1)
r12
(Ft =Fdir )
(Y
4p=S) ð3Þ
where
TR is the H*(10) leakage due to thermal neutrons (Sv
Gy21)
Ft is the fluence to H*(10) conversion factor for thermal
neutrons of average energy 0.025eV (Sv m2)
Fdir is the fluence to H*(10) conversion factor for the
direct neutrons (Sv m2)
Y is a dimensionless constant
Y normally has a value of 1.26 for a closed concrete
room. For an opening, we again make the simple and
possibly incorrect assumption that only half the room
scattered neutrons travel in the direction out of the room.
In such a case we have used a value of 0.63. The ratio (Ft/
Fdir ) is of the order of (1/19.1) [8]. For Elekta 3, H*(10)
with the door closed equates to 10.2 mSv and with it
open 5.1 mSv.
Thermal neutron shielding in the door
It is common practice to incorporate boron into
polyethylene to absorb thermal neutrons but is this
always necessary? Relative to boron, pure polyethylene
is a poor absorber of neutrons. The cross-section of
hydrogen is only 0.33 barns for thermal neutrons. This
would suggest that in a distance of 22.5 cm only half of
the thermal neutrons are captured. A transmitted H*(10)
of 2.6 mSv per annum equates to an instantaneous
H*(10) rate of 15.5 mSv h21. This would be unacceptable.
However, various references [17, 18] state that thermal
neutrons diffuse only a few centimetres in tissue before
being captured by a hydrogen nucleus. Moreover, the
fall off of dose equivalent with depth for thermal
neutrons indicates a TVL of approximately 13 cm for
tissue [17]. Polyethylene has a very similar hydrogen
content to tissue so if this TVL is used the H*(10) rate due
to thermal neutrons outside a 22.5 cm polyethylene door
would be of the order of only 0.54 mSv h21.
471

Figure 1. The bunker at Royal Sussex County Hospital.
Primary barriers (stippled) are of higher density concrete
(see text).
Measurements and results
Measurements outside the Elekta 3 treatment room door
made with the meter A indicated H*(10) rates of the order
of 0.5 mSv h21. Because of the energy dependence of the
meter the true reading could be in the range 0.1 to
1.25 mSv h21 but might be expected to be close to that
displayed. The measurement is in good agreement with
the epithermal neutron calculation of 1.25 mSv h21 for
polyethylene only, and 0.7 mSv h21 when the lead
attenuation is also considered. There is no evidence for
the higher dose rates that were predicted if polyethylene is
472
P J Rudd, D Prior and S Austin-Smith
a poor attenuator of thermal neutrons. This conclusion was
also supported by Luxel neutron dose monitoring badges
placed outside the door at floor and waist level. The
reporting threshold dose for thermal neutrons of
100 mSv was not exceeded in a 3 month monitoring period.
Badges were also placed in the treatment room either
side of the door. The badges were left in place for 21
treatment days and the total ht on time was recorded as
27.3 h. These badges registered a fast neutron Hp(10,0) of
7.9 and 13.8 mSv, an average of 10.9 mSv. If we assume
that ht on time at 10 MV was 50% of the total, then the
projected annual dose would be 132 mSv compared with
455 mSv calculated above. The poor agreement may be
due to many factors not least that we did not record the
actual beam on time at 10 MV. However, the thermal
neutron dose was recorded as 0.5 and 0.9 mSv, an
average of 0.7 mSv. This implies an annual dose of
8.5 mSv, in good agreement with the value of 10.2 mSv
calculated above.
The door provided by Atomic International exceeded
our protection requirements. The H*(10) rate for photons
at 10 MV was measured outside the treatment room door
as 1 mSv h21 giving a total value of 1.5 mSv h21 for both
photons and neutrons. Ignoring the contribution from
6 MV photons, the annual H*(10) is expected to be
0.25 mSv with 100% occupancy. This is well below the
level we would normally accept at a room entrance,
1.5 mSv with 100% occupancy.
Maze design and neutron leakage
Calculations and measurements have been performed
for an Elekta Precise linear accelerator (serial number
105802) installation at the Royal Sussex County Hospital
(Figure 1) and Elekta 4 (serial number 105959) installa-
tion at St Thomas’ (Figure 2). The scale depicted in each
figure is in millimetres. The Royal Sussex County bunker
is constructed of concrete of density 2350 kg m23 except
Figure 2. The Elekta 4 bunker at St
Thomas’ Hospital. Shaded areas
show lining of steel plates (see text).
The British Journal of Radiology, June 2007
Neutrons at 10 MV, treatment room door and maze design
for the primary barriers, shaded in Figure 1, which are of
density 3500 kg m23. The Elekta 4 bunker is constructed
of concrete of density 2350 kg m23. Vertical primary
barriers, shaded in Figure 2, and approximately one-
third of the surface area of the treatment room ceiling are
lined with steel plates. The Elekta 4 maze is fitted with a
door of 4 mm lead, 36 mm MDF and 8 mm plywood to
reduce the annual photon H*(10) to below 1 mSv. Both
bunkers are dry lined with plasterboard.
Calculations
We have used a slightly modified version of the
original Kersey method [5, 19].
H(di)~DR
L(1)
106
(r12 =R2 )
(Sm=So)
1=10(1z(di3)=5) ð4Þ
where
H(di) is the H*(10) rate at position di in the
maze (mSv h21)
di is the distance along the maze (m)
DR is the photon dose rate at the isocentre (Gy h21)
L(1) and r1 are as above (Sv Gy21 and m)
R is the distance from the isocentre to the maze
entrance (m)
Sm is the minimum cross-section of the maze (m2)
So is a an area constant (6 m2)
106 is a constant to convert Sv to mSv
We have assumed that below a di value of 3 m the
attenuation term becomes 1/10(di/3). The distances R and di
have been measured in accordance with Figures 1 and 2
which are consistent with the diagrams shown in IPEM 75.
The values of Sm and R at the Royal Sussex County bunker
and the Elekta 4 bunker at St Thomas’ are, respectively,
4.1 m2, 4.1 m and 5.4 m2 and 7.1 m. Calculated values are
shown in Tables 2 and 3. No allowance was made for the
presence of the door in the Elekta 4 maze.
Measurements at Royal Sussex County Hospital
Measurements were made using meters A and B. The
meters were placed side by side in the maze. At certain
positions the meters were interchanged and the readings
repeated. The digital scale of the meter was read on the
999.9 mSv h21 setting, which involved 34 s measuring
periods. A member of staff was present in the maze to
operate the start button on the monitors but otherwise
retired close to the maze entrance whilst the beam was
running. The gantry was pointed vertically down and the
collimator system closed down to produce a minimal size
field. Consequently personal doses were kept very low.
Measurements were made along the centre of the maze at
approximately 1.2 m above floor level. An attempt was
made to determine if the X-ray pulse affected monitor
readings by running the beam at 6 MV.
Results
The nominal photon dose rate at the isocentre was 400
monitor units per minute; this equates to 240 Gy h21 at
The British Journal of Radiology, June 2007
2.2 cm depth at the isocentre in a 10 cm square field.
Table 2 compares measurements and calculated values.
Repeat readings, made by interchanging the survey
meters, suggest that the values were reasonably repro-
ducible at each position. Measurement 1A was made
with a 6 MV beam and indicates that meter A appears
to respond to photons. This was unexpected.
Measurements 1, at 10 MV, indicated meter A readings
much higher than both meter B readings and the
calculated values. The apparent ability of meter A to
detect photons at 6 MV would not explain such a large
discrepancy. At positions further along the maze meter A
again appears to over-read but with decreasing effect.
For measurements in the range 1 to 30 mSv h21, meter
A reads 14% higher on average than the Elekta meter.
The ratio of measured/calculated H*(10) was of the
order of 0.9 for meter A and 0.8 for meter B. The accuracy
of the measurements at position 7 is affected by the
resolution of the digital scale. Calculation and measure-
ment indicate that, at the end of the maze, the annual
value of H*(10) would be of the order of only 0.1 mSv for
neutrons. Had the maze been 7 m long the neutron
H*(10) dose could have been of the order of 1 to 1.5 mSv,
dependent on using the measured or calculated values.
Measurements at St Thomas’ Hospital
Measurements were generally made with the same
conditions as at the Royal Sussex County Hospital but
limited studies were made to determine the effect of fully
opening the multileaf collimator (MLC)/jaw system and
gantry angle. Initially measurements were made using
meter A. Dr David Thomas of the National Physical
Laboratory, Teddington kindly agreed to perform some
independent neutron measurements with two Harwell
Model 0949 survey meters. At the NPL visit meter A
measurements were made only at the maze entrance.
Results
The nominal 10 MV photon dose rate at the isocentre was
450 monitor units per minute; this equates to 270 Gy h21.
Table 3 compares measured and calculated values. We
present only the average results of the two NPL meters.
Measurement 1A was made with the 6 MV beam and again
demonstrates that meter A appears to respond to photons.
Measurements at positions 1 to 3 in the range 9 to
73 mSv h21 indicated that meter A reads 20% lower on
average than the NPL meters and the ratio of measured/
calculated H*(10) was of the order of 1.59 for meter A and
2.03 for the NPL meters. The raised value of the ratio for
measurement 4 might be indicative of backscatter of
neutrons from the door and the reduction for measure-
ments 5 and 5A suggests neutron attenuation by the door
by a factor of approximately 2. Further readings were made
at the control desk side of the treatment door with meter A
to determine the effect of opening the collimator system
and gantry angle. With the gantry vertical and with the
field opened to a 40 cm square the NM2B reading was
reduced from 1.7 to 1.4 mSv h21; a reduction would be
expected since the collimation system contributes neutrons
when in the photon beam path. Directing a 40 cm square
473
 P J Rudd, D Prior and S Austin-Smith

Table 2. Comparison of measured and calculated H*(10) rates in the maze at the Royal Sussex County Hospital.
Measurement di (m) Measured (mSv h21) Calc (mSv h21) Measurement/calculation

Meter A Meter B A/B Meter A Meter B

1A 1.22 33.5 0.1

1A repeat 1.22 29.7 0.2
1 1.22 521.3 148.5 3.51 177.5 2.94 0.84
1 repeat 1.22 555.1 143.6 3.87 177.5 3.13 0.81
2 2.24 123.7 71.4 1.73 81.1 1.52 0.88
2 repeat 2.24 122.8 75.7 1.62 81.1 1.51 0.93
3 4.61 27.3 20.7 1.32 21.6 1.27 0.96
3 repeat 4.61 26.8 25.8 1.04 21.6 1.24 1.20
4 6.97 6.4 4.9 1.31 7.3 0.88 0.67
4 repeat 6.97 5.9 5.0 1.18 7.3 0.81 0.69
5 8.98 1.4 1.4 1.00 2.9 0.49 0.49
6 10.95 0.9 0.9 1.00 1.2 0.77 0.77
7 12.96 0.1 0.3 0.33 0.5 0.22 0.65
Repeat measurements included interchanging the meters.

field to a man size phantom positioned at the isocentre
yielded NM2B readings in the range of 0.7 to 2.3 mSv h21
depending on gantry angle. The variation with gantry angle
was not expected, since neutron emission from the head is
often assumed to be reasonably symmetric. The average
reading was, perhaps fortuitously, close to that at the
vertical gantry angle position. If we use the NPL reading of
2.3 mSv h21, the anticipated annual H*(10) dose equivalent
due to neutrons is 0.43 mSv. The photon H*(10) has been
determined to be of the order of 0.93 mSv. The total annual
H*(10) is therefore expected to be 1.35 mSv; this is within the
design criteria of 1.5 mSv for 100% occupancy.
Discussion and conclusions
IPEM 75 quotes a value of L(1) of 0.002% Sv Gy21,
based on data applicable to accelerators produced by
Varian, Palo Alto, USA. The Elekta Precise Planning
Guide quoted a neutron dose equivalent of 0.03%
Sv Gy21, a factor of seven times that measured. This
value appears to be consistent with Table 6.1 in IPEM 75
which depicts neutron leakage limits if a radiation
weighting factor of 10 is used. In subsequent correspon-
dence with Elekta Ltd this was revised downwards to
0.01% Sv Gy21. We used our measured value of 0.0045%
Sv Gy21 for calculations.
Calculation of neutron shielding in the direct entry
room door suggested that we use 20 cm of polyethylene
and tradition dictated that 25 mm of this be boron
loaded. Atomic International supplied 22.5 cm of poly-
ethylene, sufficient to fill the void in the door. The
instantaneous neutron H*(10) rate outside the door was
in good agreement with that calculated. Such agreement
may have been fortuitous. It would of course have
been interesting to determine how the dose rate varied
with the thickness of polyethylene, but this was not
practicable. Boron loaded polyethylene was not used and
this appeared to have had no detrimental impact.
Information on the ability of pure polyethylene to
attenuate thermal neutrons appears to be contradictory.
Meter A appeared to produce erroneous results in
fields where neutron H*(10) rates are higher than
100 mSv h21. The fact that it responds to 6 MV photon
fields suggests the delay circuit designed to eliminate the
fast photon pulse is not working correctly. At dose rates
encountered at the end of real mazes, meter A agreed
with the other three meters to better than 26%. This gives
a modicum of confidence in the use of the St Thomas’
meter. However, NM2B and Leake type meters have
similar energy responses and could be under-or over-
estimating the true H*(10) rates. It is unlikely that all the
neutrons are thermalized in typical mazes and therefore
it is unlikely that our results significantly underestimate
dose rates. Equation (4) appears to predict measured
H*(10) doses within a factor of approximately 2. Neutron
H*(10) rates along mazes of the order of 7 m or less in
length are not insignificant if the aim is to reduce total
photon and neutron dose to the order of 1.5 mSv per
annum at 100% occupancy.

Table 3. Comparison of measured and calculated H*(10) rates in the maze of the Elekta 4 bunker at St Thomas’ Hospital
Measurement di (m) Measured (mSv h21) Calc (mSv h21) Measurement/calculation

Meter A NPL A/NPL Meter A NPL

1A 2.00 0.6 0.16

1 2.00 54.7 73.0 0.75 34.8 1.57 2.10
2 3.50 21.9 14.1 1.56
3 5.50 9.2 11.0 0.84 5.6 1.64 1.96
4 7.17 5.4 2.6 2.08
5 7.69 1.7 2.1 0.81
5A 7.69 1.8 2.3 0.74 2.1 0.83 1.12
NPL, National Physical Laboratory survey meter readings, average of two instruments.

474 The British Journal of Radiology, June 2007

Neutrons at 10 MV, treatment room door and maze design
Neutron dosimetry for radiation protection is
fraught with difficulties. This paper does not purport
to be a definitive text on the subject. However, it
indicates that neutron doses cannot be neglected when
considering the safety of direct access doors or short
mazes at 10 MV.
Acknowledgments
We are grateful for the loan of the NM2B survey meter
from Elekta Ltd, Crawley. We are indebted to Dr. David
Thomas, NPL, Teddington for the measurements per-
formed at St Thomas’ and Dr R. Tanner, NRPB, Chilton
for the analysis of the PADC neutron badge results.
Angela Daynes of Guy’s and St Thomas’ ably assisted in
the measurements made on Elekta 4, Tony Greener
provided helpful comments on the paper and Philip
Sands kindly prepared the figures of the bunkers.
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