1970, Br. J. Radiol.
, 43, 859-867
Wax retraction as a technique for compensating the effect of
surface irregularities in high-energy radiotherapy
By W. Jackson, M.A., B.Sc.
Department of Clinical Physics and Bioengineering, Western Regional Hospital Board, Glasgow
(Received February, 1970)
The effect of surface irregularities is often eliminated
in medium voltage radiotherapy by adding tissue-
equivalent wax to the body tissue so as to present a
plane surface to the X-ray beam. The application
of isodose charts is then straightforward. Provided
one is not concerned with skin sparing this tech-
nique may be used with any radition energy, but
in high-energy radiotherapy reduced skin dose is
one of the major benefits. For this reason, methods
of compensating for an irregular skin surface have
been devised (Hall and Oliver, 1961). These employ
metal compensators, inserted into the beam at some
distance from the skin, and so designed that, while
preserving a large degree of skin sparing, they en-
able the normal isodose charts to be used in the es-
timation of depth dose. The method is effective
in that errors are normally very small, but it is
time-consuming in the construction of the compen-
sators. In some instances the design is such as to
give optimum compensation over a given region
(Van de Geijn, 1965) or to compensate exactly at a
chosen point in depth (Wilks and Casebow, 1969).
An alternative method used at some centres is to
wax up to a plane surface at right angles to the beam,
then to withdraw or retract the wax some distance
along the beam axis (Cohen, Burns and Sear, 1960).
As the retracting distance is increased the electron
contamination on the skin progressively diminishes,
and one hopes to find a retracting distance such
that the dose to the skin is reduced to acceptable
proportions. The errors in this technique are of
course greater than those when metal compensators
are used, since no allowance is made for beam di-
vergence. The presence article examines surface and
depth doses as a function of retracting distance with
a view to assessing the errors involved and so
indicating the limits of usefulness of the technique.
The work was done on a 4 MV linear accelerator
(Vickers) and a cobalt unit (A.E.I.) where the focal
and source distances were 100 cm and 70 cm res-
pectively.
RETRACTION AND ITS EFFECT ON SURFACE DOSE
AND DEPTH DOSE
(A) The factors on which surface dose depends
When a beam of high energy X rays is incident
859
DECEMBER 1970
on an absorbing medium, energy is imparted to the
medium by the secondary electrons released in the
interaction between photons and free electrons in
the medium. With megavoltage radiation, these
energetic electrons are generated by the Compton
effect and have a momentum in the forward direc-
tion of the beam. If, therefore, an infinitesimally
small volume on the surface of the medium is irradiat-
ed by a perpendicular beam it might be expected
that the dose there would be zero, since the forward
moving electrons do not contribute to any surface
ionisation. This would in fact be true but for two
factors. First, a component of dose is formed by the
secondary electrons produced in the air and in parts
of the generating apparatus such as the beam defin-
ing jaws. Second, some of the Compton electrons
generated near the surface undergo multiple scat-
tering in the medium and are scattered backwards
in the opposite direction to the beam, so contributing
to surface dose. The latter may be as much as 13 per
cent of the full build-up (FBU) dose for 2 MeV
radiation (Howarth, Jones and Miller, 1951). The
small range of the back-scattered electrons makes
their contribution to the dose independent of field
size. Air ionisation accounts for the considerable
variation of surface dose with field size. Since its
effect is a maximum at the centre of the field, sur-
face dose is non-uniform, falling towards the edge
of the field. It may be shown, too, that it depends
on the angle of incidence of the beam, being minimal
at perpendicular incidence. Experimentally it may
be measured by a "build-up" chamber, essentially a
very small parallel plate ionisation chamber with an
electrode spacing of only 1 or 2 mm, and a very
thin entrance wall to minimise the absorption of
electrons.
(B) Effects of wax retraction
Retraction alters both surface and depth doses.
On the surface the electron contamination diminish-
es as the wax is moved away. At depth the dose is
decreased by the partial removal of scattering mat-
erial and is altered whenever the path of the primary
ray changes. For points in the centre of the field the
path is unchanged by retraction but away from the
centre it may either be increased or decreased
VOL. 43, No. 516
W. Jackson
FIG. 1.
Basis of theoretical calculation.
according to the shape of the wax surface. The result-
ing "geometric" error is defined as the fractional
change in absorption of the primary ray due to
retraction.
(C) How retraction affects surface dose
Consider a build-up chamber on the surface of a
unit density phantom under an equilibrium thick-
ness t of tissue equivalent wax (Fig. 1). Let the
whole be irradiated by a parallel beam of high en-
ergy X rays normal to the surface. Compton elec-
trons generated in the volume A V\ will be scattered
in the forward direction of the beam, their energy
depending on the scatter angle. Some, scattered at
an angle </>, will reach the build-up chamber pro-
vided its distance from A V\ is within the range of
the secondary electrons in that direction. Making
the assumption that the scattered electrons move in
a straight line, or alternatively, as suggested by
Howarth et al. (1951), that those which are deflected
away from the chamber are just compensated by
those entering from other scattering angles, the
ionisation in the chamber may be calculated from the
Klein-Nishina formula. If/(</>) is the cross-section
per electron for the number of electrons scattered
860
EDGE of
FIELD
EQUILIBRIUM
THICKNESS of WAX
UNIT DENSITY:
PHANTOM
into unit solid angle at angle <j> then, following
Howarth et al.'s (1951) notation, the element of
volume is the ring element 2T7T2 sin (/> drd<f> and the
volume of wax between <> / and (ft-^Afi contributes
Kf(<f>) sin ^>/?^A0 to the skin dose, where R<j> is the
range of secondary electrons in the direction <> / and
J^is constant while the irradiation conditions remain
unaltered. FBU dose may be expressed as
o
If now the wax is retracted the corresponding
element of volume A V between <f) and <f>-\-A<f> makes
exactly the same contribution to the build-up dose,
neglecting the absorption of the electrons in the air.
The difference between the effects of the surface
and retracted wax is therefore seen to reside in the
different ranges of integration0 to TTJ2 for the
surface, 0 to </>o for the retracted, wax, </>o represent-
ing the point of cut-off where the wax ceases to be
irradiated by the X-ray beam. The effect of retrac-
tion is, then, an angular one. For the same level of
contamination, the retracting distance should be
proportional to field dimension, since <^o is thereby
kept the same. This is for a parallel beam but the
relation should hold approximately in practice
since beam divergence is not large, especially for
 DECEMBER 1970

Wax retraction as a technique for compensating the effect of surface irregularities

P1 O1 TABLE I
PERCENTAGE CHANGE IN PRIMARY DOSE DUE TO RETRACTION
MAXIMUM GEOMETRIC ERRORS

Field Retracting 4MV linear

size distance Cobalt unit accelerator
(cm2) (cm)
30 45 30 45
wedge wedge wedge wedge
15x15 5 2-1 3-7 1-3 2-3
10 4-1 7-3 2-6 4-5
20 8-2 14-1 51 8-8

10x10 5 1-4 2-4 0-9 1-5

10 2-7 4-8 1-7 3-0
20 5-4 9-2 3-4 5-9
5x5 5 0-7 1-1 0-4 0-7
10 1-3 2-3 0-8 1-4
20 2-6 4-5 1-6 30

T h e following analysis leads to a formula by which

the " g e o m e t r i c " error may be calculated for a
wedge of constant angle.
FIG. 2. Referring to Fig. 2 a n d t h e definition there of t h e
Retraction of wax wedge. The path of the primary ray terms used, we have, from triangle PUW
PQ becomes P'Q' on retraction.
D = retracting distance. 8v 8a 8a
6 = angle between PQ and the central ray OC. 3L
<jj = wedge angle. sin 0 sin A cos (0+0)
A = angle PQC.
OP= a = half-width of field at focal distance F. 8a D sin0 D
Now = and so 8y = a
UV is parallel and equal to P'Q'; if y = PQ, UV=P'Q' = a F cos (0+0) ~F
y-hy.UWis parallel to VQ. PU = Sa.
T h i s is for a ray on t h e left of t h e central axis;
the corresponding formula for o n e o n t h e right is
small fields. There is the added factor of air ioni- sin 0 D
sation, and it may be seen from Fig. 1 that this does 8y = a
cos (0-0) ~F
not vary in the same manner as that from the retract-
ed wax. For the same <f>o one would expect slightly T h e percentage change in absorption may be
lower levels of surface dose on the smaller retrac- calculated from t h e linear absorption coefficient of
tions because of the reduced contribution from the the m e d i u m for t h e radiation. It is zero at t h e
air. This has been found from the experimental work, centre, increasing in magnitude towards t h e field
which also showed the angular relation to hold edge, positive to t h e right in Fig. 2, negative to t h e
fairly closely. left. T a b l e I indicates the m a x i m u m values of t h e
When wax of greater than equilibrium thickness effect, at t h e field edge, for various field sizes a n d
is retracted in a parallel beam the photon fluence retracting distances. T o t h e left of t h e central axis
will be further attenuated by an amount which is the increase in t h e primary dose tends to offset t h e
the same whether the wax is retracted or not. The scatter error, whereas to t h e right of the central axis
above relation will therefore still be true and the the two errors are additive. However, near t h e right
ratio of the electron contamination produced by the edge t h e effect of t h e scatter loss is quite small, so
retracted wax to that of the surface wax will be inde- the geometric error gives a rough indication of t h e
pendent of its thickness. order of the error to be expected there.

(D) How retraction affects depth dose EXPERIMENTAL

The two factors which cause a change in depth T h e experimental apparatus was designed to
dose have already been mentioned, i.e. loss of scatter measure t h e changes in both surface a n d depth dose
and an alteration in the path of the primary ray. which result from retraction. T h e s e changes were
861
VOL. 43, No. 516
W. Jackson
examined first for uniform thicknesses of tissue-
equivalent wax and then for wedge-shaped pieces of
angles 30 and 45 deg. In practice the wax is irregular
in shape but will usually conform between these
extremes.
For the surface measurements the wax was re-
placed by boards of unit-density Pressdwood. The
build-up chamber had a collecting diameter of 1 cm
and an electrode spacing of 1 mm and was inserted
into a Pressdwood phantom with the Melinex front
window (1-2 mg/cm2) flush with the phantom sur-
face. With the chamber below the centre of the board
the procedure was to expose it with the board first
on the surface of the phantom, then retracted in the
beam direction, the exposure being the same for
both positions. The ratio of the retracted to surface
reading was found to be sensibly independent of
board thickness for the range examined (3-5 mm to
7 cm) and was plotted as a function of retracting dis-
tance for retractions up to 20 cm. Field sizes varied
from 5 x 5 cm2 to 20 X 20 cm2.
A similar method was used to determine the
depth dose errors when uniform wax thicknesses are
retracted, the wax again being replaced by Pressd-
wood boards. Depth was measured from the phan-
tom or "skin" surface while the reference surface for
the depth dose values was the top of the board,
corresponding to the "waxed-up" surface in prac-
tice. The build-up chamber was supplemented
initially by a Baldwin-Farmer dosemeter, the cap
of which fitted closely into holes in the Pressdwood.
The findings from the two chambers corresponded
closely, and in the later stages the Baldwin-Farmer
was used alone. Central axis depth doses were ex-
amined to a depth of 12 cm below the Pressdwood
surface for three field sizes5 X 5 cm2, 10 x 10 cm2
and 20 X 20 cm2 with retracting distances up to 20
cm.
The diameter of the build-up chamber, while
small, is still of the same order as the average range
of the secondary electrons in tissue and this fact
raised some doubts as to how accurately such a
chamber measures either surface or build-up dose,
when it collects electrons reaching it from a wide
range of angles. On repeating some of the measure-
ments with a chamber of 2 cm collecting diameter

V
100

60-

FIELD 2 0 x 2 0 c m 2

FIELD 1 0 x 1 0 c m 2
20-
FIELD 5x5cm2

RETRACTING DISTANCE (cm

FIG. 3.
Chamber reading with wax retracted as a percentage, R, of that with wax on surface.
4 MV linear accelerator. The experimental points are shown.
862
 DECEMBER 1970

Wax retraction as a technique for compensating the effect of surface irregularities

V
100

FIELD 20x20cm 2

FIELD 10 x 10 c m 2
20-
FIELD 5 x 5cm 2

12 20

RETRACTING DISTANCE (cm)

FIG. 4.
Chamber 60
reading with wax retracted as a percentage, R, of that with wax on surface.
Co unit. The experimental points are shown with the fitted curves.
with penumbra trimmer.
without penumbra trimmer.

changes were found in the ratio of retracted to
surface dose, the implications of which will be
discussed later.
In the technique employed for wedge retraction,
two identical wax wedges initially fitted together to
form a rectangular block placed on top of a Pressd-
wood phantom. The upper was then retracted
in the beam direction, the field size (as in normal
practice) being defined on the surface of the upper
wedge, which also determined the focal distance.
Holes drilled into phantom and lower wedge en-
abled measurements to be made with the Baldwin-
Farmer dosemeter on the central axis of the beam
and at points lateral to it. Depths to 15 cm, again
measured below the surface of the non-retracted
wedge, were examined for fields 6 x 6 cm2 and
10x10 cm2.
RESULTS
(A) Surface dose
From Figs. 3 and 4 the surface dose under the
retracted wax may be determined as a percentage,
863
R, of that with the wax on the surface. R has been
found, as expected from theory, to be very nearly
independent of wax thickness. It may therefore be
applied, in any practical case, to give the skin dose
on retraction in terms of that obtaining before
retraction. If a specific level of contamination is de-
cided upon, the corresponding retracting distance
may be read from the graphs. The data illustrate the
validity of the "angle" effect already mentioned.
On the linear accelerator fields 5 x 5 cm2 at 5 cm
retracting distance, 10x10 cm2 at 10 cm, and
20 X 20 cm2 at 20 cm give R values of 41, 45 and 46
respectively, while the 60 Co untrimmed fields all
yield values around 50. These corroborate the rule
that, for the same skin dose, retracting distance
should be proportional to field dimension. The re-
lation is not an exact one, but if we accept 45-50 per
cent of its initial value as a reasonable level of skin
dosage on retraction, we may make the working rule
that retracting distance should equal field dimen-
sion. This will be the side of the square for square
fields, the mean of the sides for rectangular fields.
VOL. 43, No. 516
W. Jackson
Using the angular relation it is possible to compute 5cm RETRACTION
values for intermediate field sizes, e.g. a retraction
of 10 cm with a 12 x 12 cm2 field will give rise to PERCENTAGE REDUCTION
in DEPTH DOSE
about the same contamination as a retraction of 8-3
cm with a 10x10 cm2 field. Moreover, the effects
of larger fields may be assessed, as in techniques,
often at increased focal distances, where a Perspex
tray is used to support lead shielding blocks. For a
30 x 30 cm2 field, with 21 cm between skin and tray,
R will approximate to that for a 20x20 cm2 field
at 14 cm, and so the skin dose under the tray can be
expressed as a percentage of that which obtains
when the tray thickness of Perspex is in contact with
the skin surface. DEPTH (cm)

As regards quality, R was found to be slightly 10cm RETRACTION

lower for the linear accelerator, especially at the lar- PERCENTAGE REDUCTION
ger retracting distances. This is to be expected since, in DEPTH DOSE

with increasing retraction, it should tend towards the '2-1

relative surface ionisation for the particular field size,

i.e. the surface ionisation for the open field as a
percentage of FBU dose, and this is higher for
60
Co radiation. Slight differences also exist between
the trimmed and non-trimmed fields on the cobalt
unit. It has been noted that near the edge of the
beam the contribution from the ionised air falls
below that at the centre. A similar resultagain
indicated by theoryholds for the retracted board.
Experimentally the surface dose at a point 2-5 cm
from the edge of a 20 X 20 cm2 field was found to
be lower than that at the mid-point by 20 per cent
for a 20 cm retraction on the cobalt unit. DEPTH(cm)

From the point of view of skin contamination, PERCENTAGE REDUCTION 20 cm RETRACTION

in DEPTH DOSE
then, the retraction technique is most suited to 14-1
small fields where correspondingly small retracting
distances are possible. Large fields require large
retracting distances unless a greater degree of sur-
face contamination can be accepted, but here prac-
tical difficulties will tend to prevent the use of such
fields.

(B) Depth dose

(a) Uniform wax thicknesses. One would expect the
change in depth dose to increase with field size, 7 cm WAX THICKNESS
since the proportion of scatter to primary radiation
increases with beam area. This was confirmed, but 4 cm WAX THICKNESS

so little difference was found in the effects of the 2cm WAX THICKNESS

three fields that the data for the 10 X 10 cm2 field

could be used as representative of all three. No sig-
nificant difference was found between the two
radiation qualities. Figures 5A-5C give the magnitude
of the effect; they show how the percentage reduc-
tion in depth dose varies with retracting distance,
wax thickness, and depth. As expected, it is greatest
for the smaller depths and it increases with wax
864
DEPTH(cm)
FIG. 5.
(A-C) Percentage reduction in depth dose when uniform wax
thicknesses are retracted, as a function of wax thickness.
Depth is measured from the base of the wax before retrac-
tion ; depth doses refer to2 the top of the wax before retrac-
tion. Field 10x10 cm. (A) 5 cm retraction; B) 10 cm
retraction; (c) 20 cm retraction.

Wax retraction as a technique for compensating the effect of surface irregularities
thickness and retracting distance. At depths greater
than about 10 cm there is little additional change.
Large retracting distances, while reducing skin
contamination, may lead to serious depth dose
errors unless the wax is thin. The data refer to central
axis depth doses and give maximum errors. For
points off the centre axis the loss of scatter is smaller
and so also the change in depth dose. In practice
the wax is of course non-uniform, but it will be
shown that the average thickness may be used with-
out introducing any serious error. The corrections
will be applied to the actual value of the depth
dose, e.g. a 5 per cent decrease in the 60 per cent
dose will reduce it to 57 per cent.
The findings may be summarised:
(i) For depths of 5 cm and greater below the skin
surface, and retractions up to 10 cm, the per-
centage depth dose drops by less than 5 per
cent of its value unless the wax is more than 6 cm
thick. For a 20 cm retraction it is still less than
5 per cent if a 3-5 cm wax thickness is not
exceeded.
(ii) For depths less than 5 cm, errors in excess of
5 per cent may arise, depending on wax thick-
ness and retracting distance. For example,
a 10 per cent error can occur at a point 3-5 cm
below the skin surface with a wax thickness of
7 cm and a retraction of 20 cm. This, however,
would be an extreme case. In many instances the
error will be less than 5 per cent provided the
the wax thickness is not excessive,
(b) Wedges. Geometric errors vary in magnitude
and sign with distance from the central axis. Scatter
errors are always negative, changing in magnitude
across the central axis because of the configuration
of the retracted wax. Depth dose is made up of both
primary and scattered radiation and its change on
retraction will depend on the proportions of each
and how they change. For example, the scatter at a
point P near the surface and to the right of the beam
(Fig. 6) is small and its change negligible, so the
error will be almost entirely geometric. At Q, rep-
resenting a depth of 15 cm, the geometric error will
again predominate, since the scatter change is small,
because of the depth. Loss of scattered radiation
will be most pronounced for points on the left-
hand edge of the beam, but the sign of the geometric
error is such as to counteract the scatter change.
It might be expected, therefore, that the combined
error here would be minimal.
The experimental work confirmed these premises.
For points on the central axis it was found that the
error could be predicted almost exactly from that of
a uniform block of thickness half the wedge height
865
DECEMBER 1970
i.e. the average wedge thicknessand that the
maximum error for points at the same depth but off
the central axis was very close to this. The central
axis error was exceededbut only slightlyat
certain points on the right edge of the beam, no
doubt because of the combined effect of the geo-
metric and scatter error. The smallest errors were
found along RS at the left-hand edge of the beam.
Points closer than 2 cm to the wedge surface were
excluded, and retracting distance was limited to
10 cm.
Retraction errors should be greater for the cobalt
unit, mainly because of the larger geometric error,
though only by 1 or 2 per cent. Experimentally, dif-
ferences of this order are difficult to measure, and in
fact no significant difference in the two qualities was
detected. The maximum errors for a 45 deg. wedge
retracted 10 cm in a 10x10 cm2 field (average
wax thickness 6 cm) were found to be as follows:
inside the wedge portion RPT (Fig. 6) 7-5 per cent,
in the remainder of the beam 5-5 per cent. For the
30 deg. wedge (average wedge thickness 3-3 cm)
the corresponding maximum errors were 5-5
and 4 per cent. These may be compared with
the ^ 3 per cent range of error given by Cohen et al.
(1960) for a cobalt unit with a 30 deg. wedge. Their
analysis included slightly larger fields, but the
retracted wax was of a lower density which increased
the primary component of the beam by 5 per cent
and so tended to offset the depth dose decrease
caused by retraction.
The results fit a pattern for practical use in which
the error at a point inside the part RPT may be
SKIN
SURFACE
WAX
WEDGE
FIG. 6.
Wedge retraction.
CA, central ray; RS, PQ, lateral rays; R, C, P, points 2 cm
from skin surface; S, A, Q, points 15 cm from top of wax
wedge.
VOL. 43, No. 516
W. Jackson
estimated from Figs. 5A-5C, using as wax thickness reasonably good, but for the larger fields theory pre-
the average thickness of the filling wax and as depth dicted values 15 or 20 per cent high. The assump-
that to the skin surface. For other points, the maxi- tions in the theoretical calculation are, however,
mum error may be taken as that for the central axis open to question, especially that in which it is
at the same depth below the wax surface. assumed that electron losses by scatter in the path
from AV% to the chamber are compensated by
THE METHOD IN PRACTICE electrons entering from neighbouring elements.
The data make it possible to estimate both the This will not hold exactly, since a proportion of
skin contamination and the maximum change in electrons undergoing multiple scattering are scat-
depth dose which arise from retraction. Following tered backwards in the opposite direction to the
the working rule, retracting distance will be decided beam and do not contribute to forward ionisation.
by field dimensions and skin dose will be reduced to Even if the numbers along a given path were
half of its pre-retraction value. The next step will unaffected by scattering processes, their energy
be to determine the depth dose error for the tumour would be reduced; this means a decrease in range
depths of interest; it will depend mainly on the re- and a consequent reduction in the number emitted
tracting distance and the average thickness of the from the board. The fact that the discrepancy be-
wax. If the error is thought to be excessive it may be tween measured and calculated values increases with
reduced by the choice of a smaller retracting dis- field size suggests that electron scattering effects
tance, though at the expense of increased skin dose. are largely responsible, since greater differences
The technique is evidently most suitable for small may be expected as the scattering angle increases
fields where adequate skin protection can be and the energy decreases. From the point of view
achieved with a small retracting distance and the of skin contamination scattering may be considered
consequent depth dose errors are also small. With beneficial in that it tends to remove some electrons
large fields it may be possible to compromise be- which would otherwise contribute to skin dose.
tween skin dose and depth dose errors by reducing A further possible cause of the differencethe
the retracting distance, but in certain instances it chamber diameterhas already been mentioned.
may well be concluded, especially if the wax is Using the 2 cm diameter chamber it was found that
thick, that the errors are unacceptable. the values of R were lower than those from the 1 cm
Field dimensions will be marked on the plane chamber, the divergence being most marked for the
surface of the retracted wax, reduced to allow for small fields. This is no doubt due to the fact that,
the retraction. Patient set-up may be effected in for these small fields, the chamber diameter ap-
two slightly different ways. In the first the focal proaches the field dimension. With the large fields
distance pertaining to the isodose chart is measured the difference was 4 per cent for a 20 cm retracting
to the wax surface before retraction. In the second, distance. Bearing in mind that the 1 cm chamber
the focal distance is set to the wax surface after gives reasonably good agreement between theory
retraction, thus increasing the original FSD by the and practice for the small fields, the conclusion is
retracting distance. There are two advantages in the that while the R values as recorded by this chamber
second method. One is that any available isocentric are probably too low, they are not seriously in error.
facility is retained; the other is that, because of the In any case, the choice of retracting distance does
longer FSD, the depth doses as referred to the origi- not depend critically on these values.
nal wax surface are increased. This increase tends to
counteract the decrease brought about by retraction.
ACKNOWLEDGMENTS
It may be calculated in a given instance (Jackson, I am grateful to Mr. S. A. Ahmed for help in the experi-
1969), but its value is usually about 1 or 2 per cent. mental work and in the construction of the 2 cm diameter
Since the depth dose decrease on retraction is chamber, also to Mr. J. Isitt for many useful discussions.
often not much greater, the normal isodose chart ABSTRACT
will give a close approximation to the correct dose. The technique of filling an irregular body contour with
tissue-equivalent wax and retracting the wax in the beam
direction, without making an allowance for beam diver-
THEORETICAL gence, has been examined from the point of view of
The ionisation from both retracted and surface (a) electron contamination on the skin;
(b) errors in depth dose which arise from loss of scatter
board was calculated by a method similar to the and also from any change in the path of the primary ray.
one already outlined, and the ratio of retracted to Skin contamination at a given point has been found
surface dose compared with that found experi- to depend on the angle subtended there by the irradiated
wax. This leads to the simple working rule that if a retract-
mentally. For small fields the agreement was ing distance equal to the average field dimension is chosen,

866

Wax retraction as a technique for compensating the effect of surface
the skin dose will be reduced to 50 per cent of its value
before retraction.
Depth dose errors, i.e., deviations from the values as read
in the normal isodose chart, have been found to depend
chiefly on retracting distance and the thickness of the re-
tracted wax. The technique is feasible provided a retracting
distance can be found which gives an acceptable skin dose
and small depth dose errors. These may be estimated from
the appropriate graphs. The conditions are most easily
fulfilled for small fields.
Forthcoming events
CONFERENCE ON RADIATION LEVELSAIR, WATER
AND FOOD
The Royal Society of Health is arranging a one-day
conference on "Radiation Levels in Air, Water and
Food" on Thursday, December 10, 1970 at Caxton
Hall, Westminster, London, S.W.I. Fee 2 2s. per
delegate. Further details are available from The
Secretary, The Royal Society of Health, 90 Buck-
ingham Palace Road, London, S.W.I.
24TH INDIAN CONGRESS OF RADIOLOGY
The 24th Indian Congress of Radiology will be held
in Calcutta from January 22 to 24, 1971 and will
cover all aspects of diagnostic and therapeutic
radiology. Further information is available from
Dr. S. Boss, Organising Secretary, 6 Harrington
Street, Calcutta 16, India.
ASSOCIATION OF RADIOLOGISTS OF WEST AFRICA
A conference on "Radiology of Bone Disorders"
867
DECEMBER 1970
irregularities
REFERENCES
COHEN, M., BURNS, J. E., and SEAR, R., 1960, Ada. Radiol.,
53, 486.
HALL, E. J., and OLIVER, R., 1961, Br. J. Radiol., 34, 43.
HOWARTH, J. L., JONES, J. C , and MILLER, H., 1951, Br. J.
Radiol., 24, 665.
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will be held from February 5 to 6, 1971, at the
Conference Centre, University of Ibadan, Ibadan,
Nigeria. Further information may be obtained from
Dr. S. B. Lagundoye, Department of Radiology,
University College Hospital, Ibadan, Nigeria.
THE INSTITUTE OF PHYSICS AND THE PHYSICAL
SOCIETY
The Vacuum Group and the Thin Films and
Surfaces Group of the Institute of Physics and The
Physical Society are arranging a one-day meeting on
"Sorption Phenomena in Vacuum" to be held at the
University of Liverpool on January 6, 1971. The
meeting will deal with mechanisms, methods of
experimental investigation and exploitation of sorp-
tion in vacuum systems. Further details and appli-
cation forms are available from the Meetings Offi-
cer, The Institute of Physics and The Physical
Society, 47 Belgrave Square, London, S.W.I.