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An energy-weighted interaction coefficient for photons, accounting for the fraction transferred to charged particles after radiative losses. It differs from the removal-probability mass attenuation coefficient. With charged-particle equilibrium, its product with photon energy fluence gives the absorbed dose.

For photons, the total mass attenuation coefficient sums contributions from photoelectric absorption, Compton scattering, coherent Rayleigh scattering, and pair production in nuclear or electronic fields when above their thresholds. At sufficiently high photon energies, photonuclear reactions can also contribute. Attenuation counts removal from the incident narrow beam, including scattering without complete local deposition of the original energy.

In water at both specified energies, Compton scattering dominates. At $140\mathrm{keV}$, photoelectric absorption and coherent Rayleigh scattering make smaller contributions; at $511\mathrm{keV}$ these are still less important. Nuclear-field pair production is impossible below $2m_e{c}^2=1.022\mathrm{MeV}$, so it occurs in neither example. The positrons used to produce the fluorine-18 annihilation radiation do not change that threshold for interactions of its $511\mathrm{keV}$ photons in water.

Strictly, $\mu$ is a linear attenuation coefficient, whereas $\mu /\rho$ is a mass attenuation coefficient; the source's wording blurs these units. The mass energy-absorption coefficient ${\mu }_{\mathrm{en}}/\rho$ weights the fraction of incident photon energy transferred to charged particles and retained after radiative losses, rather than simply counting all removals. Coherent scattering contributes attenuation with negligible energy transfer. A photon deflected by Compton scattering can carry much of the original energy away. One often writes ${\mu }_{\mathrm{en}}=(1-g){\mu }_{\mathrm{tr}}$, with $g$ the fraction of secondary charged-particle kinetic energy lost radiatively. Under charged-particle equilibrium, multiplying photon energy fluence by ${\mu }_{\mathrm{en}}/\rho$ gives the absorbed dose; that equilibrium condition matters near interfaces and in buildup regions.^[ref]

For a megavoltage X-ray beam, the surface absorbed dose is below the subsurface maximum. Photons generate energetic secondary electrons, mainly through Compton scattering; the downstream electron fluence initially builds up until approximate charged-particle equilibrium is established. Beyond this buildup region, decreasing primary photon fluence, scattering and geometric spreading make the depth-dose curve fall gradually. A penetrating photon beam has a substantial exit dose.

A nearly monoenergetic proton beam deposits a moderate entrance dose, then a sharp Bragg peak near the end of its range. As nonrelativistic protons slow, their electronic stopping power rises approximately as $1/v^2$ over the relevant part of the track. Once the protons stop, the dose falls steeply. Range straggling and energy spread broaden the peak; nuclear interactions add a smaller nonideal tail, so an exact hard cutoff is an idealization. Superposing appropriate incident energies produces a spread-out Bragg peak covering an extended target.^[ref]

The label MV for an X-ray treatment beam specifies the nominal accelerating potential of the electron accelerator. Its bremsstrahlung beam is a broad photon energy spectrum with an endpoint of order $eV$, not a monoenergetic beam whose individual photons all carry the quoted numerical energy. Proton therapy beam energies can instead be specified directly in MeV per incident proton.

Energy carried by incident photons per unit area. For monoenergetic photons, $\Psi =E_{\gamma }\Phi$, where $\Phi$ is photon fluence. With charged-particle equilibrium, $D=\Psi {\mu }_{\mathrm{en}}/\rho$ relates it to absorbed dose.