SU‐C‐BRD‐06: Sensitivity Study of An Automated System to Acquire and Analyze EPID Exit Dose Images

Abstract

Purpose:The dosimetric consequences of errors in patient setup or beam delivery and anatomical changes are not readily known. A new product, PerFRACTION (Sun Nuclear Corporation), is designed to detect these errors by comparing the EPID exit dose image from each field of each fraction to those from baseline fraction images. This work investigates the sensitivity of PerFRACTION to detect the deviation of induced errors in a variety of realistic scenarios.Methods:Eight plans were created mimicking potential delivery or setup errors. The plans consisted of a nominal field and the field with an induced error. These were used to irradiate the EPID simulating multiple fractions with and without the error. Integrated EPID images were acquired in clinical mode and saved in ARIA. PerFRACTION automatically pulls the images into its database and performs the user defined comparison. In some cases, images were manually pushed to PerFRACTION. We varied the distance‐to‐agreement or dose tolerance until PerFRACTION showed failing pixels in the affected region and recorded the values. We induced errors of 1mm and greater in jaw, MLC, and couch position, 2 degree collimation rotation (patient yaw), and 0.5% to 1.5% in machine output. Both static and arc fields with the rails in or out were also acquired and compared.Results:PerFRACTION detected position errors of the jaws, MLC, and couch with an accuracy of better than 0.5 mm, and 0.2 degrees for collimator and gantry error. PerFRACTION detected a machine output error within 0.2% and detected the change in rail position.Conclusion:A new automated system for monitoring daily treatments for machine or patient variations from the first fraction using integrated EPID images was found to be sensitive enough to detect small positional, angular, and dosimetric errors within 0.5mm, 0.2 degrees, and 0.2%, respectively.Sun Nuclear Corporation has provided a software license for the product described.