Chamber Electronic Portal Imaging Device Research Articles

Dosimetric properties of the liquid ionization chamber electronic portal imaging device (EPID).

In the relation between the pixel values of the electronic portal imaging device (EPID) and dose rate, pixel values have been reported to be proportional to the square roots of the dose rates although some researchers have reported that each EPID pixel value was almost proportional to the dose rates when they were more than 1 Gy/min. To resolve this contradiction, in this study we have investigated the dosimetric properties of the liquid ionization chamber EPID based on a two-dimensional matrix of liquid- filled ionization chambers. Our results show that the pixel values of this EPID were proportional to the square roots of the dose rates when they were less than 0.5 Gy/min, and the values were proportional to the dose rates when they were more than that. In addition, the survival time of electrons in the liquid of the EPID is reportedly dependent on the amount of impurities in the liquid ionizing chamber of EPID. The pixel values of the EPID acquired in rapid succession, increased. In the results, the pixel values were constantly increased to approximately 0.2% of pre-images for less than 15 s of the rest interval. When changes in the sensitivity of each pixel value were approximately 1%, approximately 5% changes were observed against the transformed dose rate. To avoid this difference, we developed the following formula relating the pixel value, P, and dose rate, D. P=a D + b radicalD - k h (a, b, h: constants, k : variable).

Evaluation of relative transmitted dose for a step and shoot head and neck intensity modulated radiation therapy using a scanning liquid ionization chamber electronic portal imaging device

The dose delivery verification for a head and neck static intensity modulated radiation therapy (IMRT) case using a scanning liquid ionization chamber electronic portal imaging device (SLIC-EPID) was investigated. Acquired electronic portal images were firstly converted into transmitted dose maps using an in-house developed method. The dose distributions were then compared with those calculated in a virtual EPID using the Pinnacle3 treatment planning system (TPS). Using gamma evaluation with the ΔDmax and DTA criteria of 3%/2.54 mm, an excellent agreement was observed between transmitted dose measured using SLIC-EPID and that calculated by TPS (gamma score approximately 95%) for large MLC fields. In contrast, for several small subfields, due to SLIC-EPID image blurring, significant disagreement was found in the gamma results. Differences between EPID and TPS dose maps were also observed for several parts of the radiation subfields, when the radiation beam passed through air on the outside of tissue. The transmitted dose distributions measured using portal imagers such as SLIC-EPID can be used to verify the dose delivery to a patient. However, several aspects such as accurate calibration procedure and imager response under different conditions should be taken into the consideration. In addition, SLIC-EPID image blurring is another important issue, which should be considered if the SLIC-EPID is used for clinical dosimetry verification.

Modification of the gamma function for the recognition of over- and under-dose regions in three dimensions

In order to evaluate two-dimensional radiation dose distributions, an algorithm called the Gamma function has recently been modified. The current study concentrates on modification of the gamma function as a three-dimensional dose distribution evaluation tool, and includes the recognition of over-dose/under-dose areas. Using a sign term, the conventional gamma function separates the disagreed areas into two parts: over-dose and under-dose areas. The new gamma function was modified using an extension of the dose difference criterion, ΔD, from two dimensions into three dimensions. In order to provide two-dimensional dose maps for analysis, several images were acquired for a range of regular and irregular radiation fields using a Scanning Liquid Ionization Chamber Electronic Portal Imaging Device. The raw images were then converted into two-dimensional transmitted dose maps using an empirical method. They were utilized as reference dose maps. Translational and rotational manipulations were performed on the reference dose distribution maps to provide evaluated dose maps. The reference and evaluated dose maps were then compared using conventional and modified gamma tools. The results indicated that the modified algorithm is able to enhance the over- and under-dose regions. In addition, a slight increase of the agreement percentage for reference and evaluated dose maps were observed by the extension of ΔD to three dimensions. It is concluded that the modified method is more realistic and applicable for the evaluation of both two-dimensional and three-dimensional dose distributions.

Evaluation of dosimetric characteristics of multi-leaf and conventional collimated radiation fields using a scanning liquid ionization chamber EPID

The characteristics of radiation fields set up using conventional and Multi-Leaf collimators were investigated using a Scanning Liquid Ionization Chamber Electronic Portal Imaging Device (SLIC-EPID). Results showed that the radiation fields set up using MLCs are generally larger than those set up using conventional collimators. A significant difference was observed between the penumbra width for conventional and MLC radiation fields. SLIC-EPID was found to be a sensitive device to evaluate the characteristics of the radiation fields generated with MLCs.

Verification of dose delivery for a prostate sIMRT treatment using a SLIC–EPID

The current work focuses on the verification of transmitted dose maps, measured using a scanning liquid ionization chamber–electronic portal imaging device (SLIC–EPID) for a typical step-and-shoot prostate IMRT treatment using an anthropomorphic phantom at anterior–posterior (A–P), and several non-zero gantry angles. The dose distributions measured using the SLIC–EPID were then compared with those calculated in the modelled EPID for each segment/subfield and also for the corresponding total fields using a gamma function algorithm with a distance to agreement and dose difference criteria of 2.54 mm and 3%, respectively.

The use of extended dose range film for dosimetric calibration of a scanning liquid‐filled ionization chamber electronic portal imaging device

A scanning liquid‐filled ionization chamber electronic portal imaging device (SLIC‐EPID) and extended dose range (EDR2) films were used to evaluate transmitted dose profiles for homogeneous and inhomogeneous phantoms. Calibrated ionization chamber measurements were used to convert the pixel values acquired from the electronic portal images to dose. Because SLIC‐EPID was developed to have a uniform response for all liquid ionization chambers, the off‐axis dose values were reconstructed using a correction factor matrix, defined as the ratio of the relative EDR2 film and the corresponding EPID dose values measured in air. The transmitted dose distributions in the EPID detector layer were also modeled using a Pinnacle3 treatment planning system (TPS: Philips Radiation Oncology Systems, Milpitas, CA). The gamma function algorithm was then used to assess agreement between transmitted dose distributions measured using a SLIC‐EPID and EDR2 film, and those calculated using the TPS. For homogenous and inhomogeneous phantoms, more than 90% agreement was achieved using gamma criteria of 2% and 3 mm and 3% and 2.5 mm respectively. Our results indicate that the calibration procedure proposed in the present study should be performed if SLIC‐EPID is to be used as a reliable two‐dimensional transmitted dosimeter for clinical purposes.PACS numbers: 87.53.Tf, 87.53.Oq

Evaluation of MLC leaf positioning using a scanning liquid ionization chamber EPID

A method was developed to determine the accuracy of multileaf collimator (MLC) positioning using transmitted dose maps measured by a scanning liquid ionization chamber electronic portal imaging device (SLIC-EPID). Several MLC fields were designed, using the Varian C-series standard MLC-80, as reference fields for open fields. The MLC leaves were then shifted from the reference positions along the direction of MLC leaf movement towards the central axis from 0.1 to 1.6 mm. The electronic portal images (EPIs), acquired for each case, were converted to two-dimensional dose maps using an appropriate calibration method and the relative dose difference maps were then calculated. The experiment was then performed at non-zero gantry angles in the presence of an anthropomorphic phantom for typical prostate and head and neck fields. Several standard edge detection algorithms were also used in order to find the shifted MLC leaf position. In addition, the short-term reproducibility of MLC leaf positioning was evaluated using the above-mentioned methods. It was found that the relationship between the relative dose difference and MLC leaf spatial displacement is linear. A variation of 0.2 mm in leaf position leads to approximately 4% change in the relative dose values for open fields. The variation of the relative dose difference for phantom studies depends on the phantom positioning and the EPI normalization. From the standard edge detection algorithms, used in the current study, the ‘Canny’ algorithm was found to be the optimum method to identify the minimum detectable MLC leaf displacements with a precision of approximately 0.1 mm for all cases. However, the result of edge detection algorithms generally is binary and there is no additional information compared to the relative dose maps. The reproducibility of MLC positions was found to be within 0.3 mm. In conclusion, a SLIC-EPID can be used for regular quality assurance (QA) of MLC leaf positioning. Despite significant difference in the pixel size of the acquired SLIC-EPIs, it can be concluded that the SLIC-EPID can be used for MLC quality assurance protocols with similar accuracy compared to amorphous silicon (a-Si) EPID results.

Comparison of two-dimensional transmitted dose maps: evaluation of existing algorithms

Composite analysis and the gamma function are often used to assess the agreement between a reference and an evaluated two-dimensional dose maps. The intent of the study is to compare advantages, disadvantages and limitations of dose evaluation tools reported in the literature. In addition, in order to improve the gamma function output, a "Signed Matrix" was introduced using the ratio of relative dose difference maps. Transmitted dose maps were acquired for a range of homogeneous phantoms using Extended Dose Range (EDR2) films and a Scanning Liquid Ionization Chamber Electronic Portal Imaging Device (SLIC-EPID). For inhomogeneous case, the transmitted dose maps were obtained from EDR2 films measurement and a Treatment Planning System (TPS). The corresponding dose maps were compared based on composite and gamma function algorithms. The results showed that the agreement between reference and evaluated dose maps for the composite analysis were generally greater than those obtained using the gamma function. For homogeneous phantom comparison, the difference between the agreeing fractions calculated using composite analysis and gamma function increases with the increase of phantom thickness for deltaD = 0.5% and 1%. For inhomogeneous cases, a significant difference (approximately 5% for deltaD = 1.5%) was observed between the percentage agreement as calculated by composite and gamma function techniques. The concept of the composite model is closer than gamma function to the idea of the two-dimensional dose verification protocol proposed originally by van Dyk. However, the composite model results only display the passed or failed regions in the dose maps. On the other hand, the gamma function provides continuos information by distinguishing the points within each region. The overdosed/underdosed regions (the ratio of reference and evaluated doses at a given point) and the direction of the misalignment can be recognized with the enhanced gamma map convolved with a "Signed Matrix".

Two-dimensional transmitted dose measurements using a scanning liquid ionization chamber EPID

The use of a scanning liquid ionization chamber electronic portal imaging device (SLIC-EPID) for two-dimensional transmitted dosimetry was investigated and a calibration method was developed using extended dose range (EDR2) film. In order to convert pixel value to dose, the acquired SLIC-EPID pixel values were calibrated using an ionization chamber on the central axis. The relationship between pixel values, dose rate and absorbed dose was identified for various linac output repetition rates. To correct EPIs for dosimetric purposes, the off-axis ratio of dose profiles measured by EPIDs and EDR2 film was used to derive correction factor matrices (CFMs) for a range of source-to-EPID distances (SEDs). The corrected relative dose maps acquired for different conditions, including open and wedged fields, measured using a SLIC-EPID were compared with EDR2 film images using a gamma function algorithm with distance to agreement (DTA) = 2.5 mm and dose difference (ΔDmax) = 1% criteria. The results showed that (a) for two-dimensional dosimetric purposes, EPIDs must be calibrated using appropriate two-dimensional correction factors and (b) SLIC-EPIDs can be used to measure the transmitted dose with good accuracy.

Evaluation of rapid dose map acquisition of a scanning liquid-filled ionization chamber electronic portal imaging device

Purpose We evaluated the performance of a new dosimetry module in the LC250 scanning liquid-filled ionization chamber (SLIC) electronic portal imaging device (EPID) for intensity-modulated radiotherapy (IMRT) verification. This module permits one to convert EPID readings to two-dimensional (2D) maps of IMRT dose rate in real time, and to integrate them over time to produce a profile of accumulated dose for treatment verification. Methods and materials The EPID was calibrated using an iterative procedure, from which a lookup table for dose integration was generated and transferred to the image-acquisition hardware. To evaluate the EPID’s integration capability, we investigated the linearity of imaging time (vs. monitor unit [MU]) and integrated dose (vs. planned dose) for static and IMRT fields, in both standard (∼2.7 s/image) and fast (∼1 s/image) synchronous acquisition modes (S- and F-modes). We also compared the EPID-measured profiles with that measured using film and ionization chamber, or calculated from the treatment planning system. For the EPID’s patient dose verification capability, we compared the integrated central-axis (CAX) dose with the planned dose for 25 prostate IMRT fields. We also compared the measured relative profiles with the planned ones using a linear regression model, which returns an index σ (root mean squared error) for the goodness of fit. We identified errors that are either associated with the timing of the EPID—start delay and end truncation, or with the integration process—detector memory effects (decrease in detector’s sensitivity with time during the fast continuous acquisition) and beam hold-off effects (the withholding of linac beam pulses when multileaf collimator leaves are not in the correct positions). The CAX doses of static fields were corrected using the ratio of the irradiation time to the imaging time. A linear decay model was proposed to correct the detector memory effect. To investigate the beam hold-off effect, we verified the relative profiles of a five-field prostate IMRT plan for five different MU settings, and correlated the goodness of fit with the percent of beam hold-off. Results The imaging time is linearly proportional to the given MU with a slope of 0.250 MU/s (ideal slope is 0.250 MU/s) and a R 2 = 1.0. Although the R 2 of the linearity for the measured vs. planned dose is 1.0 for both modes, only the slopes for the S-mode are within 3% of unity. The slopes for the F-mode deviate from unity due to detector memory effects, and are accurately corrected using the linear decay model. The EPID measured profiles agree well (within 2.0%) with the planned dose and profiles for both modes. For the CAX dose of the 25 IMRT fields, the S-mode is within 2% of the planned dose, whereas the F-mode is off significantly (>3%) if not corrected for detector memory effects. For the relative profile verification, lower MU always produces higher σ for the same mode. The F-mode is more accurate than the S-mode for the same MU; however, the improvement is not proportional to the difference in imaging speed. Analysis of the correlation of the goodness of fit with the percent of beam hold-off indicates that the accuracy of profile verification for the F-mode is predominantly determined by the beam hold-off effect for lower MU. Conclusion The S-mode of LC250 combined with a large MU can be used for the pretreatment verification of IMRT beam delivery with a significant reduction of processing time and computer resources in comparison to off-line processing. Real-time verification during treatment requires the F-mode. Although the detector memory effects encountered in the F-mode can be compensated using the proposed linear decay model, sufficient accuracy for real-time verification requires a resolution of the beam hold-off problem.

Electronic and film portal images: a comparison of landmark visibility and review accuracy

Purpose: To quantitatively compare a scanning liquid ion chamber electronic portal imaging device (SLIC-EPID) and an amorphous silicon flat panel (aSi) EPID with portal film in clinical applications using measures of landmark visibility and treatment review accuracy.Methods and Materials: Six radiation oncologists viewed 39 electronic portal images (EPIs) from the SLIC-EPID, 36 EPIs from the aSi-EPID, and portal films of each of these treatment fields. The physicians rated the clarity of anatomic landmarks in the portal images, and the scores were compared between EPID and film. Nine hundred portal image reviews were performed. EPID and film portal images were acquired with known setup errors in either phantom or cadaver treatments. Physicians identified the errors visually in portal films and with computerized analysis for EPID.Results: There were no statistically significant (p < 0.05) differences between film and SLIC-EPID in ratings of landmark clarity. Eleven of 12 landmarks were more visible in aSi-EPID than in film. Translational setup errors were identified with an average accuracy of 2.5 mm in film, compared to 1.5 mm with SLIC-EPID and 1.3 mm with aSi-EPID.Conclusions: Both EPIDs are clinically viable replacements for film, but aSi-EPID represents a significant advancement in image quality over film.

Accurate measurement of the dynamic response of a scanning electronic portal imaging device.

An important condition for the safe introduction of dynamic intensity modulated radiotherapy (IMRT) using a multileaf collimator (MLC) is the ability to verify the leaf trajectories. In order to verify IMRT using an electronic portal imaging device (EPID), the EPID response should be accurate and fast. Noninstantaneous dynamic response causes motion blurring. The aim of this study is to develop a measurement method to determine the magnitude of the geometrical error as a result of motion blurring for imagers with scanning readout. The response of a liquid-filled ionization chamber EPID, as an example of a scanning imager, on a moving beam is compared with the response of a diode placed at the surface of the EPID. The signals are compared under the assumption that all EPID rows measure the same dose rate when a straight moving field edge is imaged. The measurements are performed at several levels of attenuation to investigate the influence of dose rate on the response of the detector. The accuracy of the measurement method is better than 0.25 mm. We found that the liquid-filled ionization chamber EPID does not suffer from significant motion blurring under clinical circumstances. Using a maximum gradient edge detector to determine the field edge in an image obtained by a liquid-filled ionization chamber EPID, errors smaller than 1 mm are found at a dose rate of 105 MU/min and a field edge speed of 1.1 cm/s. The errors reduce at higher dose rates. The presented method is capable of quantifying the geometrical errors in determining the position of the edge of a moving field with subpixel accuracy. The errors in field edge position determined by a liquid-filled ionization chamber EPID are negligible in clinical practice. Consequently, these EPIDs are suitable for geometric IMRT verification, as far as dynamic response is concerned.

Verification of milled two-dimensional photon compensating filters using an electronic portal imaging device.

A computer-driven milling machine is being installed at the Mallinckrodt Institute of Radiology to fabricate photon compensating filters for conventional compensation and beam-intensity modulation. Commissioning and quality assurance procedures are being developed for the design, fabrication, and delivery systems prior to using the milled filters in the clinic. The portion of the quality assurance procedures governing the filter fabrication using a computer-driven milling machine includes, in part, a comparison of designed and fabricated filters. Test filters include geometrically regular filters, such as flat surfaces and steps. The verification of these shapes is accomplished using spatial measurements. However, to test the mill's ability to generate complex curved surfaces, filters with more complicated surfaces are generated. These filters do not lend themselves to precise verification using physical measurement of the thickness distribution. A method has been developed to verify the thickness distributions of these complex filters by irradiating the filters with high-energy x rays and comparing the scattered and transmitted fluence to the fluence calculated using the intended filter shape. The fluence measurement is made using a calibrated commercial liquid ionization chamber electronic portal imaging device. The calculated fluence is separated into transmitted primary and scattered fluences and is determined using a convolution of a distributed radiation source kernel with an exponential filter attenuation function. The attenuation coefficient is measured for the filter material (Lipowitz metal) and fit to a second-order polynomial in filter thickness and off-axis distance. The distributed source kernel is measured using a split-field technique and fit to a sum of three two-dimensional Gaussian distributions. The scattered radiation is modeled by the Klein-Nishina cross section. The algorithm is tested by comparing calculated fluences with measured fluences for a series of machined filters: an open field, flat filters of 9.6-, 15.8-, and 31.6-mm thickness, split-field filters, and a pyramid-shaped filter. In each case, the algorithm calculates the fluence to within 3% of the measured values over the entire irradiated field size to within 1.5 cm of the collimated field edges.

Dosimetric characteristics of a liquid-filled electronic portal imaging device

To determine the characteristics of a commercial electronic portal imaging device (EPID), based on a two-dimensional matrix of liquid-filled ionization chambers, for transmission dose measurements during patient treatment. Electronic portal imaging device measurements were performed in a cobalt-60 beam and two accelerator x-ray beams, and compared with measurements performed with a Farmer-type ionization chamber in air in a miniphantom and in an extended water phantom. The warming up time of the EPID is about 1 h. The long-term stability of the detector is better than 1% under reference conditions for a period of about 3 months. The signal of the ionization chambers follows approximately the square root of the dose rate, although the relation becomes more linear for larger (> 1 Gy/min) dose rates. The signal can be transformed to dose rate with an accuracy of 0.6% (1 SD). The short-term influence of integrated dose on the sensitivity of the ionization chambers is small. The sensitivity increases about 0.5% for all ionization chambers after an absorbed dose of 8 Gy and returns to its original value in less than 5 min after stopping the irradiation. This small increase in sensitivity can be ascribed to the electrode distance of the ionization chambers in commercial EPIDs, which is 0.8 +/- 0.1 mm. The sensitivity increase depends on the electrode distance and is 4% for a 1.4 mm electrode distance. The scattering properties of the EPID ionization chambers were between those of an ionization chamber in a miniphantom and in a water phantom. The matrix ionization chamber EPID has characteristics that make it very suitable for dose rate measurements. It is therefore a very promising device for in vivo dosimetry purposes.