Electronic portal imaging devices (EPIDs) are commonly installed on modern linear accelerators (LINACs) and are convenient for imaging and, potentially, dosimetry. However, owing to their construction with metal and scintillating layers of high atomic number, they exhibit nonwater-equivalent response and oversensitivity to low-energy photons. Therefore, EPIDs are not ideal for dosimetry purposes. Additionally, nonlinearities due to the combined use of scintillators and photodiodes have been reported. Here, an EPID which employs a variable gain Gas Electron Multiplier (GEM) and direct detection of electrons is introduced. To investigate its dosimetric performance, measurements characterizing the novel EPID are performed and compared with measurements from ionization chambers and conventional EPIDs. Linearity, dose rate dependence, field size dependence, off-axis response, and transmission response were measured for all available energy settings (6, 10, 6MV Flattening Filter Free (FFF) and 10MVFFF) using three different detector gain settings. Additionally, an evaluation of the ghosting and image lag of the panel was completed. Reference ionization chamber measurements were performed for the off-axis and transmission response and existing data for conventional EPIDs and ionization chambers from equivalent measurements were used for comparison of the field size dependence. Elsewhere, values from the linac monitoring chambers were used. In the range from 10 to 1000 Monitor Units (MU), the detector was linear within 1% for all combinations of gain settings and energies. The dose rate dependence was also within 1% for all energies and for two out of three gain settings. Regarding field size dependency, the ratio of ionization chamber and panel values was 0.94 and 0.98 for the conventional EPID and GEMini respectively, at 20×20cm2 and 10MV. For 6MV, 6MVFFF, and 10MVFFF these ratios were 0.97, 0.98, and 0.99 for the GEMini, and 0.95, 0.97, and 0.97 for the conventional EPID. Similar performance between the GEMini and conventional EPID is observed for field sizes smaller than 10×10cm2 . The transmission response was within 5% for all energies for thicknesses up to 30cm, compared to 10-20% for a conventional EPID. The off-axis response for shifts up to 16cm was within 1% and 3% for 6MV and 10MV, with and without phantom. The rise and fall of the signal from the detector correspond well to monitor chamber measurements indicating little ghosting and image lag, regardless of gain setting. The GEM EPID exhibits dose rate dependence and linearity within 1%, and negligible ghosting and image lag. In this regard, it performs particularly well using 50 and 250V of gain, and either could be chosen. For higher sensitivity, 250V is the recommended base gain setting, although other applications may warrant different gains. For most tests performed in this study, the GEM EPID demonstrates a more water-equivalent response than conventional EPIDs making GEMs a viable technology for dosimetry in radiation therapy.
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