Silicon Electronic Portal Imaging Device Research Articles

A regression-based approach to compute the pixels sensitivity map of linear accelerator portal imaging devices.

To determine the pixel sensitivity map (PSM) for amorphous silicon electronic portal imaging devices (EPIDs) using a single flood field signal. A raw EPID signal results from the incident particle energy fluence, the inherent pixels response, and the background signal. In large open fields, particle energy fluence is a slow-varying signal that is locally considered spatially constant. Pixels response is a fast and abrupt varying behavior. The background signal is due to the EPID panel electronics, which is determined during radiation absence. To determine the PSM, after correcting for the background signal, we apply a model that captures the underlying smooth particle energy fluence-induced signal. This fluence signal-fitted model is then used to determine the PSM. Here, we use a polynomial-based regression surface model in both x and y dimensions. To validate the generated PSM, we measure beams and compute PSMs for multiple beam energies with and without flattening filters and for multiple source-to-imager distances. Since the PSM is a detector characteristic, it should be independent of those variables. We also intercompare measurements of fixed slit fields with the EPID being shifted between measurements. The fluence signal of the flattening filter-free (FFF) beams was optimally modeled as a 12th degree polynomial surfaces, which had 0.1% residuals near the central axis. The 6 and 10MV FFF PSMs were within ˜0.1%, and independent of the EPID SID, suggesting that the PSM is energy independent. The 6, 10, and 15MV flattened-beam PSMs were well modeled as 12th degree polynomial surfaces, which were equivalent within ˜0.24% but differed from the FFF PSM by up to 0.5% near the beam central axis. Applying the FFF PSMs to the flattened-beam measurements reduced the central-axis deviation between the raw and corrected signal to 0.1%, confirming the PSM energy independence hypothesis. When the FFF PSM is utilized, output verification with shifted slit deliveries agreed within ˜0.5% for all beam energies, which is within the radiation delivery uncertainty of ˜0.57%. PSM for MV EPIDs can be determined by separating out the slowly varying, well-behaved fluence signal from the pixel-to-pixel sensitivity variations. The quality of the PSM is found to be dependent on the quality of the surface fit, which is best for the 6MV FFF beam measured at SID equal to 180cm. Within fitting errors, the PSM is independent of beam energy for 6, 10, and 15MV beams with and without flattening filters. The PSM generation does not require shifting the EPID panel nor multiple EPID panel irradiations and should be usable for linacs with fixed geometry EPIDs.

Use of Amorphous Silicon (ASi) Electronic Portal Imaging Devices for Other applications for Linear Accelerator Quality Assurance

The success of radiation therapy depends critically on the accuracy of patient alignment in treatment position day after day. Electronic portal imaging devices (EPIDs) are widely used to monitor patient position during daily radiotherapy sessions. To verify other applications for medical linear accelerator quality assurance (linac QA), images of a 10×10 cm² and 18×18 cm² open field were acquired. The EPID was positioned at a fixed detector distance of 150 cm. The wedge profile and wedge factors with high level of accuracy were demonstrated. The profiles acquired using EPID deviated in shape and magnitude by up to 16% from the ion chamber profiles. The use of EPID for linac QA could be simplified by improving the available software analysis tools, thus making it more efficient. The study showed that the EPID aSi500 has the potential to be used as a relative dosimeter, making it a very simple and efficient tool for daily QA. All EPID measurements were performed using the linear accelerator model Varian DMX. The physical characteristics measured in this work suggest that the SLIC-EPID can be an efficient tool for daily QA.

Development of a Fluence Generating Programme for Patient-Specific Quality Assurance and Calibration of an Amorphous Silicon EPID

Patient-specific quality assurance (QA) is an essential part of intensity-modulated radiotherapy (IMRT) and volumetric arc therapy (VMAT) treatments. This study aims to develop a Patient-specific QA system through the development of a fluence generating programme and utilization of amorphous silicon (aSi) electronic portal imaging device (EPID). The EPID was investigated on the dependency of dose rate, uniformity of detector sensitivity and output factor. A fluence generating programme was written using MATLAB. Five simple dynamic arc plans and one patient VMAT plan were created using the Monaco treatment planning system which were used in the programme to generate fluence maps. The accuracy of the programme was evaluated by performing gamma analysis between the generated and measured fluence. EPID signal was found to be linearly proportional to dose (1-1000 MU) and independent of dose rate. The mean uniformity ratio was 1.07 ± 0.04%. The measured fluence maps were corrected for uniformity before gamma analysis. Output factor and dose deposition were taken into account in the process. The average result of the gamma analysis passed the 95% threshold. A fluence generating programme was developed, serving as the foundation of the Patient-specific QA system using aSi EPID for IMRT/VMAT delivery in this centre.

A simple and efficient method to measure beam attenuation through a radiotherapy treatment couch and immobilization devices.

We propose a simple and efficient method to measure beam attenuation in one or two dimensions using an amorphous silicon electronic portal imaging device (a-Si EPID). The proposed method was validated against ionization chamber measurements. Beam attenuation through treatment couches (Varian Medical Systems) and immobilization devices (CIVCO Radiotherapy, USA) was examined. The dependency of beam attenuation on field size, photon energy, thickness of the couch, and the presence of a phantom were studied. Attenuation images were derived by computing the percentage difference between images obtained without and with a couch or immobilization devices determining the percentage of attenuation at the center and the mean attenuation. The beam attenuation measurements obtained with an a-Si EPID and an ionization chamber agreed to within ± 0.10 to 1.80%. No difference was noted between the center and mean of an attenuated image for a small field size of 5 × 5 cm2, whereas a large field size of 15 × 15 cm2 exhibited differences of up to 1.13%. For an 18 MV beam, the a-Si EPID required additional build-up material for accurate assessment of beam attenuation. The a-Si EPID could measure differences in beam attenuation through an image guided radiotherapy (IGRT) couch regardless of the variabilities in couch thickness. Interestingly, the addition of a phantom reduced the magnitude of attenuation by approximately 1.20% for a field size of 15 × 15 cm2. A simple method is proposed that provides the user with beam attenuation data in either 2D or 1D within a few minutes.

15 Characterization of an aSi-1000 EPID response in integrated and continuous acquisition modes for SBRT dosimetry applications

Introduction The amorphous silicon (a-Si) electronic portal imaging devices (EPIDs) mounted on linacs have been extensively studied and have shown dose-response characteristics suitable for dose verification. Their use for dosimetric purposes is already in clinical routine. However, the response of EPID in continuous acquisition mode was not so studied in literature, and in less extent when considering it for dosimetric applications in stereotactic body radiotherapy (SBRT) conditions (i.e. small fields, and high dose rates using flattening filter free (FFF) beams). The purpose of this work was therefore to characterize the EPID response in terms of relevant dosimetric properties, mainly for the potential use of continuous mode for further SBRT dosimetry with dynamic techniques. Methods The EPID used in this study was the aSi-1000 model installed on a Varian TrueBeamSTx. Its response was characterized in FFF photon beams with nominal energies of 6 and 10 MV and maximum available dose rates (1400 and 2400 MU/min, for 6 and 10 MV respectively). Different sets of images were acquired in both integrated and continuous modes, with EPID at 150 cm from the source, to study dose linearity, repeatability and reproducibility of response, field-size dependence, ghosting effect and response to energy spectrum variations. Before data acquisition, dark field and flood filed images were acquired for offset and gain corrections. As fluctuations in dose rate can potentially influence the response of EPID when using dynamic techniques with continuous acquisition mode, the linearity of EPID response was further evaluated by irradiating a 10 × 10 cm2 field in 20° and 90° arcs focusing on low MU range (3–100 MU), and was also compared to static irradiations. Results Conclusions The characterization of the aSi-1000 EPID response to relevant dosimetric properties was investigated, showing the feasibility of its use for dosimetry with FFF beams and high dose rates. Results for continuous mode, which differed from dosimetric non-linearity reported in previous published studies [ [1] McCurdy B.M.C. Greer P.B. Dosimetric properties of an amorphous-silicon EPID used in continuous acquisition mode for application to dynamic and arc IMRT. Med Phys. 2009; 36: 3028-3039 Crossref PubMed Scopus (73) Google Scholar ], also encourage the use of EPID for SBRT with dynamic techniques in future works for 3D dosimetry applications (e.g. quality assurance including in vivo dosimetry). The amorphous silicon (a-Si) electronic portal imaging devices (EPIDs) mounted on linacs have been extensively studied and have shown dose-response characteristics suitable for dose verification. Their use for dosimetric purposes is already in clinical routine. However, the response of EPID in continuous acquisition mode was not so studied in literature, and in less extent when considering it for dosimetric applications in stereotactic body radiotherapy (SBRT) conditions (i.e. small fields, and high dose rates using flattening filter free (FFF) beams). The purpose of this work was therefore to characterize the EPID response in terms of relevant dosimetric properties, mainly for the potential use of continuous mode for further SBRT dosimetry with dynamic techniques. The EPID used in this study was the aSi-1000 model installed on a Varian TrueBeamSTx. Its response was characterized in FFF photon beams with nominal energies of 6 and 10 MV and maximum available dose rates (1400 and 2400 MU/min, for 6 and 10 MV respectively). Different sets of images were acquired in both integrated and continuous modes, with EPID at 150 cm from the source, to study dose linearity, repeatability and reproducibility of response, field-size dependence, ghosting effect and response to energy spectrum variations. Before data acquisition, dark field and flood filed images were acquired for offset and gain corrections. As fluctuations in dose rate can potentially influence the response of EPID when using dynamic techniques with continuous acquisition mode, the linearity of EPID response was further evaluated by irradiating a 10 × 10 cm2 field in 20° and 90° arcs focusing on low MU range (3–100 MU), and was also compared to static irradiations. The characterization of the aSi-1000 EPID response to relevant dosimetric properties was investigated, showing the feasibility of its use for dosimetry with FFF beams and high dose rates. Results for continuous mode, which differed from dosimetric non-linearity reported in previous published studies [ [1] McCurdy B.M.C. Greer P.B. Dosimetric properties of an amorphous-silicon EPID used in continuous acquisition mode for application to dynamic and arc IMRT. Med Phys. 2009; 36: 3028-3039 Crossref PubMed Scopus (73) Google Scholar ], also encourage the use of EPID for SBRT with dynamic techniques in future works for 3D dosimetry applications (e.g. quality assurance including in vivo dosimetry).

Pretreatment quality control of single isocenter half- beam treatment planning technique using an amorphous silicon electronic portal-imaging device (EPID)

Introduction: Electronic portal imaging devices (EPIDs) are fundamentally used for instantaneous verification of the patient set‐up, block shape, and leaf positions during radiation therapy. In radiotherapy, situations arise in which an inclined PTV must be treated mutually with adjacent nodal regions. This methodology is most widely used for matching tangential/lateral breast/head and neck fields to supraclavicular and axillary nodal fields. The single-isocenter half-beam technique (SIHB) is the commonly used technique for field matching in the three-dimensional radiation therapy (3DCRT) in which abutting fields asymmetrically with no divergence at the central axis are matched. Linear accelerator asymmetric jaw junctioning is used in single isocenter half-beam treatment planning (SIHB) technique. In practice, the major difficulty of the SIHB technique lies in creating the dose accuracy at the central axis and dose homogeneity in the abutting region of half beams with sufficient precision represents. The aim of this work was to investigate the use of amorphous silicon EPIDs for pretreatment quality control of the SIHB-based treatment plans. Materials and Methods: The zero jaw position was studied at the gantry angle of 0o. All measurements were made for 6, 10, and 15MV photon beams. The EPID used in this study was a CCD camera‐based iView EPID mounted to an Elekta synergy platform. The EPID has been calibrated to convert a grayscale EPID image into a two‐dimensional absolute dose distribution. In addition, calculations of the central field dose were performed at a fixed EPID distance of 157.5cm. The double-exposure technique and EPID was used for measuring the junction doses for each asymmetric jaw. The junction dose was obtained as a function of jaw position. Then, the EPID- based junction dose measurements were compared with radiographic film measurements of junction dose. Results: The results, obtained for 6, 10, and 15MV photon beams, showed that there was an approximately linear relationship between doses and gap or overlap. Because of the non- water equivalent EPID scattering properties, there were a different in the junction doses measured with the EPID and film. A correction factor was obtained to convert the EPID measured junction dose to film measured equivalent. Conclusions: The inaccurate abutting junction between the half beams results in under or overdose of the normal tissue between the two volumes. In the present study, we carried out a procedure for daily EPID-based quality assurance of the SIHB technique of treatment planning. The utilization of this method can be significant enough to warrant the accuracy and safety of the SIHB technique in clinical procedures. Conclusion: our study showed that the aSi EPID can be used as a transit dosimeter. The technique to reconstruct the dose delivered in the patient is straightforward, reproducible, and rapid for repeated in vivo dose verification.

Dosimetric Comparison of Amorphous Silicon EPID and 2D Array Detector for Pre-Treatment Verification of Intensity Modulated Radiation Therapy

Purpose: To study the dosimetric characteristics of amorphous silicon Electronic Portal Imaging Device EPID and 2D array detector for dose verification of radiotherapy treatment plans, and the quality assurance QA testing of IMRT was investigated. Materials and methods: All measurements were done with Varian IX linear accelerator, aSi-1000 EPID and 2D array detector. The dose linearity, reproducibility, output factors, dose rate, SDD and response with slap phantom thickness have been measured and compared against those measured by ion chamber. Results: The characteristics of EPID and 2D array: the response of EPID agreed with 2D array and ion chamber 0.6cc. EPID and 2D array showed short-term output reproducibility with SD = 0.1%. The dose rates of 2D array SD = ±0.7%, EPID = ±0.4% compared with a 0.6 cc SD = ±0.5%. Output factor measurements for the central chamber of the EPID and 2D array showed no considerable deviation from ion chamber measurements. Measurement of beam profiles with the EPID and 2D array matched very well with the ion chamber measurements in the water phantom. The EPID is more sensitive to lower energy photons by increasing solid water phantom thickness. The mean and standard deviation passing rates (γ%≤1) for film, 2D array and EPID for 30 IMRT fields of five patients were 95.93 ± 0.96%, 99.05 ± 0.24%, and 99.37 ± 0.12%, respectively. Conclusion: The study shows that EPID and 2D array are a reliable and accurate dosimeter and a useful tool for quality assurance. We found that the EPID was more accurate compared with both 2D array and ion chamber. The gamma criterion of 3%/3 mm is the most suitable criteria for IMRT plans of QA.

Dosimetric Comparison of a-Si 1200 and a-Si 1000 Electronic Portal Imager for Intensity Modulated Radiation Therapy (IMRT)

Aim: This study investigates the dosimetric impact of a-Si 1200 over a-Si 1000 portal imager for 6 MV photon beam of a Varian Amorphous Silicon Electronic Portal Imaging Device (a-Si EPID) installed on Edge and Novalis TxLinac. Materials and Methods: The performance of an a-Si EPID 1200 was assessed and compared to its performance with a-Si EPID 1000 and dose measurements using an ionization chamber. This study was conducted for 6MV photon energy and the EPID performance was assessed as function of the delivered dose, dose rate, field size, SDD effect, Ghosting effect, Backscatter arm shielding impact and intensity-modulated radiation therapy fields. Results: The dose response for a-Si 1200 was within 0.5% for low MU (2-10) as compared to 1.4% for a-Si 1000 portal imager and less than 1% for both the imager above 10 MU. The output factor variation for 25 × 25 cm2 was 1.3% for a-Si 1200 and 3.8% for a-Si 1000 when compared with ionisation chamber. The ghosting was measured to be 0.2% for a-Si 1200 as compared to 0.8% for a-Si 1000 portal imager. There is a significant improvement in a-Si 1200 portal image due to backscatter shielding material attached to the back of the panel of a-Si 1200 portal imager. Conclusion: The new aS1200 detector showed a significant dosimetric improvement when compared with previous aS1000 hence providing more accurate measurements for pre-treatment patient specific Quality Assurance (QA).

The Influence of Acquisition Mode on the Dosimetric Performance of an Amorphous Silicon Electronic Portal Imaging Device.

Aims:This study investigates the impact of cine acquisition mode on the dosimetric characteristics of a Varian aS500 amorphous silicon electronic portal imaging device (a-Si EPID).Materials and Methods:The performance of an a-Si EPID operated in cine mode was assessed and compared to its performance when operated in an integrated mode and dose measurements using an ionization chamber. This study was conducted at different photon energies and the EPID performance was assessed as function of the delivered dose, dose rate, multileaf collimator speed, field size, phantom thickness, and intensity-modulated radiation therapy fields.Results:The worst nonlinearity was observed at low monitor unit (MU) settings < 100 MU with the highest dose per frame. The nonlinearity of response at a low MU setting was attributed due to the loss of four cine images during each delivery. The EPID response with changing dose rate for 10 MU delivered had similar results to its performance in an integrated mode and ionization chamber. Despite the nonlinearity of response with low MU delivered, EPID performance operated in cine and integrated acquisition modes had comparable responses within 2%.Conclusions:For EPID dosimetry application using cine mode, this study recommends the calibration of the EPID images to be undertaken at a large MU. There were no additional corrections that were required when the EPID operated in cine acquisition mode as compared to calibration in integrated mode.

MO‐AB‐BRA‐03: Development of Novel Real Time in Vivo EPID Treatment Verification for Brachytherapy

Purpose:High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification.Methods:MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities such as tissue compositions/densities and different applicators. Simulated results are then compared against EPID measurements acquired with ∼0.14s time resolution which allows dose measurements for each dwell position. The EPID has been calibrated using an Ir‐192 HDR source and experiments were performed using different phantoms, including tissue equivalent materials (PMMA, lung and bone). A source positioning accuracy of 0.2 mm, without including the afterloader uncertainty, was ensured using a robotic arm moving the source.Results:An EPID can acquire 3D Cartesian source positions and its response varies significantly due to differences in the material composition/density of the irradiated object, allowing detection of changes in patient geometry. The panel time resolution allows dose rate and dwell time measurements. Moreover, predicted EPID images obtained from clinical treatment plans provide anatomical information that can be related to the patient anatomy, mostly bone and air cavities, localizing the source inside of the patient using its anatomy as reference.Conclusion:Results obtained show the feasibility of the proposed dose verification system that is capable to verify all the brachytherapy treatment steps in real time providing data about treatment delivery quality and also applicator/structure motion during or between treatments.

Determination of dosimetric leaf gap using amorphous silicon electronic portal imaging device and its influence on intensity modulated radiotherapy dose delivery.

As complex treatment techniques such as intensity modulated radiotherapy (IMRT) entail the modeling of rounded leaf-end transmission in the treatment planning system, it is important to accurately determine the dosimetric leaf gap (DLG) value for a precise calculation of dose. The advancements in the application of the electronic portal imaging device (EPID) in quality assurance (QA) and dosimetry have facilitated the determination of DLG in this study. The DLG measurements were performed using both the ionization chamber (DLGion) and EPID (DLGEPID) for sweeping gap fields of different widths. The DLGion values were found to be 1.133 mm and 1.120 mm for perpendicular and parallel orientations of the 0.125 cm3 ionization chamber, while the corresponding DLGEPID values were 0.843 mm and 0.819 mm, respectively. It was found that the DLG was independent of volume and orientation of the ionization chamber, depth, source to surface distance (SSD), and the rate of dose delivery. Since the patient-specific QA tests showed comparable results between the IMRT plans based on the DLGEPID and DLGion, it is concluded that the EPID can be a suitable alternative in the determination of DLG.

Performance Evaluation of the Siemens Electronic Portal Imaging Device for IMRT Plan Verification

A commercially available amorphous Silicon Electronic Portal imaging device (aSi-EPID) installed onto Siemens Oncor Linear accelerator was evaluated with the objective to be implemented for IMRT quality assurance. EPID properties were investigated; these include reproducibility, dependences between the relative EPID responses and field size, dose rate were studied for both photon beams. To determine the inherent build-up of the EPID, varied thickness of Solid-water was placed onto the detector surface and changes in EPID signals were investigated. EPID measurements were compared with ionization chamber measurements (type 30013) connected to a UNIDOS electrometer (PTW-Freiberg) in Water phantom. The use of EPID dose maps was tested by comparing it with TPS-calculated one for IMRT plan applying gamma criteria of 3%/3mm. The results demonstrated that the aSi-EPID signals were reproducible, and response to the applied MUs were linear up to 100 MUs, and then the response became stable for MUs higher than 200, detector should be calibrated in this range. The results showed a clear dependency on the field size and energy. The dosimetric properties measured in this work shows promise that the aSi-EPID can be used for IMRT verifications.

Dose calibration of EPIDs for segmented IMRT dosimetry.

The purpose of this study was to investigate the dose response of amorphous silicon (a‐Si) electronic portal imaging devices (EPIDs) under different acquisition settings for both open jaw defined fields and segmented intensity‐modulated radiation therapy (IMRT) fields. Four different EPIDs were used. Two Siemens and one Elekta plus a standalone Perkin Elmer research EPID. Each was operated with different acquisition systems and settings. Dose response linearity was measured for open static jaw defined fields and ‘simple’ segmented IMRT fields for a range of equipment and system settings. Six ‘simple’ segmented IMRT fields were used. The segments of each IMRT field were fixed at 10×10cm2 field size with equal MU per segment, each field having a total of 20 MU. Simultaneous measurements with an ionization chamber array (ICA) and EPID were performed to separate beam and detector response characteristics. Three different pixel calibration methods were demonstrated and compared for an example ‘clinical IMRT field’. The dose response with the Elekta EPID for ‘simple’ segmented IMRT fields versus static fields agreed to within 2.5% for monitor unit (MU)≥2. The dose response for the Siemens systems was difficult to interpret due to the poor reproducibility for segmented delivery, at MU≤5, which was not observed with the standalone research EPID nor ICA on the same machine. The dose response measured under different acquisition settings and different linac/EPID combinations matched closely (≤1%), except for the Siemens EPID. Clinical IMRT EPID dosimetry implemented with the different pixel‐to‐dose calibration methods indicated that calibration at 20 MU provides equivalent results to implementing a ghosting correction model. The nonlinear dose response was consistent across both clinical EPIDs and the standalone research EPID, with the exception of the poor reproducibility seen with Siemens EPID images of IMRT fields. The nonlinear dose response was relatively insensitive to acquisition settings and appears to be primarily due to gain ghosting effects. No additional ghosting correction factor is necessary when the pixel‐to‐dose calibration factor at small MU calibration method is used.PACS numbers: 87.53.Bn, 87.55.Qr, 87.56.Fc, 87.57.uq

Sensitivity of an Elekta iView GT a-Si EPID model to delivery errors for pre-treatment verification of IMRT fields.

A Monte Carlo model of an Elekta iViewGT amorphous silicon electronic portal imaging device (a-Si EPID) has been validated for pre-treatment verification of clinical IMRT treatment plans. The simulations involved the use of the BEAMnrc and DOSXYZnrc Monte Carlo codes to predict the response of the iViewGT a-Si EPID model. The predicted EPID images were compared to the measured images obtained from the experiment. The measured EPID images were obtained by delivering a photon beam from an Elekta Synergy linac to the Elekta iViewGT a-Si EPID. The a-Si EPID was used with no additional build-up material. Frame averaged EPID images were acquired and processed using in-house software. The agreement between the predicted and measured images was analyzed using the gamma analysis technique with acceptance criteria of 3%/3mm. The results show that the predicted EPID images for four clinical IMRT treatment plans have a good agreement with the measured EPID signal. Three prostate IMRT plans were found to have an average gamma pass rate of more than 95.0% and a spinal IMRT plan has the average gamma pass rate of 94.3%. During the period of performing this work a routine MLC calibration was performed and one of the IMRT treatments re-measured with the EPID. A change in the gamma pass rate for one field was observed. This was the motivation for a series of experiments to investigate the sensitivity of the method by introducing delivery errors, MLC position and dosimetric overshoot, into the simulated EPID images. The method was found to be sensitive to 1mm leaf position errors and 10% overshoot errors.

Dose-to-water conversion for the backscatter-shielded EPID: a frame-based method to correct for EPID energy response to MLC transmitted radiation.

To develop a frame-by-frame correction for the energy response of amorphous silicon electronic portal imaging devices (a-Si EPIDs) to radiation that has transmitted through the multileaf collimator (MLC) and to integrate this correction into the backscatter shielded EPID (BSS-EPID) dose-to-water conversion model. Individual EPID frames were acquired using a Varian frame grabber and iTools acquisition software then processed using in-house software developed inMATLAB. For each EPID image frame, the region below the MLC leaves was identified and all pixels in this region were multiplied by a factor of 1.3 to correct for the under-response of the imager to MLC transmitted radiation. The corrected frames were then summed to form a corrected integrated EPID image. This correction was implemented as an initial step in the BSS-EPID dose-to-water conversion model which was then used to compute dose planes in a water phantom for 35 IMRT fields. The calculated dose planes, with and without the proposed MLC transmission correction, were compared to measurements in solid water using a two-dimensional diode array. It was observed that the integration of the MLC transmission correction into the BSS-EPID dose model improved agreement between modeled and measured dose planes. In particular, the MLC correction produced higher pass rates for almost all Head and Neck fields tested, yielding an average pass rate of 99.8% for 2%/2 mm criteria. A two-sample independent t-test and fisher F-test were used to show that the MLC transmission correction resulted in a statistically significant reduction in the mean and the standard deviation of the gamma values, respectively, to give a more accurate and consistent dose-to-water conversion. The frame-by-frame MLC transmission response correction was shown to improve the accuracy and reduce the variability of the BSS-EPID dose-to-water conversion model. The correction may be applied as a preprocessing step in any pretreatment portal dosimetry calculation and has been shown to be beneficial for highly modulated IMRT fields.

Transit dosimetry in dynamic IMRT with an a-Si EPID.

Using an amorphous silicon (a-Si) EPID for transit dosimetry requires detailed characterization of its dosimetric response in a variety of conditions. In this study, a measurement-based model was developed to calibrate an a-Si EPID response to dose for transit dosimetry by comparison with a reference ionization chamber. The ionization chamber reference depth and the required additional buildup thickness for electronic portal imaging devices (EPID) transit dosimetry were determined. The combined effects of changes in radiation field size, phantom thickness, and the off-axis distance on EPID transit dosimetry were characterized. The effect of scattered radiation on out-of-field response was investigated for different field sizes and phantom thicknesses by evaluation of the differences in image profiles and in-water measured profiles. An algorithm was developed to automatically apply these corrections to EPID images based on the user-specified field size and phantom thickness. The average phantom thickness and an effective field size were used for IMRT fields, and images were acquired in cine mode in the presence of an anthropomorphic phantom. The effective field size was defined as the percentage of the jaw-defined field that was involved during the delivery. Nine head and neck dynamic IMRT fields were tested by comparison with a MatriXX two-dimensional array dosimeter using the Gamma (3%, 3 mm) evaluation. A depth of 1.5 cm was selected as the ionization chamber reference depth. An additional 2.2 mm of copper buildup was added to the EPID. Comparison of EPID and MatriXX dose images for the tested fields showed that using a 10% threshold, the average number of points with Gamma index <1 was 96.5%. The agreement in the out-of field area was shown by selection of a 2% threshold which on average resulted in 94.8% of points with a Gamma index <1. The suggested method is less complicated than previously reported techniques and can be used for all a-Si EPIDs regardless of the manufacturer.

SU-E-T-148: Efficient Verification Method for Modulated Electron Radiotherapy Treatment Plans

Purpose: For shallow tumors, modulated electron radiotherapy (MERT) promises a reduction of dose to distal organs at risk. At our institution a framework was developed in order to create treatment plans for MERT employing both forward and inverse optimization. In this work, an efficient quality assurance (QA) process is established. Methods: Treatment plans for three different tumor sites were created using an inverse optimization. These plans consist of 6–12 segments and energies between 6 and 18 MeV. An already established QA process for photon IMRT plans is now extended to additionally handle MERT plans. First, the dose distributions are calculated in a homogenous water phantom. For this task a dedicated Monte Carlo (MC) framework for MERT is used. Second, the segments are applied on a stand-alone amorphous silicon electronic portal imaging device (EPID) using a source-to-surface distance of 70 cm. This device was calibrated for electron beams in a previous work. An in-house developed analysis software, is then utilized for comparisons and evaluation of the measured and calculated dose distributions. Results: For all three plans the calculated dose distributions agree well with the measured ones. Using a 2D gamma comparison (2% of dose max/2 mm and 10% dose threshold) passingmore » rates >98% are achieved.The dose calculation for each plan on the water phantom, using voxels of 0.2×0.2×0.2 cm{sup 3}, takes at maximum 30 min on a single core Pentium 2.66 GHz system with 6 GB RAM, to reach a statistical uncertainty of 2% (1 std. dev.). Conclusion: An already established QA procedure for IMRT photon plans was applied for MERT. The dedicated MC framework and the use of EPID measurements allow an efficient QA procedure in a clinical environment. This work was supported by Varian Medical Systems.« less

Monte Carlo simulation of the transit dosimetric response of an a-Si electronic portal imaging device

Amorphous silicon (a-Si) electronic portal imaging devices (EPIDs) are x-ray detectors frequently used in radiotherapy imaging and dosimetry applications. EPIDs employ a copper plate and gadolinium oxysulfide phosphor screen with an array of a-Si photodiodes to indirectly detect incident radiation. In this study, a previously developed Monte Carlo (MC) model of an a-Si EPID has been extended for transit dosimetry. The GEANT4 MC toolkit was used to integrate an a-Si EPID model with two phantoms and a 6 MV x-ray source. A solid water phantom was used to simulate EPID transmission factors, field size output factors and relative dose profiles and results were compared to experimental measurements. An anthropomorphic head phantom was used to qualitatively compare simulated and measured portal images of humanoid anatomy. Calculated transmission factors and field size output factors agreed to within 2.0% and 1.9% of experimental measurements, respectively. A comparison of calculated and measured relative dose profiles yielded >98% of points passing a gamma analysis with 3%/3 mm criterion for all field sizes. The simulated anthropomorphic head phantom image shows macroscopic anatomical features and qualitatively agrees with the measured image. Results validate the suitability of the MC model for predicting EPID response in transit dosimetry.

Evaluation of MegaVoltage Cone Beam CT image quality with an unmodified Elekta Precise Linac and EPID: a feasibility study

In order to increase the accuracy of patient positioning for complex radiotherapy treatments various 3D imaging techniques have been developed. MegaVoltage Cone Beam CT (MVCBCT) can utilise existing hardware to implement a 3D imaging modality to aid patient positioning. MVCBCT has been investigated using an unmodified Elekta Precise Linac and iView amorphous silicon electronic portal imaging device (EPID). Two methods of delivery and acquisition have been investigated for imaging an anthropomorphic head phantom and quality assurance phantom. Phantom projections were successfully acquired and CT datasets reconstructed using both acquisition methods. Bone, tissue and air were clearly resolvable in both phantoms even with low dose (22 MU) scans. The feasibility of MVCBCT was investigated using a standard linac, amorphous silicon EPID and a combination of a free open source reconstruction toolkit as well as custom in-house software written in Matlab. The resultant image quality has been assessed and presented. Although bone, tissue and air were resolvable in all scans, artifacts are present and scan doses are increased when compared with standard portal imaging. The feasibility of MVCBCT with unmodified Elekta Precise Linac and EPID has been considered as well as the identification of possible areas for future development in artifact correction techniques to further improve image quality.

Pretreatment Patient Specific Quality Assurance and Gamma Index Variation Study in Gantry Dependent EPID Positions for IMRT Prostate Treatments

Pretreatment quality assurance (QA) is a major concern in complex radiation therapy treatment plans like intensity modulated radiation therapy (IMRT). Present study considers the variations in gamma index for gantry dependent pretreatment verification and commonly practiced zero gantry angle verifications for ten prostate IMRT plans using two commercial medical linear accelerators (Varian 2300 CD, Varian Clinac iX). Two verification plans (the one with all fields at the actual treatment angles and one with all fields merged to 0 degree gantry angles) for all the patients were generated to obtain dose fluence mapping using amorphous silicon electronic portal imaging device (EPID). The gamma index was found depend on gantry angles but the difference between zero and the nonzero treatment angles is in the confidence level for clinical acceptance. The acceptance criteria of gamma method were always satisfied in both cases for two machines and are stable enough to execute the patient specific pretreatment quality assurance at 0 degree gantry angle for prostate IMRTs, where limited number of gantry angles are used.