Development of a daily dosimetric control for radiation therapy using an electronic portal imaging device (EPID)

Electronic Portal Imaging Devices (EPIDs) can be used to perform dose measurements during radiation therapy treatments if dedicated calibration and correction procedures are applied. The purpose of this study was to provide a new calibration and correction model for an amorphous silicon (a-Si) EPID for use in transit dose verification of step-and-shoot intensity modulated radiation therapy (IMRT). A model was created in a commercial treatment planning system to calculate the nominal two-dimensional (2D) dose map of each radiation field at the EPID level. The EPID system was calibrated and correction factors were determined using a reference set-up, which consisted a patient phantom and an EPID phantom. The advantage of this method is that for the calibration, the actual beam spectrum is used to mimic a patient measurement. As proof-of-principle, the method was tested for the verification of two 7-field IMRT treatment plans with tumor sites in the head-and-neck and pelvic region. Predicted and measured EPID responses were successfully compared to the nominal data from treatment planning using dose difference maps and gamma analyses. Based on our result it can be concluded that this new method of 2D EPID dosimetry is a potential tool for simple patient treatment fraction dose verification.