A review on radiochromic film dosimetry for dose verification in high energy photon beams

Highlights: • Review of the aspects to establish a radiochromic film dosimetry system in clinic. • Guide for new users on the practical implementation of a film dosimetry system. • Absolute dose verification in high energy photon beams. A dosimetry system composed by Gafchromic™ EBT films and a flatbed document scanner is a valuable tool for patient-specific quality assurance (QA) of complex external beam radiotherapy treatment plans. However, it is still not widely used in clinical practice. The need for a comprehensive characterization of the film-scanner performance and the establishment of a complex dosimetry protocol may be one of the causes of this weak adhesion. The purpose of this work is to shed light on how to establish a reliable film dosimetry system for dose verification in external photon beam radiotherapy. The practical aspects to take into account are reviewed and the advantages and limitations of the different approaches are critically discussed according to the current state of the art, working as a guide for new users.