Evaluation of a fast method of EPID-based dosimetry for IMRT and Comparison with 3D EPID-based dosimetry system using conventional two- and three-dimensional detectors for VMAT

Introduction: Electronic portal imaging devices (EPIDs) could potentially be useful for intensity-modulated radiation therapy (IMRT) and VMAT QA. The data density, high resolution, large active area, and efficiency of the MV EPID make it an attractive option. However, EPIDs were designed as imaging devices, not dosimeters, and as a result they do not inherently measure dose in tissue equivalent media. EPIDose is a tool designed for the use of EPIDs in IMRT and VMAT QA that uses raw MV EPID images to estimate absolute dose planes normal to the beam axis in a homogeneous medi. However, because of the inherent challenges of the EPID-based dosimetry, validating and commissioning such a system must be done very carefully, by exploring the range of use cases and using well-proven “standards” for comparison. Converted EPID images were compared to 2D diode array absolute dose. To provide a 3D dosimetric evaluation of a commercial portal dosimetry system using 2D/3D detectors under ideal conditions using VMAT.
Material & Method: A 2D ion chamber array, radiochromic film and gel dosimeter were utilized to provide a dosimetric evaluation of transit phantom and pre-treatment fluence’ EPID back-projected dose distributions for a standard IMRT & VMAT plan. In house 2D and 3D gamma methods compared pass statistics relative to each dosimeter and TPS dose distributions.
 Results: Fluence mode and transit EPID dose distributions back-projected onto phantom geometry produced 2D gamma pass rates in excess of 97% relative to other tested detectors and exported TPS dose planes when a 3%, 3mm global gamma criterion was applied. Use of a gel dosimeter within a glass vial allowed comparison of measured 3D dose distributions versus EPID 3D dose and TPS calculated distributions. 3D gamma comparisons between modalities at 3%, 3mm gave pass rates in excess of 92%. Use of fluence mode was indicative of transit results under ideal conditions with slightly reduced dose definition.
Conclusions:  3D EPID back projected dose distributions were validated against detectors in both 2D and 3D. Cross validation of transit dose delivered to a patient is limited due to reasons of practicality and the tests presented are recommended as a guideline for 3D EPID dosimetry commissioning; allowing direct comparison between detector, TPS, fluence and transit modes. The results indicate achievable gamma scores for a complex VMAT plan in a homogenous phantom geometry and contributes to growing experience of 3D EPID dosimetry.