Dosimetric IMRT verification with a flat-panel EPID

A convolution-based calibration procedure has been developed to use an amorphous silicon flat-panel electronic portal imaging device (EPID) for accurate dosimetric verification of intensity-modulated radiotherapy (IMRT) treatments. Raw EPID images were deconvolved to accurate, high-resolution 2-D distributions of primary fluence using a scatter kernel composed of two elements: a Monte Carlo generated kernel describing dose deposition in the EPID phosphor, and an empirically derived kernel describing optical photon spreading. Relative fluence profiles measured with the EPID are in very good agreement with those measured with a diamond detector, and exhibit excellent spatial resolution required for IMRT verification. For dosimetric verification, the EPID-measured primary fluences are convolved with a Monte Carlo kernel describing dose deposition in a solid water phantom, and cross-calibrated with ion chamber measurements. Dose distributions measured using the EPID agree to within 2.1% with those measured with film for open fields of 2X2 cm(2) and 10X10 cm(2). Predictions of the EPID phantom scattering factors (S-PE) based on our scatter kernels are within 1% of the S-PE measured for open field sizes of up to 16X16 cm(2). Pretreatment verifications of step-and-shoot IMRT treatments using the EPID are in good agreement with those performed with film, with a mean percent difference of 0.2+/-1.0% for three IMRT treatments (24 fields). (C) 2003 American Association of Physicists in Medicine.