Use of EPID for leaf position accuracy QA of dynamic multi-leaf collimator (DMLC) treatment Journal Article


Authors: Chang, J.; Obcemea, C. H.; Sillanpaa, J.; Mechalakos, J.; Burman, C.
Article Title: Use of EPID for leaf position accuracy QA of dynamic multi-leaf collimator (DMLC) treatment
Abstract: We describe in this paper an alternative method for routine dynamic multi-leaf collimator (DMLC) quality assurance (QA) using an electronic portal imaging device (EPID). Currently, this QA is done at our institution by filming an intensity-modulated radiotherapy (IMRT) test field producing a pattern of five 1-mm bands 2 cm apart and performing a visual spot-check for leaf alignment, motion lags, sticking and any other mechanical problems. In this study, we used an amorphous silicon aS500 EPID and films contemporaneously for the DMLC QA to test the practicality and efficacy of EPID vis-à-vis film. The EPID image was transformed to an integrated dose map by first converting the reading to dose using a calibration curve, and then multiplying by the number of averaged frames. The EPID dose map was then back-projected to the central axis plane and was compared to the film measurements which were scanned and converted to dose using a film dosimetry system. We determined the full-width half-maximum (FWHM) of each band for both images, and evaluated the dose to the valley between two peaks. We also simulated mechanical problems by increasing the band gap to 1.5 mm for some leaf pairs. Our results show that EPID is as good as the film in resolving the band pattern of the IMRT test field. Although the resolution of the EPID is lower than that of the film (0.78 mm/pixel vs 0.36 mm/pixel for the film), it is high enough to faithfully reproduce the band pattern without significant distortion. The FWHM of the EPID is 2.84 mm, slightly higher than the 2.01 mm for the film. The lowest dose to the valley is significantly lower for the EPID (15.5% of the peak value) than for the film (28.6%), indicating that EPID is less energy independent. The simulated leaf problem can be spotted by visual inspection of both images; however, it is more difficult for the film without being scanned and contrast-enhanced. EPID images have the advantage of being already digital and their analysis can easily be automated to flag leaf pairs outside tolerance limits of set parameters such as FWHM, peak dose values, peak location, and distance between peaks. This automation is a new feature that will help preempt MLC motion interlocks and decrease machine downtime during actual IMRT treatment. We conclude that since EPID images can be acquired, analyzed and stored much more conveniently than film, EPID is a good alternative to film for routine DMLC QA. © 2004 American Association of Physicists in Medicine.
Keywords: intensity modulated radiation therapy; radiation dose; sensitivity and specificity; quality control; reproducibility of results; radiotherapy dosage; calibration; automation; imaging system; imrt; dosimetry; quality assurance, health care; contrast enhancement; collimator; radiometry; radiotherapy, conformal; film dosimeter; film dosimetry; image processing; film; radiographic image interpretation, computer-assisted; epid; equipment failure analysis; radiographic image enhancement; electronics; electronic portal imaging device; priority journal; article; dmlc qa; dynamic multileaf collimator
Journal Title: Medical Physics
Volume: 31
Issue: 7
ISSN: 0094-2405
Publisher: American Association of Physicists in Medicine  
Date Published: 2004-07-01
Start Page: 2091
End Page: 2096
Language: English
DOI: 10.1118/1.1760187
PROVIDER: scopus
PUBMED: 15305462
DOI/URL:
Notes: Med. Phys. -- Cited By (since 1996):29 -- Export Date: 16 June 2014 -- CODEN: MPHYA -- Source: Scopus
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  1. Chandra M Burman
    154 Burman
  2. Ceferino Obcemea
    33 Obcemea
  3. Jenghwa Chang
    63 Chang