skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: SU-F-T-240: EPID-Based Quality Assurance for Dosimetric Credentialing

Abstract

Purpose: We propose a novel dosimetric audit method for clinical trials using EPID measurements at each center and a standardized EPID to dose conversion algorithm. The aim of this work is to investigate the applicability of the EPID method to different linear accelerator, EPID and treatment planning system (TPS) combinations. Methods: Combination of delivery and planning systems were three Varian linacs including one Pinnacle and two Eclipse TPS and, two ELEKTA linacs including one Pinnacle and one Monaco TPS. All Varian linacs had the same EPID structure and similarly for the ELEKTA linacs. Initially, dose response of the EPIDs was investigated by acquiring integrated pixel value (IPV) of the central area of 10 cm2 images versus MUs, 5-400 MU. Then, the EPID to dose conversion was investigated for different system combinations. Square field size images, 2, 3, 4, 6, 10, 15, 20, 25 cm2 acquired by all systems were converted to dose at isocenter of a virtual flat phantom then the dose was compared to the corresponding TPS dose. Results: All EPIDs showed a relatively linear behavior versus MU except at low MUs which showed irregularities probably due to initial inaccuracies of irradiation. Furthermore, for all the EPID models, themore » model predicted TPS dose with a mean dose difference percentage of 1.3. However the model showed a few inaccuracies for ELEKTA EPID images at field sizes larger than 20 cm2. Conclusion: The EPIDs demonstrated similar behavior versus MU and the model was relatively accurate for all the systems. Therefore, the model could be employed as a global dosimetric method to audit clinical trials. Funding has been provided from Department of Radiation Oncology, TROG Cancer Research and the University of Newcastle. Narges Miri is a recipient of a University of Newcastle postgraduate scholarship.« less

Authors:
 [1];  [2];  [3];  [2];  [4]
  1. University of Newcastle, Newcastle, NSW (Australia)
  2. Calvary Mater Newcastle, Newcastle, NSW (Australia)
  3. Liverpool Hospital, Sydney, NSW (Australia)
  4. (Australia)
Publication Date:
OSTI Identifier:
22648856
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; 43 PARTICLE ACCELERATORS; 60 APPLIED LIFE SCIENCES; CLINICAL TRIALS; DOSIMETRY; EDUCATIONAL FACILITIES; IMAGES; LINEAR ACCELERATORS; QUALITY ASSURANCE

Citation Formats

Miri, N, Lehmann, J, Vial, P, Greer, P, and University of Newcastle, Newcastle, NSW. SU-F-T-240: EPID-Based Quality Assurance for Dosimetric Credentialing. United States: N. p., 2016. Web. doi:10.1118/1.4956380.
Miri, N, Lehmann, J, Vial, P, Greer, P, & University of Newcastle, Newcastle, NSW. SU-F-T-240: EPID-Based Quality Assurance for Dosimetric Credentialing. United States. doi:10.1118/1.4956380.
Miri, N, Lehmann, J, Vial, P, Greer, P, and University of Newcastle, Newcastle, NSW. 2016. "SU-F-T-240: EPID-Based Quality Assurance for Dosimetric Credentialing". United States. doi:10.1118/1.4956380.
@article{osti_22648856,
title = {SU-F-T-240: EPID-Based Quality Assurance for Dosimetric Credentialing},
author = {Miri, N and Lehmann, J and Vial, P and Greer, P and University of Newcastle, Newcastle, NSW},
abstractNote = {Purpose: We propose a novel dosimetric audit method for clinical trials using EPID measurements at each center and a standardized EPID to dose conversion algorithm. The aim of this work is to investigate the applicability of the EPID method to different linear accelerator, EPID and treatment planning system (TPS) combinations. Methods: Combination of delivery and planning systems were three Varian linacs including one Pinnacle and two Eclipse TPS and, two ELEKTA linacs including one Pinnacle and one Monaco TPS. All Varian linacs had the same EPID structure and similarly for the ELEKTA linacs. Initially, dose response of the EPIDs was investigated by acquiring integrated pixel value (IPV) of the central area of 10 cm2 images versus MUs, 5-400 MU. Then, the EPID to dose conversion was investigated for different system combinations. Square field size images, 2, 3, 4, 6, 10, 15, 20, 25 cm2 acquired by all systems were converted to dose at isocenter of a virtual flat phantom then the dose was compared to the corresponding TPS dose. Results: All EPIDs showed a relatively linear behavior versus MU except at low MUs which showed irregularities probably due to initial inaccuracies of irradiation. Furthermore, for all the EPID models, the model predicted TPS dose with a mean dose difference percentage of 1.3. However the model showed a few inaccuracies for ELEKTA EPID images at field sizes larger than 20 cm2. Conclusion: The EPIDs demonstrated similar behavior versus MU and the model was relatively accurate for all the systems. Therefore, the model could be employed as a global dosimetric method to audit clinical trials. Funding has been provided from Department of Radiation Oncology, TROG Cancer Research and the University of Newcastle. Narges Miri is a recipient of a University of Newcastle postgraduate scholarship.},
doi = {10.1118/1.4956380},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = 2016,
month = 6
}
  • Purpose: Report on implementation of a Virtual EPID Standard Phantom Audit (VESPA) for IMRT to support credentialing of facilities for clinical trials. Data is acquired by local facility staff and transferred electronically. Analysis is performed centrally. Methods: VESPA is based on published methods and a clinically established IMRT QA procedure, here extended to multi-vendor equipment. Facilities, provided with web-based comprehensive instructions and CT datasets, create IMRT treatment plans. They deliver the treatments directly to their EPID without phantom or couch in the beam. They also deliver a set of simple calibration fields. Collected EPID images are uploaded electronically. In themore » analysis, the dose is projected back into a virtual phantom and 3D gamma analysis is performed. 2D dose planes and linear dose profiles can be analysed when needed for clarification. Results: Pilot facilities covering a range of planning and delivery systems have performed data acquisition and upload successfully. Analysis showed agreement comparable to local experience with the method. Advantages of VESPA are (1) fast turnaround mainly driven by the facility’s capability to provide the requested EPID images, (2) the possibility for facilities performing the audit in parallel, as there is no need to wait for a phantom, (3) simple and efficient credentialing for international facilities, (4) a large set of data points, and (5) a reduced impact on resources and environment as there is no need to transport heavy phantoms or audit staff. Limitations of the current implementation of VESPA for trials credentialing are that it does not provide absolute dosimetry, therefore a Level 1 audit still required, and that it relies on correctly delivered open calibration fields, which are used for system calibration. Conclusion: The implemented EPID based IMRT audit system promises to dramatically improve credentialing efficiency for clinical trials and wider applications. VESPA for VMAT will follow soon.« less
  • Purpose: The aim of this work was to investigate the use of amorphous silicon electronic portal imaging devices (EPIDs) for regular quality assurance of linear accelerator asymmetric jaw junctioning. Methods: The method uses the beam central axis position on the EPID measured to subpixel accuracy found from two EPID images with 180 degree sign opposing collimator angles. Individual zero jaw position (''half-beam blocked'') images are then acquired and the jaw position precisely determined for each using penumbra interpolation. The accuracy of determining jaw position with the EPID method was measured by translating a block (simulating a jaw) by known distances,more » using a translation stage, and then measuring each translation distance with the EPID. To establish the utility of EPID based junction dose measurements, radiographic film measurements of junction dose maxima/minima as a function of jaw gap/overlap were made and compared to EPID measurements. Using the method, the long-term stability of zero jaw positioning was assessed for four linear accelerators over a 1-1.5 yr time period. The stability at nonzero gantry angles was assessed over a shorter time period. Results: The accuracy of determining jaw translations with the method was within 0.14 mm found using the translation stage [standard deviation (SD) of 0.037 mm]. The junction doses measured with the EPID were different from film due to the nonwater equivalent EPID scattering properties and hence different penumbra profile. The doses were approximately linear with gap or overlap, and a correction factor was derived to convert EPID measured junction dose to film measured equivalent. Over a 1 yr period, the zero jaw positions at gantry zero position were highly reproducible with an average SD of 0.07 mm for the 16 collimator jaws examined. However, the average jaw positions ranged from -0.7 to 0.9 mm relative to central axis for the different jaws. The zero jaw position was also reproducible at gantry 90 degree sign position with 0.1 mm SD variation with the mean jaw position offset from the gantry zero position consistently by 0.3-0.4 mm for the jaws studied. Conclusions: The EPID based method is efficient and yields more precise data on linear accelerator jaw positioning and reproducibility than previous methods. The results highlight that zero jaw positions are highly reproducible to a level much smaller than the displayed jaw resolution and that there is a need for better methods to calibrate the jaw positioning.« less
  • Purpose: This work uses repeat images of intensity modulated radiation therapy (IMRT) fields to quantify fluence anomalies (i.e., delivery errors) that can be reliably detected in electronic portal images used for IMRT pretreatment quality assurance. Methods: Repeat images of 11 clinical IMRT fields are acquired on a Varian Trilogy linear accelerator at energies of 6 MV and 18 MV. Acquired images are corrected for output variations and registered to minimize the impact of linear accelerator and electronic portal imaging device (EPID) positioning deviations. Detection studies are performed in which rectangular anomalies of various sizes are inserted into the images. Themore » performance of detection strategies based on pixel intensity deviations (PIDs) and gamma indices is evaluated using receiver operating characteristic analysis. Results: Residual differences between registered images are due to interfraction positional deviations of jaws and multileaf collimator leaves, plus imager noise. Positional deviations produce large intensity differences that degrade anomaly detection. Gradient effects are suppressed in PIDs using gradient scaling. Background noise is suppressed using median filtering. In the majority of images, PID-based detection strategies can reliably detect fluence anomalies of {>=}5% in {approx}1 mm{sup 2} areas and {>=}2% in {approx}20 mm{sup 2} areas. Conclusions: The ability to detect small dose differences ({<=}2%) depends strongly on the level of background noise. This in turn depends on the accuracy of image registration, the quality of the reference image, and field properties. The longer term aim of this work is to develop accurate and reliable methods of detecting IMRT delivery errors and variations. The ability to resolve small anomalies will allow the accuracy of advanced treatment techniques, such as image guided, adaptive, and arc therapies, to be quantified.« less
  • The performance stability of a Varian aS500 amorphous silicon (a-Si) electronic portal imaging device (EPID) was monitored over an 18-month period using a variety of standard quality assurance (QA) tests. The tests were selected to provide ongoing information about image quality and dose response from the time of EPID acceptance into clinical service. To evaluate imaging performance, we made spatial resolution and contrast measurements using both PortalVision and QC-3V phantoms for 6- and 15-MV photon beams at repetition rates of 100, 300, and 400 MU/min in standard scanning mode. To assess operational stability for dosimetry applications, we measured central axismore » radiation response and beam pulse variability for the same image acquisition modes. Using the QC-3V phantom, values for the critical frequency of 0.435 {+-} 0.005 lp/mm for 6 MV and 0.382 {+-} 0.003 lp/mm for 15 MV were obtained. The contrast-to-noise ratio was found to be {approx}20% higher for the lower photon energy. Beam pulse variability remained within the tolerance of 3% set by the manufacturer. The central axis pixel response of the EPID remained constant within {+-}1% over a 5-month period for the 6-MV beam, but fell {approx}4% over the same period for the 15-MV beam. The Varian aS500 EPID studied exhibited consistent image quality and a stable radiation response. These characteristics render it suitable for quantitative applications such as clinical dose measurement.« less
  • Amorphous silicon based electronic portal imaging devices (EPIDs) have been shown to be a good alternative to radiographic film for routine quality assurance (QA) of multileaf collimator (MLC) positioning accuracy. In this work, we present a method of acquiring an EPID image of a traditional strip-test image using analytical fits of the interleaf and leaf abutment image signatures. After exposure, the EPID image pixel values are divided by an open field image to remove EPID response and radiation field variations. Profiles acquired in the direction orthogonal to the leaf motion exhibit small peaks caused by interleaf leakage. Gaussian profiles aremore » fitted to the interleaf leakage peaks, the results of which are, using multiobjective optimization, used to calculate the image rotational angle with respect to the collimator axis of rotation. The relative angle is used to rotate the image to align the MLC leaf travel to the image pixel axes. The leaf abutments also present peaks that are fitted by heuristic functions, in this case modified Lorentzian functions. The parameters of the Lorentzian functions are used to parameterize the leaf gap width and positions. By imaging a set of MLC fields with varying gaps forming symmetric and asymmetric abutments, calibration curves with regard to relative peak height (RPH) versus nominal gap width are obtained. Based on this calibration data, the individual leaf positions are calculated to compare with the nominal programmed positions. The results demonstrate that the collimator rotation angle can be determined as accurate as 0.01 deg. . A change in MLC gap width of 0.2 mm leads to a change in RPH of about 10%. For asymmetrically produced gaps, a 0.2 mm MLC leaf gap width change causes 0.2 pixel peak position change. Subpixel resolution is obtained by using a parameterized fit of the relatively large abutment peaks. By contrast, for symmetrical gap changes, the peak position remains unchanged with a standard deviation of 0.05 pixels, or 0.026 mm. A trial run of 36 test images, each with gap widths varying from 0.4 to 1.4 mm, were used to analyze 8640 abutments. The leaf position variations were detected with a precision of 0.1 mm at a 95% confidence level, with a mean of 0.04 mm and a standard deviation of 0.03 mm. The proposed method is robust and minimizes the effect of image noise and pixel size and may help physicists to establish reliable and reasonable action levels in routine MLC QA.« less