Characteristics of Gafchromic XRQA2 films for kV image dose measurement

Purpose: In this study, the relevant characteristics of the new Gafchromic XRQA2 film for its application in measuring kV cone beam computed tomography (CBCT) image doses were thoroughly investigated. Methods: The film was calibrated free in air to air kerma levels between 0 and 9 cGy using 120 kVp photon beams produced by the x-ray volume imager. Films were scanned using transmission and reflection scanning modes with the Epson Expression 10000 XL flat-bed document scanner. The impact of film size, region of interest for the analysis, scan uniformity, scan resolution, scan orientation and alternate scanning sides on the analysis process were investigated. Energy dependence, postirradiation growth of reflectance with time and irradiation angular dependence of the film were tested at different air kerma levels. Results: The net reflectance changed by ∼3% when the size of the film piece changed from 1 cm × 2 cm to 10 cm × 11 cm and changed by ∼1% when ROI changed from 0. 7 cm × 0. 7 cm to 8 cm × 8 cm, suggesting a good uniformity of the film. The film was successfully analyzed using the transmission scanning mode, calibration curves from both transmission and reflection scanning modes showed similar behavior. The calibration uncertainty was somewhat lower when the film was scanned using reflection mode (6% and 8% for reflection and transmission modes, respectively.) Higher scanning resolution came with increasing calibration uncertainty. The calibration uncertainty for reflection and transmission modes increased from ∼3.5% to 7% and from ∼3.5% to 9%, respectively when scanning resolution was changed from 50 to 400 dpi. Scanning the film on alternate sides using transmission mode led to variation of 16%–19% in the net optical density at doses commonly used for CBCT procedures. The film response changed by almost 10% when it was exposed to beams of two different energies (100 and 120 kVp.) Other features of the film such as film orientation, postexposure growth, and irradiation angular dependence were also investigated. Conclusions: The size of film piece and analysis ROI used for calibration slightly affected the film response. Both transmission and reflection scanning modes can be used to analyze the Gafchromic XRQA2, with the reflection mode having a somewhat lower calibration uncertainty. Scanning films on alternate sides using transmission mode significantly affects the optical density. The film response was shown to be energy dependent. The films reached