Portal dose image verification: the collapsed cone superposition method applied with different electronic portal imaging devices

Two different commercial electronic portal imaging devices (EPIDs), one based on a liquid ion chamber matrix and the other based on a fluoroscopic CCD camera, were used to acquire readings that, through a calibration procedure, provided images proportional to the absolute dose to a virtual water slab located at the EPID plane. The transformation of the matrix ion chamber image into a portal dose image (PDI) was based on a published relationship between dose rate and ionization current. For the fluoroscopic CCD-camera-based system, the transformation was based on a deconvolution with a radial light scatter kernel. Local response variations were corrected in the images from both systems using open field fluence maps. The acquired PDIs were compared with PDIs calculated with the collapsed cone superposition method for a three-dimensional detector model in water equivalent buildup material. The calculation model was based on the beam modelling and geometrical description of the treatment unit and energy used for treatment planning in a kernel-based system. The validity of the calculation method was evaluated for several field shapes and thicknesses of patient phantoms for the matrix ion chamber at 6 MV x-rays and for the camera-based EPID at 6 and 15 MV x-rays. The agreement between predicted and measured PDIs was evaluated with dose comparisons at points of interest and gamma index calculations. The average area failing the passing criteria in dose and position deviation was analysed to validate the performance of the method. For the matrix ion chamber on average an area less than 1% fails the passing criteria of 3 mm and 3%. For the camera-based EPID, the average area is 7% and 1% for 6 and 15 MV, respectively. The overall agreement centrally in the fields was 0.1 +/- 1.6% (1 sd) for the camera-based EPID and -0.1 +/- 1.6% (1 sd) for the matrix ion chamber. Thus, an absolute dose calibrated EPID could validate the delivered dose to the patient by comparing a calculated and a measured PDI.