SU‐E‐T‐171: Missing Dose in Integrated EPID Images

Purpose: A dosimetric artifact has been observed with Varian EPIDs in the presence of beam interrupts. This work determines the root cause and significance of this artifact. Methods: Integrated mode EPID images were acquired both with and without a manual beam interrupt for rectangular, sliding gap IMRT fields. Simultaneously, the individual frames were captured on a separate computer using a frame‐grabber system. Synchronization of the individual frames with the integrated images allowed the determination of precisely how the EPID behaved during regular operation as well as when a beam interrupt was triggered. The ability of the EPID to reliably monitor a treatment in the presence of beam interrupts was tested by comparing the difference between the interrupt and non‐interrupt images. Results: The interrupted images acquired in integrated acquisition mode displayed unanticipated behaviour in the region of the image where the leaves were located when the beam interrupt was triggered. Differences greater than 5% were observed as a result of the interrupt in some cases, with the discrepancies occurring in a non‐uniform manner across the imager. The differences measured were not repeatable from one measurement to another. Examination of the individual frames showed that the EPID was consistently losing a small amount of dose at the termination of every exposure. Inclusion of one additional frame in every image rectified the unexpected behaviour, reducing the differences to 1% or less. Conclusions: Although integrated EPID images nominally capture the entire dose delivered during an exposure, a small amount of dose is consistently being lost at the end of every exposure. The amount of missing dose is random, depending on the exact beam termination time within a frame. Inclusion of an extra frame at the end of each exposure effectively rectifies the problem, making the EPID more suitable for clinical dosimetry applications. The authors received support from Varian Medical Systems in the form of software and equipment loans as well as technical support.