title: An EPID based method for efficient and precise asymmetric jaw alignment quality assurance.
abstract: OBJECTIVE
  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 degrees 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, 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 degrees 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.
authors.affiliation: Calvary Mater Newcastle Hospital, Newcastle, New South Wales, 2298, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Clews
authors.forename: Peter B
authors.initials: PB
authors.lastname: Greer
mesh_terms: D002138:Calibration; D003952:Diagnostic Imaging; D011786:Quality Control; D011878:Radiotherapy / Q000592:standards*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D015203:Reproducibility of Results; D012825:Silicon; D013997:Time Factors
chemical_list: D012825:Silicon