title: Validation of a treatment plan-based calibration method for 2D detectors used for treatment delivery quality assurance.
abstract: OBJECTIVE
  Dosimetry using film, CR, electronic portal imaging, or other 2D detectors requires calibration of the raw image data to obtain dose. Typically, a series of known doses are given to the detector, the raw signal for each dose is obtained, and a calibration curve is created. This calibration curve is then applied to the measured raw signals to convert them to dose. With the advent of IMRT, film dosimetry for quality assurance has become a routine and labor intensive part of the physicist's day. The process of calibrating the film or other 2D detector takes time and additional film or images for performing the calibration, and comes with its own source of errors. This article studies a new methodology for the relative dose calibration of 2D imaging detectors especially useful for IMRT QA, which relies on the treatment plan dose image to provide the dose information which is paired with the raw QA image data after registration of the two images (plan-based calibration).
  
  
  METHODS
  Validation of the accuracy and robustness of the method is performed on ten IMRT cases performed using EDR2 film with conventional and plan-based calibration. Also, for each of the ten cases, a 5 mm registration error was introduced and the Gamma analysis was reevaluated. In addition, synthetic image tests were performed to test the limits of the method. The Gamma analysis is used as a measure of dosimetric agreement between plan and film for the clinical cases and a dose difference metric for the synthetic cases.
  
  
  RESULTS
  The QA image calibrated by the plan-based method was found to more accurately match the treatment plan doses than the conventionally calibrated films and also to reveal dose errors more effectively when a registration error was introduced. When synthetic acquired images were systematically studied, localized and randomly placed dose errors were correctly identified without excessive falsely passing or falsely failing pixels, unless the errors were concentrated in a majority of pixels in a contiguous narrow dose band. Irregularities seen in the calibration curve expose these errors.
  
  
  CONCLUSIONS
  The plan-based calibration method was found to be an accurate, efficient procedure, capable of detecting IMRT QA relative dosimetry errors as well as, or better than conventional calibration methods.
authors.affiliation: Department of Radiation Oncology, University of Southern California, Los Angeles, 90027, USA. aolch@chla.usc.edu
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Olch
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Whitaker
mesh_terms: D002138:Calibration; D003120:Colorado; D005373:Film Dosimetry / Q000295:instrumentation* / Q000592:standards*; D006801:Humans; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000295:instrumentation* / Q000592:standards*