title: A calibration method for patient specific IMRT QA using a single therapy verification film.
abstract: OBJECTIVE
  The aim of the present study is to develop and verify the single film calibration procedure used in intensity-modulated radiation therapy (IMRT) quality assurance.
  
  
  BACKGROUND
  Radiographic films have been regularly used in routine commissioning of treatment modalities and verification of treatment planning system (TPS). The radiation dosimetery based on radiographic films has ability to give absolute two-dimension dose distribution and prefer for the IMRT quality assurance. However, the single therapy verification film gives a quick and significant reliable method for IMRT verification.
  
  
  METHODS
  A single extended dose rate (EDR 2) film was used to generate the sensitometric curve of film optical density and radiation dose. EDR 2 film was exposed with nine 6 cm × 6 cm fields of 6 MV photon beam obtained from a medical linear accelerator at 5-cm depth in solid water phantom. The nine regions of single film were exposed with radiation doses raging from 10 to 362 cGy. The actual dose measurements inside the field regions were performed using 0.6 cm(3) ionization chamber. The exposed film was processed after irradiation using a VIDAR film scanner and the value of optical density was noted for each region. Ten IMRT plans of head and neck carcinoma were used for verification using a dynamic IMRT technique, and evaluated using the gamma index method with TPS calculated dose distribution.
  
  
  RESULTS
  Sensitometric curve has been generated using a single film exposed at nine field region to check quantitative dose verifications of IMRT treatments. The radiation scattered factor was observed to decrease exponentially with the increase in the distance from the centre of each field region. The IMRT plans based on calibration curve were verified using the gamma index method and found to be within acceptable criteria.
  
  
  CONCLUSIONS
  The single film method proved to be superior to the traditional calibration method and produce fast daily film calibration for highly accurate IMRT verification.
authors.affiliation: Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, 160 012, India.
authors.forename: Arvind Kumar
authors.initials: AK
authors.lastname: Shukla
authors.affiliation: Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, 160 012, India.
authors.forename: Arun S
authors.initials: AS
authors.lastname: Oinam
authors.affiliation: Department of Applied Sciences, Chitkara University, Rajpura 140 401, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Applied Sciences, Chitkara University, Rajpura 140 401, India.
authors.forename: I S
authors.initials: IS
authors.lastname: Sandhu
authors.affiliation: Department of Radiotherapy, Post Graduate Institute of Medical Education and Research, 160 012, India.
authors.forename: S C
authors.initials: SC
authors.lastname: Sharma
keywords: EDR 2 film; IMRT; Patient specific quality assurance; Sensitometric curve