SU-F-T-299: An Experimental 2D Computed Radiography (CR) Dosimeter for IMRT. Are In-Field Measurements Affected by the Low Energy Photon Overresponse?

PURPOSE: Computed Radiography (CR) dosimetry could offer film dosimetry resolution and flexibility but with reusability and instantaneous processing. For an experimental CR-plate, designed for radiotherapy (Zeff=18), CR's typical out-of-field over-response to low energy photons was previously reduced to 8%. The present work assesses the impact of the residual over-response when open-fields are combined or when intensity modulated fields are used.

METHODS: Agfa Healthcare's experimental CRplate was scanned and erased 4min after each irradiation using a flying-spot CR-15-X-engine based reader, which was adapted for radiotherapy dosimetry. A CR-plate specific calibration and uniformity correction was used.For open-fields two abutting half beams (5×10cm(2) ) captured out-offield and in-field doses in a single image. Additionally, both half beams were measured individually as well as a 3×18Gy open-field SBRT-lung treatment. For intensity modulated fields standard test patterns (Chair and Pyramid) and a clinical 5×5Gy rectal VMAT plan were captured. All measurements were compared to the corresponding dose calculations.

RESULTS: For open-fields the out-of-field overdose was clearly larger than the in-field overdose (10% vs. 4%). The sum of the individual measurements corresponded well with the combined measurement (dose difference, ΔD<-2.2%). The SBRT case had no overdose in the high dose region; ΔD=-5.6%±3.3%, the deviation was attributed to CR-fading effects (-0.3%/min) which were not corrected for.Compared to open-fields, intensity modulated deliveries had a further increased over-response out-offield (ΔD=+58% to +125% [Chair] +43% [Pyramid]), due to the increased amount of low energy photons for IMRT. However, this effect was not measured in-field where even decreased dose signals were observed (ΔD=-0.3% to +2.25% [Chair], -4.5% to -0.1% [Pyramid]). The rectal VMAT treatment had a dose difference +2.4%±6.0%. The in-field deviations were attributed to a residual non-uniformity.

CONCLUSION: The experimental CRplate's out-of-field over-response does not propagate in in-field overresponse errors when static or dynamic (IMRT/VMAT) abutting fields are used.