Daily monitoring and correction of radiation field placement using a video-based portal imaging system: a pilot study

We have developed a video-based portal imaging system for radiotherapy localization. The system can acquire high quality portal images automatically using short (1-3 monitor unit) irradiations and immediately display the images. The major advantage of the imaging system is that it can be used routinely to check and correct patient positioning before much of the daily irradiation has been delivered. The portal imaging system has been used in a pilot study to monitor five patients during each of their daily treatments. The study has shown that: (i) image quality is sufficiently high to detect discrepancies in field placement from that prescribed on the simulator film; (ii) discrepancies in field placement occur frequently; and, (iii) routine correction of patient and block positioning can reduce the size of these discrepancies. This is the first time that field placement in radiation therapy has been checked and corrected routinely, before the treatment irradiation. However, limitations in the size of the field of view and in the methods of extracting and presenting the geometric information to the users limits the clinical utility of the imaging system. Solutions to these limitations are currently under development.