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X-ray Dose Reduction through Adaptive Exposure in Fluoroscopic Imaging

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A field size specific backscatter correction algorithm for accurate EPID dosimetry.

Sean L Berry¹, Cynthia S Polvorosa, Cheng-Shie Wuu

¹Department of Applied Physics and Applied Mathematics, Columbia University, New York, New York 10027, USA. berrys@mskcc.org

Medical Physics

|July 17, 2010

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Electronic portal imaging device (EPID) dose images have artifacts due to backscattered radiation that vary with field size. Correcting for this field size dependence significantly improves EPID dosimetry accuracy.

Area of Science:

Medical Physics
Radiation Oncology
Imaging Science

Background:

Electronic portal imaging devices (EPIDs) are used for in-vivo dosimetry in radiation therapy.
EPID images are affected by backscattered radiation, which introduces artifacts.
The backscatter signal is dependent on field size (FS) and location, yet most algorithms do not account for this.

Purpose of the Study:

To investigate the impact of field size-dependent backscatter on EPID dosimetry.
To propose and evaluate methods for correcting EPID dose images for backscatter artifacts.

Main Methods:

Acquired open field dose images across a range of field sizes (2x2 to 30x40 cm2).
Analyzed images to quantify backscatter and developed FS-specific correction matrices and a generalized equation.

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Validated correction methods on clinical data from 49 treatment fields in ten patients.

Main Results:

Backscatter causes signal asymmetry, primarily in the in-plane direction, with errors up to 3.6% for smaller fields.
Correction methods significantly improved dosimetric accuracy (p << .001).
The percentage of points passing gamma criteria (2%, 2mm) increased from 90.6% to 96.7-97.2% after correction.

Conclusions:

EPID dose image accuracy is influenced by the deviation of the treatment field size from calibration conditions.
FS-specific backscatter correction methods enhance EPID's dosimetric capabilities.
Accurate EPID dosimetry necessitates correction for field size-dependent backscatter using the presented techniques.