Sci-Thurs PM: Delivery-04: Comprehensive fluence model for absolute portal dose image prediction in IMRT...

Amorphous silicon (a-Si) electronic portal imaging devices (EPIDs) have been heavily investigated as treatment verification tools, with a particular focus on intensity modulated radiation therapy (IMRT). This verification could be accomplished through a comparison of measured portal images to predicted images. A general fluence determination for portal dose image prediction would be a great asset in order to model the complex modulation of IMRT. A physically-based parameter fluence model was developed by matching multi-leaf collimator defined predicted images to measured image profiles. The fluence model was composed of a focal Gaussian and extrafocal Gaussian-like source (Pearson VII). Specific aspects of the MLCs and secondary collimators were also modeled (eg. jaw and MLC transmission factors, MLC rounded leaf tips, tongue and groove effect, interleaf leakage, MLC offsets). The resulting calculated fluence was then convolved with Monte Carlo generated EPID-specific dose kernels to convert incident fluence to dose delivered to the EPID. Measured EPID data was obtained with an a-Si EPID for various MLC-defined fields (1×1 to 20×20 cm² ) over a range of source-to-imager distances. These measured profiles were used to determine the fluence model parameters and the resulting model was tested on prostate and oropharyngeal IMRT fields. The model predicted the open-field profiles within 2%, 2mm, while the predicted IMRT fields were generally within 3%, 3mm for at least 96% of the pixels. This model demonstrates the necessary accuracy needed for IMRT portal dose image prediction in complex clinical examples (<3%, 3mm) and could be used for pre-treatment verification.